Why Do 58 Nursing Homes Lack PPE?

by Carol J. Bova

The Centers for Medicare and Medicaid (CMS) publishes COVID-19 data reported by nursing homes as of May 31. Only five Virginia facilities reported not having enough essential supplies for current use, but that still put the safety of 554 residents plus an unknown number of staff members at risk for COVID-19 or other infections.

Glenburnie Rehab and Manorcare–Imperial, both in Richmond, reported no current supplies of hand sanitizer, gloves, N-95 masks, surgical masks, eye protection or gowns.

Woodbine Rehabilitation in Alexandria reported no N-95 or surgical masks and no gowns.

Albemarle Health and Rehab in Charlottesville and The Springs Nursing Center in Hot Springs didn’t have any N-95 masks.

Looking ahead, CMS had also asked if nursing homes had a week’s supply of the five PPE items and hand sanitizer.

  • 11 facilities said they might not have enough hand sanitizer.
  • 11 others might nothave enough gloves.
  • 47 might not have a week’s supply of N-95 masks.
  • 28 might not have surgical masks.
  • 36 might lack gowns.
  • 24 might have no eye protection.

As of May 31, CMS reported a total of 58 nursing homes without a week’s supply of necessary supplies. The same day, a Virginia Hospital and Healthcare Association dashboard showed only 17 nursing homes reporting difficulties in obtaining supplies: Fourteen facilities reported potential shortages of N-95 masks, seven surgical masks, six gloves, nine face shields, and fourteen gowns. (Hand sanitizer is not on the VHHA report.)

Why aren’t the Commonwealth’s plans working?

On paper, Virginia has plans to cope with the virus. They are summarized in a CMS document, “Toolkit on State Actions to Mitigate COVID-19 Prevalence in Nursing Homes.”

Among Virginia’s tools in the tookkit is an LTC Facility Playbook to Access Resources to Support COVID-19 Outbreak Response. The playbook serves as a resource for how to access various staffing, supplies, infection control expertise, and other resources to support response to COVID-19 outbreaks

Another Virginia contribution to the Toolkit: the Virginia Hospital Alerting & Status System (VHASS)•VHASS, an emergency management partnership between the Virginia Department of Health and the Virginia Hospital & Healthcare Association, has created an online COVID-19 resource center and Virginia COVID-19 surveillance data.

  • A long-term care VHASS daily situation report, posted daily, includes the number of nursing home residents with reported/confirmed COVID-19, number of residents pending confirmation, and current personal protective equipment (PPE) needs in nursing homes
  • Regional health care coalitions are the point of contact for skilled nursing facilities, dialysis centers, and hospitals that need PPE.

The “Long-Term Care Facility Playbook” says, “LTCFs are encouraged to continue working through private sector vendors, associations and corporate offices to ensure availability of PPE. When a facility cannot secure an adequate level of PPE through normal channels, the Commonwealth may be able to support critical resource requests: Skilled nursing facilities ​can contact their ​Regional Healthcare Coalition​.”

Virginia has six healthcare coalitions (HCCs). Each HCC has a Regional Healthcare Coordinating Center (RHCC) designed to act as a hub in the event of a public health or healthcare emergency. RHCCs serve as the liaison between regions and the VDH Emergency Coordination Center.

One of the RHCC’s responsibilities is to “request needed assets from other regions, the state and federal governments.” The five facilities who reported no supplies to CMS are in three RHCCs.

The Central Virginia Healthcare Coalition has two resource request forms on the home page of its website.

Northern RHCC requires a login to see what it offers.

North West RHCC has half a page of legal disclaimers after a general mission statement and no direct link to request resources. It does have a “Contact Us” page.

So, did the facilities reach out to the RHCCs? It’s not likely a layperson can get an answer to that question.

I have emailed a question about the reported shortages, asking, “…whether the Virginia Department of Health reviewed the data set and what action they took, if any.”

If Secretary Daniel Carey’s office, or Commissioner Norman Oliver’s spokesperson, or someone at the COVID-19 Joint Information Center at VDEM replies to that question, this story will be updated to share that information.

Carol J. Bova is a writer who lives in Mathews County.