Nursing homes in Mountain Home, Yellville and Harrison are among a group of facilities reporting it took three days or longer to get results back for each week from the beginning of October through Nov. 8, the most recent date for which data was available.While the delays were persistent for this group of facilities, roughly a third of Arkansas’ nursing homes have recently reported delays in receiving their residents’ COVID-19 test results, an Arkansas Democrat-Gazette analysis of federal data shows.
The findings suggest testing lags that have persisted months into the global health crisis, and which experts say could ignite further outbreaks in long-term care facilities.
The newspaper’s review of weekly data nursing homes submit to the government found that 77 of the state’s facilities reported at least once in October or November it took “3-7 days” to get residents’ test results back. The homes’ staff selected that response instead of “less than one day,” “1-2 days” or “more than 7 days,” which were the other options.
Twelve homes said it took three days or longer to get results back for each week from the beginning of October through Nov. 8, the most recent date for which data was available.
They included homes in Mountain Home, Yellville, Harrison, Little Rock, Benton, Conway, Greenbrier, Pine Bluff, Hot Springs and Springdale.
Prompt diagnosis of COVID-19 is especially important for elderly nursing-home residents, who are at a high risk of becoming seriously ill or dying if sickened. On Wednesday, health policy nonprofit Kaiser Family Foundation said it has tallied more than 100,000 U.S. deaths of those residents and nursing-home staff related to the new coronavirus.
The reports of delayed results come as Arkansas’ average COVID-19 death rate for nursing-home residents climbs to the fourth-highest among states, at 96.3 per 1,000 as of Wednesday, records show.
When test results don’t come back promptly, residents “can’t be protected — and neither can the employees,” says Martha Deaver, president of Arkansas Advocates for Nursing Home residents. Delays are a “huge issue” that she regularly hears complaints about from families, she says.
Rachel Bunch, executive director of the nursing-home advocacy and lobbying group Arkansas Health Care Association, says she had heard reports “off and on” about slow test results from members, especially in the wake of new testing requirements from the federal Centers for Medicare and Medicaid Services agency which oversees nursing homes.
The situation seems to have improved in recent weeks, she says, adding that “what I’m hearing more now is about labs that are busy because of outbreaks in communities.”
Arkansas Department of Health’s medical director for infectious disease says he also couldn’t easily explain what the nursing homes reported, saying that the health agency’s lab is testing nursing homes about once a week and returns results in 24-30 hours.
He echoed the idea that there has been a recent shift, noting that “last month might have been different — things now have improved,” the director, Dr. Naveen Patil, says.
While data shows fewer homes reporting longer test response times compared with early October, 29 Arkansas facilities said they were experiencing the issue in the first full week of November.
Waits of several days to get results are “like you’re not getting the test at all,” warned Rajendram Rajnarayanan, assistant dean of research at New York Institute of Technology College of Osteopathic Medicine at Arkansas State University. Degraded specimens could return inaccurate results, and exposing others while waiting can spread infection, he said.
It’s not clear if the delays reported by many nursing homes were related to a particular laboratory, whether they also are using quicker but less-reliable rapid antigen tests for residents or if the delays stemmed from the surveillance testing Patil says the state’s lab conducts of nursing homes.
Of 12 nursing homes that consistently reported three days or more to get residents’ test results, 10 didn’t provide elaboration. Administrators and staff at four declined to comment, four did not return messages or answer the phone, one said it was a bad time for a call because regulators were on-site and one hung up on a reporter.
The newspaper’s analysis of weekly reports also showed that 12 homes reported three days or longer waits for test results during a week when they reported an initial case of COVID-19 among residents. Seventeen homes reported testing residents with new symptoms in the same week they reported the longer testing turnaround time.
The delays add to a string of discouraging data points about the pandemic’s effect on nursing-home residents, both in the state and around the country.
Between Nov. 6 and Nov. 23, documents show the Arkansas Department of Health reported 188 additional nursing-home resident deaths — almost 17% of the state’s 1,078 total resident deaths. Altogether, 6,961 residents have been sickened, according to the same records.
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