Assisted living communities left out of state COVID-19 testing, data initiatives

Associations representing assisted living operators are calling attention to the fact that in some states, assisted living communities are being left out of testing and data initiatives.

At the national level, AMDA – The Society for Post-Acute and Long-Term Care Medicine, said that although some states are issuing orders for universal COVID-19 testing at assisted living communities and nursing homes, testing needs to be part of a broader strategy to address costs, staffing, frequency and type of tests.

AMDA issued a policy statement citing a number of issues that should be addressed before implementing a universal testing strategy, including defining universal testing and frequency, identifying who should be tested and what type of test to use, paying for tests, addressing test results and access to testing, planning for staffing impacts, and preparing for the emotional impact of repeated testing of residents.

The policy statement points out that mandates for universal testing differ by state and populations. Some include only nursing homes, whereas others include assisted living facilities. Both populations, according to the statement, are vulnerable, and testing is an “important concern for multilevel campuses where spread can occur from one level of care to another.”

“Testing alone is not enough, and there are no one-size-fits-all solutions,” said AMDA Executive Director Christopher E. Laxton, adding that plans must address clinical case-finding, staff screenings, visitor restrictions and transmission prevention with universal masking, appropriate use of personal protective equipment and environmental cleaning.

Although universal testing mandates are well-intentioned, AMDA states, they miss the mark in many ways because post-acute and long-term care “expertise and situational understanding” was not included when policies were developed. 

“Testing decisions must be individualized to the facility with a clear understanding of the regional prevalence of disease, local testing accessibility and capacity, and well-defined goals of testing,” according to the policy statement.