NC still lacks plan for regular mass testing in nursing homes
Posted July 13, 2020 1:30 p.m. EDT
Updated July 13, 2020 4:57 p.m. EDT
A crucial element of controlling the spread of the novel coronavirus in nursing homes is routine testing of the staff who come in and out of the building each day and may have caught the virus without knowing it, experts say.
In North Carolina, nursing home residents make up almost half of all coronavirus deaths in the state, the latest data show. And there have been reported outbreaks at some 40% of the state’s more than 400 nursing homes.
Yet four months into the pandemic, North Carolina still lacks a plan for regular testing in those facilities, where COVID-19 has hit hardest.
State officials now recommend nursing homes test staff every other week, half as often as the U.S. Centers for Disease Control and Prevention and U.S. Centers for Medicare and Medicaid Services advise, though federal guidelines give state and local officials leeway to adjust based on the local prevalence of the virus. At least some states have adopted plans for following the guidelines, but North Carolina has not.
The state and federal recommendations for regular staff testing also come without special funding. Insurance companies have paid for COVID-19 tests when they are “medically necessary,” as required by Congress. But companies generally do not pay for surveillance testing, which is also considered to be mass testing.
Especially now that community spread of the coronavirus is widespread in North Carolina, medical researchers are concerned that staff have a greater chance of bringing COVID-19 into nursing homes, where the state's most vulnerable residents live.
This makes it particularly important that nursing home workers in communities with a rising number of infections are tested repeatedly, experts say, but North Carolina has opted for a focus on infection prevention rather than routine testing.
“(Testing) is not a solution to prevent infection, really, it’s a mechanism to detect infection,” said Dr. Susan Kansagra, the section chief of chronic disease and injury at the state’s Department of Health and Human Services, in an interview Thursday.
Kansagra emphasized that North Carolina has focused on consulting with nursing homes on infection control measures like setting up isolation rooms and better sanitizing the facilities.
Late last month, however, the state announced a plan to test around 70,000 nursing home staff and residents by the end of August. Pharmacy giant CVS will send workers into nursing homes to collect the samples, Kansagra said. Every resident and staff member who consents to a test is supposed to get one, and the state will cover the cost when health insurance will not.
It’s unclear how often nursing home staff in North Carolina have been tested. Few nursing homes responded to a survey by the North Carolina Watchdog Reporting Network and the state Department of Health and Human Services has not been tracking that information to date.
DHHS Secretary Dr. Mandy Cohen said last month, “My understanding right now is if they do not have any cases, they are not doing proactive testing.”
COVID-19 outbreaks in NC long-term care facilities
|Facility||Type||County||Staff cases||Staff deaths||Resident cases||Resident deaths||Total cases||Total deaths|
|Alamance Health Care Center||Nursing Home||Alamance||6||0||5||0||11||0|
|Blakey Hall Memory Care Facility||Nursing Home||Alamance||1||0||1||0||2||0|
|Coble Creek||Nursing Home||Alamance||2||0||0||0||2||0|
|Peak Resources – Alamance||Nursing Home||Alamance||3||0||1||0||4||0|
|Anson Health & Rehab||Nursing Home||Anson||1||0||2||0||3||0|
|Wadesboro Health & Rehab Center||Nursing Home||Anson||1||0||3||0||4||0|
|Margate Health and Rehab||Nursing Home||Ashe||2||0||2||0||4||0|
|Ridgewood Living & Rehabilitation Center||Nursing Home||Beaufort||7||0||20||0||27||0|
|River Trace Nursing and Rehab||Nursing Home||Beaufort||11||0||2||0||13||0|
|Brian Center Health & Rehabilitation/Windsor||Nursing Home||Bertie||6||0||2||0||8||0|
|Bladen East Health and Rehab||Nursing Home||Bladen||10||0||0||2||10||2|
|Autumn Care of Shallotte||Nursing Home||Brunswick||17||0||8||1||25||1|
|Aston Park Health Care Center Inc||Nursing Home||Buncombe||1||0||1||0||2||0|
|Black Mountain Neuro-Medical Treatment Center||Nursing Home||Buncombe||26||0||27||5||53||5|
|Brooks-Howell Home||Nursing Home||Buncombe||11||0||1||0||12||0|
|Carolina Pines Nursing Home||Nursing Home||Buncombe||0||0||2||0||2||0|
|Deerfield Episcopal Retirement Community Inc||Nursing Home||Buncombe||14||1||6||1||20||2|
|Laurels of Summit Ridge||Nursing Home||Buncombe||29||0||47||10||76||10|
|Stonecreek Health and Rehabilitation||Nursing Home||Buncombe||34||0||78||9||112||9|
|Western NC Baptist Home||Nursing Home||Buncombe||4||0||1||0||5||0|
|Autumn Care of Drexel||Nursing Home||Burke||8||0||28||1||36||1|
|Carolina Rehab of Burke||Nursing Home||Burke||21||0||50||11||71||11|
|College Pines Health and Rehabilitation||Nursing Home||Burke||9||2||20||2||29||4|
|Grace Heights Health and Rehabilitation||Nursing Home||Burke||30||0||60||13||90||13|
|Brian Center Health & Retirement/Cabarrus||Nursing Home||Cabarrus||30||0||47||4||77||4|
|Five Oaks Manor||Nursing Home||Cabarrus||2||0||0||0||2||0|
|PruittHealth-Town Center||Nursing Home||Cabarrus||8||0||19||3||27||3|
|Transitional Housing Services of Kannapolis||Nursing Home||Cabarrus||9||0||6||0||15||0|
|Brian Center Health & Rehabilitation/Hickory East||Nursing Home||Catawba||7||0||24||7||31||7|
|Conover Nursing and Rehab||Nursing Home||Catawba||1||0||2||0||3||0|
|Trinity Ridge||Nursing Home||Catawba||18||0||19||6||37||6|
|Trinity Village||Nursing Home||Catawba||10||0||2||0||12||0|
|Carolina Meadows Health Center||Nursing Home||Chatham||21||0||4||1||25||1|
|Murphy Rehab and Nursing||Nursing Home||Cherokee||2||0||2||0||4||0|
|Valley View Care and Rehabilitation Center||Nursing Home||Cherokee||1||0||1||0||2||0|
|Cleveland Pines||Nursing Home||Cleveland||15||0||30||0||45||0|
|Peak Resources Shelby||Nursing Home||Cleveland||5||0||0||0||5||0|
|White Oak Manor - Shelby||Nursing Home||Cleveland||25||0||16||4||41||4|
|White Oak Manor-Kings Mountain||Nursing Home||Cleveland||62||0||110||22||172||22|
|Liberty Commons||Nursing Home||Columbus||6||0||1||0||7||0|
|Shoreland Health and Rehab||Nursing Home||Columbus||1||0||1||0||2||0|
|Riverpoint Crest Nursing and Rehabilitation Center||Nursing Home||Craven||2||0||2||1||4||1|
|Carolina Rehab Center||Nursing Home||Cumberland||2||0||0||0||2||0|
|Haymount Rehabilitation & Nursing Center Inc||Nursing Home||Cumberland||10||0||3||0||13||0|
|Highland House Rehabilitation and Healthcare||Nursing Home||Cumberland||27||0||47||4||74||4|
|Village Green Health and Rehabilitation||Nursing Home||Cumberland||14||0||21||3||35||3|
|Whispering Pines||Nursing Home||Cumberland||2||0||1||0||3||0|
|Woodlands Nursing and Rehab||Nursing Home||Cumberland||11||0||48||1||59||1|
|Abbotts Creek Center||Nursing Home||Davidson||2||0||4||0||6||0|
|Mount Vista Health Park||Nursing Home||Davidson||3||0||0||0||3||0|
|Pelican Health||Nursing Home||Davidson||2||0||0||0||2||0|
|Piedmont Crossing||Nursing Home||Davidson||2||0||0||0||2||0|
|Pine Ridge Health and Rehabilitation Center||Nursing Home||Davidson||13||0||40||6||53||6|
|Accordius Health at Rose Manor||Nursing Home||Durham||5||0||2||0||7||0|
|Carver Living Center (Rehabilitation)||Nursing Home||Durham||37||0||84||10||121||10|
|Croasdaile Village Pavilion Health Center||Nursing Home||Durham||14||0||15||3||29||3|
|Durham Nursing & Rehabilitation Center||Nursing Home||Durham||4||0||0||0||4||0|
|Durham VA Community||Nursing Home||Durham||10||0||1||0||11||0|
|Pettigrew Rehabilitation Center||Nursing Home||Durham||3||0||1||0||4||0|
|Pruitt Health Durham||Nursing Home||Durham||9||0||43||1||52||1|
|The Forest at Duke||Nursing Home||Durham||11||0||0||0||11||0|
|Edgecombe Health and Rehabilitation||Nursing Home||Edgecombe||19||0||69||14||88||14|
|The Fountains at the Albermarle||Nursing Home||Edgecombe||14||0||16||1||30||1|
|Accordius Health of Clemmons||Nursing Home||Forsyth||6||0||33||4||39||4|
|Brookridge Retirement Community||Nursing Home||Forsyth||2||0||1||0||3||0|
|Oak Forest Health and Rehabilitation||Nursing Home||Forsyth||30||0||47||1||77||1|
|Piney Grove Nursing and Rehabilitation Center||Nursing Home||Forsyth||4||0||1||0||5||0|
|Silas Creek Rehabilitation Center||Nursing Home||Forsyth||7||0||2||0||9||0|
|Trinity Glen||Nursing Home||Forsyth||23||0||29||5||52||5|
|Accordius Health - Gastonia||Nursing Home||Gaston||2||0||0||0||2||0|
|Belaire Healthcare Center||Nursing Home||Gaston||20||0||13||0||33||0|
|Peak Resources - Gastonia||Nursing Home||Gaston||3||0||0||0||3||0|
|Graham Healthcare and Rehabilitation Center||Nursing Home||Graham||14||0||37||0||51||0|
|Brantwood Nursing and Retirement Center||Nursing Home||Granville||6||0||1||0||7||0|
|Universal Health Care/Oxford||Nursing Home||Granville||44||0||96||20||140||20|
|Greendale Forest Nursing and Rehabilitation Center||Nursing Home||Greene||1||0||2||0||3||0|
|Clapps Nursing Center||Nursing Home||Guilford||2||0||1||0||3||0|
|Maple Grove Health and Rehabilitation Center||Nursing Home||Guilford||29||0||97||22||126||22|
|Maryfield Nursing Home||Nursing Home||Guilford||3||0||0||0||3||0|
|River Landing Assisted Living||Nursing Home||Guilford||2||0||0||0||2||0|
|Westchester Manor||Nursing Home||Guilford||4||0||0||0||4||0|
|Accordius Health at Scotland Manor||Nursing Home||Halifax||1||0||2||0||3||0|
|Bryan Health and Rehab||Nursing Home||Halifax||2||0||1||0||3||0|
|Signature Healthcare of Roanoke Rapids||Nursing Home||Halifax||13||0||31||8||44||8|
|Cornerstone Nursing and Rehabilitation Center||Nursing Home||Harnett||5||0||0||0||5||0|
|Emerald Health and Rehab Center||Nursing Home||Harnett||8||0||1||0||9||0|
|Harnett Woods Nursing and Rehabilitation Center||Nursing Home||Harnett||7||0||11||1||18||1|
|Universal HealthCare||Nursing Home||Harnett||1||0||8||0||9||0|
|Maggie Valley Nursing and Rehab||Nursing Home||Haywood||0||0||2||0||2||0|
|Silver Bluff Village||Nursing Home||Haywood||55||0||97||27||152||27|
|Blue Ridge Health and Rehabilitation Center||Nursing Home||Henderson||7||0||18||3||25||3|
|Hendersonville Health and Rehabilitation||Nursing Home||Henderson||50||0||70||4||120||4|
|Universal Healthcare of Fletcher||Nursing Home||Henderson||2||0||0||0||2||0|
|Accordius at Creekside||Nursing Home||Hertford||16||0||55||9||71||9|
|Autumn Care of Raeford||Nursing Home||Hoke||6||0||1||0||7||0|
|Cross Creek Healthcare||Nursing Home||Hyde||11||0||21||3||32||3|
|Accordius Health at Mooresville||Nursing Home||Iredell||1||0||1||0||2||0|
|Accordius Health at Statesville||Nursing Home||Iredell||3||0||1||0||4||0|
|Autumn Care of Statesville||Nursing Home||Iredell||2||0||0||0||2||0|
|Maple Leaf Health Care||Nursing Home||Iredell||32||0||83||8||115||8|
|Smithfield Manor Nursing and Rehab||Nursing Home||Johnston||8||0||3||0||11||0|
|Springbrook Rehabilitation and Nursing Center||Nursing Home||Johnston||11||0||7||0||18||0|
|Brook Stone Living Center||Nursing Home||Jones||15||0||56||11||71||11|
|Harmony Hall Nursing and Rehabilitation Center||Nursing Home||Lenoir||1||0||2||0||3||0|
|Signature Healthcare Kinston||Nursing Home||Lenoir||1||0||2||0||3||0|
|Lincolnton Rehabilitation Center||Nursing Home||Lincoln||7||0||3||0||10||0|
|Roanoke River Nursing and Rehabilitation Center||Nursing Home||Martin||20||0||24||0||44||0|
|Deer Park Health and Rehab||Nursing Home||McDowell||18||0||26||13||44||13|
|Accordius Health at Midwood||Nursing Home||Mecklenburg||13||0||14||0||27||0|
|Brookdale Carriage Club Providence||Nursing Home||Mecklenburg||2||0||0||0||2||0|
|Citadel at Myers Park||Nursing Home||Mecklenburg||6||0||11||0||17||0|
|Clear Creek Nursing & Rehabilitation Center||Nursing Home||Mecklenburg||8||0||1||0||9||0|
|Huntersville Oaks||Nursing Home||Mecklenburg||13||0||7||0||20||0|
|Mecklenburg Health & Rehabilitation Center||Nursing Home||Mecklenburg||29||0||86||14||115||14|
|Olde Knox Commons at The Villages of Mecklenburg||Nursing Home||Mecklenburg||1||0||1||0||2||0|
|Pavilion Health Care at Brightmore||Nursing Home||Mecklenburg||4||0||0||0||4||0|
|Pelican Health Randolph||Nursing Home||Mecklenburg||21||0||56||13||77||13|
|Pelican Health at Charlotte||Nursing Home||Mecklenburg||12||0||40||3||52||3|
|Pineville Rehab and Living Center||Nursing Home||Mecklenburg||1||0||1||0||2||0|
|Sharon Towers||Nursing Home||Mecklenburg||12||1||17||4||29||5|
|The Pines at Davidson||Nursing Home||Mecklenburg||2||0||0||0||2||0|
|University Place Nursing and Rehabilitation Center||Nursing Home||Mecklenburg||47||0||70||11||117||11|
|White Oak Manor – Charlotte||Nursing Home||Mecklenburg||9||0||13||0||22||0|
|WillowBrooke Court SC Ctr at Plantation Estates||Nursing Home||Mecklenburg||26||0||54||17||80||17|
|Wilora Lake Healthcare Center||Nursing Home||Mecklenburg||1||0||1||0||2||0|
|Brian Center Health and Rehabilitation/Spruce Pine||Nursing Home||Mitchell||3||0||1||0||4||0|
|Autumn Care of Biscoe||Nursing Home||Montgomery||29||0||53||7||82||7|
|Accordius Health at Aberdeen||Nursing Home||Moore||25||0||53||0||78||0|
|Quail Haven Liberty Healthcare||Nursing Home||Moore||3||0||7||0||10||0|
|St. Joseph's of the Pines||Nursing Home||Moore||3||0||0||0||3||0|
|The Greens at Pinehurst Rehabilitation & Living Center||Nursing Home||Moore||2||0||4||0||6||0|
|Hunter Hill Nursing and Rehab||Nursing Home||Nash||1||0||9||0||10||0|
|The Lodge at Rocky Mount||Nursing Home||Nash||7||0||34||1||41||1|
|Autumn Care of Myrtle Grove||Nursing Home||New Hanover||3||0||3||0||6||0|
|Bradley Creek Health Center||Nursing Home||New Hanover||5||0||3||0||8||0|
|Liberty Commons||Nursing Home||New Hanover||19||0||13||0||32||0|
|NorthChase Nursing and Rehabilitation Center||Nursing Home||New Hanover||8||0||2||0||10||0|
|The Davis Community||Nursing Home||New Hanover||31||0||22||2||53||2|
|Carol Woods||Nursing Home||Orange||16||0||4||1||20||1|
|Parkview Health and Rehabilitation Center||Nursing Home||Orange||1||0||1||0||2||0|
|Peak Resources - Brookshire||Nursing Home||Orange||2||0||0||0||2||0|
|Elizabeth City Health and Rehabilitation||Nursing Home||Pasquotank||1||0||1||0||2||0|
|Woodbury Wellness Center||Nursing Home||Pender||4||0||4||0||8||0|
|Person Memorial Hospital Extended Care Unit||Nursing Home||Person||5||0||9||3||14||3|
|Ayden Court Nursing and Rehabilitation Center||Nursing Home||Pitt||2||0||0||0||2||0|
|PruittHealth Farmville||Nursing Home||Pitt||5||0||16||0||21||0|
|Universal Health Care/Greenville||Nursing Home||Pitt||11||0||6||0||17||0|
|Autumn Care of Saluda||Nursing Home||Polk||5||0||12||0||17||0|
|Alpine Health and Rehabilitation of Asheboro||Nursing Home||Randolph||11||0||17||1||28||1|
|Universal Healthcare Ramseur||Nursing Home||Randolph||2||0||0||0||2||0|
|Pembroke Center||Nursing Home||Robeson||5||0||1||0||6||0|
|Brian Center Health and Rehabilitation/Eden||Nursing Home||Rockingham||3||0||19||1||22||1|
|Jacob's Creek Nursing and Rehab Center||Nursing Home||Rockingham||39||0||75||1||114||1|
|Accordius Health of Salisbury||Nursing Home||Rowan||6||0||37||7||43||7|
|Autumn Care of Salisbury||Nursing Home||Rowan||16||0||37||5||53||5|
|Liberty Commons Nursing and Rehab||Nursing Home||Rowan||6||0||11||4||17||4|
|The Citadel Salisbury||Nursing Home||Rowan||5||0||2||0||7||0|
|Trinity Oaks Health and Rehab||Nursing Home||Rowan||43||0||46||8||89||8|
|Oak Grove Healthcare Center||Nursing Home||Rutherford||2||0||0||0||2||0|
|Willow Ridge Rehab and Living Center||Nursing Home||Rutherford||8||0||7||1||15||1|
|Scotia Village||Nursing Home||Scotland||3||0||2||0||5||0|
|Scottish Pines||Nursing Home||Scotland||13||0||27||3||40||3|
|Bethany Woods Nursing and Rehabilitation Center||Nursing Home||Stanly||17||0||23||0||40||0|
|Forrest Oakes Healthcare Center||Nursing Home||Stanly||13||0||24||7||37||7|
|Stanly Manor||Nursing Home||Stanly||21||0||54||6||75||6|
|Trinity Place||Nursing Home||Stanly||18||0||38||8||56||8|
|Central Continuing Care||Nursing Home||Surry||2||0||1||0||3||0|
|Pruitt Health-Elkin||Nursing Home||Surry||20||0||52||10||72||10|
|Surry Community Health and Rehab||Nursing Home||Surry||3||0||11||2||14||2|
|Mountainview Manor Nursing||Nursing Home||Swain||2||0||1||0||3||0|
|Accordius Health at Brevard||Nursing Home||Transylvania||23||0||51||5||74||5|
|Autumn Care of Marshville||Nursing Home||Union||4||0||1||0||5||0|
|Jesse Helms Nursing Center||Nursing Home||Union||1||0||1||0||2||0|
|Lake Park Nursing and Rehab||Nursing Home||Union||6||0||0||0||6||0|
|Monroe Rehabilitation Center||Nursing Home||Union||7||0||3||0||10||0|
|Pruitt Union Point||Nursing Home||Union||3||0||1||0||4||0|
|White Oak Manor Waxhaw||Nursing Home||Union||8||0||0||0||8||0|
|Kerr Lake Nursing and Rehabilitation Center||Nursing Home||Vance||32||0||49||12||81||12|
|Bellarose Nursing and Rehab||Nursing Home||Wake||3||0||0||0||3||0|
|Capital Nursing and Rehabilitation Center||Nursing Home||Wake||31||0||63||8||94||8|
|Dan E and Mary Louise Stewart Health Center||Nursing Home||Wake||28||0||27||6||55||6|
|Hillside Nursing Center of Wake Forest||Nursing Home||Wake||10||0||75||19||85||19|
|Raleigh Rehabilitation Center||Nursing Home||Wake||3||0||3||0||6||0|
|The Laurels of Forest Glenn||Nursing Home||Wake||17||0||81||14||98||14|
|Tower Nursing and Rehabilitation Center||Nursing Home||Wake||20||0||69||14||89||14|
|UNC Rex Rehabilitation and Nursing Care Center of Raleigh||Nursing Home||Wake||21||0||28||6||49||6|
|Universal Health Care/Fuquay-Varina||Nursing Home||Wake||3||0||9||1||12||1|
|Wellington Rehabilitation and Healthcare||Nursing Home||Wake||41||0||40||14||81||14|
|Glenbridge Health and Rehab||Nursing Home||Watauga||3||0||22||3||25||3|
|O'Berry Neuro-Medical Treatment Center||Nursing Home||Wayne||38||0||16||0||54||0|
|Willow Creek Nursing and Rehabilitation Center||Nursing Home||Wayne||8||0||13||0||21||0|
|Westwood Hills Nursing and Rehabilitation Center||Nursing Home||Wilkes||46||0||71||12||117||12|
|Accordius Health at Wilson||Nursing Home||Wilson||0||0||7||1||7||1|
|Brian Center||Nursing Home||Wilson||11||0||20||1||31||1|
|LongLeaf Neuro–Medical Treatment Center||Nursing Home||Wilson||42||0||31||3||73||3|
|Yadkin Nursing Center||Nursing Home||Yadkin||1||0||3||0||4||0|
|RHA Group Home in Ashe County||Residential Care Facility||Ashe||2||0||2||0||4||0|
|Pantego Rest Home||Residential Care Facility||Beaufort||4||0||12||0||16||0|
|Windsor House||Residential Care Facility||Bertie||4||0||16||1||20||1|
|Carolina Dunes Behavioral Health||Residential Care Facility||Brunswick||27||0||14||0||41||0|
|J Iverson Riddle Developmental Center||Residential Care Facility||Burke||18||0||10||0||28||0|
|Morningside of Concord||Residential Care Facility||Cabarrus||1||0||1||0||2||0|
|The Living Center at Concord||Residential Care Facility||Cabarrus||4||0||16||1||20||1|
|Caswell House||Residential Care Facility||Caswell||2||0||8||2||10||2|
|Catawba Valley Living At Rock Barn||Residential Care Facility||Catawba||4||0||1||1||5||1|
|Elmcroft Assisted Living||Residential Care Facility||Catawba||1||0||4||0||5||0|
|Shelby Manor||Residential Care Facility||Cleveland||3||0||2||0||5||0|
|Summit Place of Kings Mountain||Residential Care Facility||Cleveland||2||0||0||0||2||0|
|Courtyards at Berne Village||Residential Care Facility||Craven||4||0||2||0||6||0|
|Croatan Village ALF||Residential Care Facility||Craven||16||0||8||0||24||0|
|RHA Howell Longterm Care Facility||Residential Care Facility||Craven||6||0||8||0||14||0|
|The Arc of Hope Mills||Residential Care Facility||Cumberland||12||0||24||2||36||2|
|Currituck House||Residential Care Facility||Currituck||4||0||10||0||14||0|
|Mallard Ridge Assisted Living||Residential Care Facility||Davidson||1||0||3||0||4||0|
|Autumn Village||Residential Care Facility||Duplin||6||0||14||2||20||2|
|Brookdale||Residential Care Facility||Durham||0||0||3||1||3||1|
|Durham Ridge Assisted Living||Residential Care Facility||Durham||0||0||2||0||2||0|
|Heritage Retirement Center||Residential Care Facility||Edgecombe||9||0||67||8||76||8|
|Cadence Living at Clemmons||Residential Care Facility||Forsyth||4||0||0||0||4||0|
|Danby Assisted Living Facility||Residential Care Facility||Forsyth||6||0||22||4||28||4|
|Kerner Ridge ALF||Residential Care Facility||Forsyth||2||0||0||0||2||0|
|Southfork||Residential Care Facility||Forsyth||7||0||30||0||37||0|
|Trinity Elms||Residential Care Facility||Forsyth||15||0||19||3||34||3|
|Southern Living for Seniors of Louisburg NC||Residential Care Facility||Franklin||2||0||19||3||21||3|
|Wellington House||Residential Care Facility||Gaston||0||0||3||0||3||0|
|Gates House||Residential Care Facility||Gates||5||0||0||0||5||0|
|Murdoch Developmental Center||Residential Care Facility||Granville||47||0||30||1||77||1|
|Scotland House||Residential Care Facility||Halifax||3||0||1||0||4||0|
|Green Leaf Care Center||Residential Care Facility||Harnett||2||0||0||0||2||0|
|Carolina Village Medical Center and Assisted Living||Residential Care Facility||Henderson||4||0||3||0||7||0|
|The Crossings at Wayside||Residential Care Facility||Hoke||0||0||2||0||2||0|
|Brookdale Peachtree AL||Residential Care Facility||Iredell||1||0||3||0||4||0|
|Brookdale Peachtree Memory Care||Residential Care Facility||Iredell||2||0||2||0||4||0|
|RHA Health Services Bear Creek||Residential Care Facility||Lenoir||18||0||14||1||32||1|
|Rose Vista Assisted Living||Residential Care Facility||Lenoir||13||1||34||5||47||6|
|Cedarbrook ALF||Residential Care Facility||McDowell||2||0||0||0||2||0|
|Brookdale - Southpark||Residential Care Facility||Mecklenburg||2||0||1||0||3||0|
|Elmcroft of Little Avenue||Residential Care Facility||Mecklenburg||4||0||4||1||8||1|
|Parker Terrace Assisted Living (Aldersgate)||Residential Care Facility||Mecklenburg||1||0||3||0||4||0|
|Summit Place of Southpark||Residential Care Facility||Mecklenburg||6||0||9||3||15||3|
|The Haven at Carolina Place||Residential Care Facility||Mecklenburg||3||0||0||0||3||0|
|The Laurels and Haven in Highland Creek||Residential Care Facility||Mecklenburg||3||0||1||0||4||0|
|Waltonwood Long Term Care||Residential Care Facility||Mecklenburg||13||0||10||6||23||6|
|Willow Ridge ALF||Residential Care Facility||Mecklenburg||1||0||1||0||2||0|
|Sandy Ridge Memory Care||Residential Care Facility||Montgomery||13||0||41||4||54||4|
|Elmcroft Senior Living||Residential Care Facility||Moore||4||0||4||0||8||0|
|RHA Health Services Aberdeen||Residential Care Facility||Moore||4||0||4||0||8||0|
|Breckenridge Retirement Center||Residential Care Facility||Nash||4||0||5||0||9||0|
|Brookdale Rocky Mount||Residential Care Facility||Nash||1||0||4||0||5||0|
|Spring Arbor of Rocky Mount||Residential Care Facility||Nash||2||0||8||3||10||3|
|Crescent Green of Carrboro||Residential Care Facility||Orange||5||0||6||0||11||0|
|The Stratford||Residential Care Facility||Orange||11||0||29||3||40||3|
|Waterbrooke LTCF||Residential Care Facility||Pasquotank||8||0||16||3||24||3|
|Brookdale Dickenson Avenue||Residential Care Facility||Pitt||1||0||1||0||2||0|
|Care One Assisted Living of Greenville||Residential Care Facility||Pitt||2||0||4||0||6||0|
|Cypress Glen Retirement Community||Residential Care Facility||Pitt||14||0||7||1||21||1|
|Oakhaven Assisted Living||Residential Care Facility||Pitt||6||0||21||0||27||0|
|Tar River - RHA Services||Residential Care Facility||Pitt||2||0||0||0||2||0|
|Winterville Manor||Residential Care Facility||Pitt||2||0||18||0||20||0|
|Laurelwoods||Residential Care Facility||Polk||3||0||10||0||13||0|
|Compass Assisted Living Rowan||Residential Care Facility||Rowan||2||0||1||0||3||0|
|Yadkin Valley Senior Living||Residential Care Facility||Surry||1||0||4||1||5||1|
|The Addison of Indian Trail||Residential Care Facility||Union||8||0||7||2||15||2|
|Woodridge Assisted Living Facility||Residential Care Facility||Union||3||0||6||0||9||0|
|Addison of Knightdale||Residential Care Facility||Wake||1||0||6||0||7||0|
|Brookdale Cary||Residential Care Facility||Wake||2||0||0||0||2||0|
|Elmcroft of Northridge||Residential Care Facility||Wake||4||0||22||1||26||1|
|Falls River Court Memory Care Community||Residential Care Facility||Wake||2||0||8||2||10||2|
|HeartFields at Cary||Residential Care Facility||Wake||2||0||0||0||2||0|
|Morningside of Raleigh||Residential Care Facility||Wake||1||0||10||0||11||0|
|Sunrise at North Hills||Residential Care Facility||Wake||1||0||2||1||3||1|
|The Covington||Residential Care Facility||Wake||3||0||53||2||56||2|
|Eagle's Point Assisted Living||Residential Care Facility||Wayne||5||0||5||1||10||1|
|Spring Arbor of Wilson||Residential Care Facility||Wilson||3||0||6||0||9||0|
|Alamance County Detention Center||Correctional Facility||Alamance||11||0||116||0||127||0|
|Carteret County Jail||Correctional Facility||Carteret||2||0||0||0||2||0|
|Davidson County Jail||Correctional Facility||Davidson||3||0||4||0||7||0|
|Durham County Detention Center||Correctional Facility||Durham||9||0||21||0||30||0|
|Gaston County Jail||Correctional Facility||Gaston||1||0||6||0||7||0|
|Johnston County Jail||Correctional Facility||Johnston||16||0||3||0||19||0|
|Mecklenburg County Detention Center||Correctional Facility||Mecklenburg||6||1||64||0||70||1|
|Orange County Detention Center||Correctional Facility||Orange||3||0||1||0||4||0|
|Pitt County Detention Center||Correctional Facility||Pitt||8||0||27||0||35||0|
|Randolph County Detention Center||Correctional Facility||Randolph||0||0||7||0||7||0|
|Rowan County Detention center||Correctional Facility||Rowan||3||0||0||0||3||0|
|Wake County Detention Center||Correctional Facility||Wake||0||0||26||0||26||0|
|S Sparta Pkwy Sparta||Other||Alleghany||127||0||0||0||127||0|
|East Healing Springs Rd. Crumpler||Other||Ashe||9||0||0||0||9||0|
|Bridges St. Battleboro||Other||Edgecombe||0||0||14||0||14||0|
|Prentiss Bridge Rd. Franklin||Other||Macon||0||0||47||0||47||0|
|McDonald St Rocky Mount||Other||Nash||0||0||6||0||6||0|
|Ira B Tart Rd Dunn||Other||Sampson||0||0||2||0||2||0|
|Mittie Lane Autryville||Other||Sampson||1||0||8||0||9||0|
|Savannah Hill Rd Dunn||Other||Sampson||2||0||0||0||2||0|
Experts say North Carolina’s turn toward broad-based testing comes too late.
“It should have been done earlier,” said Chris Laxton, executive director of The Society For Post-Acute and Long-Term Care Medicine. “It’s not a useless exercise, it’s a very important one, but it should have been done earlier because we’d know from a baseline perspective where to put resources.”
Charlene Harrington, a professor emerita in the School of Nursing at the University of California, San Francisco, who has been studying long-term care for two decades, called the state’s plan “inadequate.”
“People are going to die that don’t have to die,” said Don Taylor, professor in the Sanford School of Public Policy at Duke University.
West Virginia announced universal testing in nursing homes in mid-April, more than two months before North Carolina.
Testing isn’t cheap
North Carolina has not committed to covering the cost of the repeat staff testing it advises.
“For the follow up testing, we are recommending that facilities use private lab vendors,” Kansagra said Thursday.
The state’s nursing homes have received a temporary bump in Medicaid funding and federal stimulus funds to cover costs associated with the coronavirus, but industry representatives and some experts say that’s not enough.
About 22% of nursing home workers in North Carolina lack health insurance, according to the most recent data from the American Community Survey, and many insurers won’t pay for tests that aren’t prompted by the worker having symptoms of the disease or being notified by a contact tracer to get one.
The tests can cost anywhere from $70 to $250, said Adam Sholar, president and CEO of the North Carolina Health Care Facilities Association, an industry trade group. One nursing home operator told reporters they had been quoted $300 a test.
“It is a huge financial investment to do testing every single week of the staff,” Cohen said in a presentation to legislators in mid-June. “A lot of these staff do not have insurance.”
Cohen said testing staff at facilities would cost “in the multi-millions of dollars every week.” Sholar estimates about $10,000 a week per facility.
The industry has asked the state to cover the cost of staff testing, Sholar said, and he’s hopeful that part of a $100 million allocation made by the Legislature last month to several COVID-19 relief efforts could help.
However, the state is not paying to test people at other types of residential care homes, including many assisted living facilities. North Carolina licenses 56,000 beds for operation at homes that do not fall into the nursing home category.
Many of the people who live in these facilities are elderly and have chronic health conditions that make COVID-19 particularly dangerous, but so far there have been fewer large outbreaks in these settings than in nursing homes.
Experts say the current arrangement disincentivizes staff testing. On top of the question of who will pay for the test itself is a question of who will pay if a test comes up positive. Many workers in the industry lack paid time off, so it might serve them better not to know their infection status.
Long turnaround times for test results are another obstacle, experts and industry representatives say.
“If you don't get a result back within 48 hours at the latest it becomes kind of useless,” said Laxton, of the medical society. “You really can't do good infection control if you have to wait a week, two weeks to get a test result back.”
The results are used to separate infected residents from others who have not contracted the virus.
Kansagra said, ideally, test results would come back within three days, but she did not directly respond to a question about whether CVS would be penalized if it could not deliver timely results and the department has not made the terms of the contract public.
The scale of the cost and the supply-chain problems require federal intervention, with a plan for using the testing program to advance knowledge about the coronavirus and how to contain it, said Taylor, the Duke professor, but he thinks the chances of that happening are slim.
“The cavalry’s not coming,” he said.
Why focus on staff?
A characteristic of the novel coronavirus that has made it particularly hard to control is its long incubation period. Symptoms may not show up for days, and in some people, they never do, but that doesn’t mean the infected person isn’t spreading the virus.
Nursing home staff are the “principal vectors of transmission,” and it’s hard to control what they do when off the clock, said Laxton, the executive director of the medical society.
Routine testing can help identify asymptomatic cases. In April, a Columbus County nursing home reported an outbreak of 40 cases, two of which were staff members who were asymptomatic at the time of their tests.
North Carolina defines an outbreak as two or more cases among residents and staff. All but a handful of the 696 nursing home deaths have been residents.
Both the Centers for Disease Control and Prevention and the state recommend that everyone associated with a nursing home get tested after there’s a single confirmed case. The residents and staff are supposed to be tested every three to seven days until 14 days have passed without the discovery of a new case.
In March, Gov. Roy Cooper signed an executive order that barred most visitors from all long-term care homes. Residents now leave very rarely, only to receive essential medical care that’s not available in the nursing home, such as dialysis.
Though nursing homes are on lockdown, the staff leave, go home, go to the grocery store and mingle in the community, said Lauren Zingraff, executive director of Friends of Residents in Long-Term Care, an advocacy group.
“We continue to have people all over North Carolina who refuse to wear a mask,” Zingraff said. “Wearing a mask is not a political statement. Wearing a mask is a public health need to protect not only yourself but others.”
Zingraff has been pushing for universal nursing home testing for COVID-19 since the pandemic began. Sometimes it is difficult to tell when a resident has symptoms, she said.
“Some people have lost verbal capacity or their ability to write something on a piece of paper,” Zingraff said last month.
“They might not be able to say to anyone ‘I am starting to feel like I have the flu. I might need a COVID-19 test.’ And in a lot of cases, only family members can tell what’s going on.”
But with most visitors barred from all nursing homes, family members can no longer visit in person.
“People are acting like people in long-term care have the capability and ability to freely communicate their health needs,” she said. “That is simply not the case.”
Zingraff said reopening long-term care facilities to visitors is entirely dependent on robust testing for COVID-19.
“We still don’t have a definitive timeline for residents when they can see their loved ones again,” Zingraff said. “Every day we go without (facilities) letting them see their family members is another day from their life.”
CORRECTION: This story was updated to correct Lauren Zingraff’s title. She is executive director of Friends of Residents in Long-Term Care, not the president.
This story was also updated to correct the spelling of Adam Sholar's name and title. He is president and CEO of the North Carolina Health Care Facilities Association, not its executive director.
This story was jointly reported and edited by Kate Martin and Frank Taylor, of Carolina Public Press; Carli Brosseau, Lucille Sherman and Jordan Schrader, of The News & Observer; Ames Alexander and Gavin Off, of The Charlotte Observer; Nick Ochsner, of WBTV; Emily Featherston, of WECT; and Tyler Dukes, of WRAL.