Congressman Tom Reed’s Covid-19/Nursing Home Roundtable

May 29, 2020

From Congressman Tom Reed:

Rep. Reed hosted a roundtable conversation with over 50 representatives from regional health providers, insurers, hospitals, nursing home administrators, and numerous state lawmakers.

The Governor’s office received an invitation and declined to join the discussion.

“Our roundtable confirmed the worst; New York’s nursing home guidance can only be described as catastrophically wrong given the clear and overwhelming pushback they’ve received from the medical community. The state has ignored the experts and now left the medical community completely in the dark with its latest testing order. Until the Governor starts collaborating with stakeholders on solutions that can actually work and won’t cripple our health system, this situation will only get worse,” said Reed.

After the roundtable, Reed led a press call to discuss the roundtable’s findings with the media. The video recording from that Zoom press call can be found here.

Key takeaways include:
• The state ignored immediate and direct warnings from the medical community regarding its March executive order to force nursing homes to receive COVID-positive patients.
• New York, unlike other states, has made no effort to reach out to the medical community and incorporate their feedback or concerns throughout the crisis.
• The rash decision to mandate twice-weekly testing is not supported by medical recommendations, insurance policies, or New York regulations. Consistently conducting invasive testing puts staff at risk.
• Among all stakeholders, there is extreme confusion over who is purchasing, facilitating, and covering the cost of twice-weekly testing, which is estimated to cost over $40 million dollars per week.
• Without additional information and coordination immediately, hospitals fear their spare bed capacity will drop dramatically and that they will be unable to help coordinate effectively with nursing homes.
• No one has received any of the funding Congress sent Albany to support COVID testing. All indications suggest nursing home facilities will be forced to bear the cost of testing despite suffering severe financial strain.
• Baseline testing for residents is important as part of a larger strategy, but mass duplicative testing will reduce critical staff capacity and drain resources.
• We need to avoid a one-size-fits-all approach because overtesting overwhelms the system. Testing frequency should be based on outbreak and incidence within the community. Efforts should also focus on supporting specific facilities with the equipment, space, and staff to keep COVID-positive patients and the caregivers who serve them entirely separate from COVID-negative populations.
Important resources and files referenced during the press conference include:

-CMS’ original March guidance (Link 1, Link 2)
-NYS’ original March guidance
-Letter from Society For Post Acute And Long-Term Care Medicine
-Letter outlining the cost of testing twice a week

The speakers from today’s press conference include:

-Rep. Tom Reed
-State Senator George Borrello
-State Senator Chris Jacobs
-State Senator Tom O’Mara
-Chemung County Nursing Facility Administrator Michael Youmans
-Cayuga Medical CEO Marty Stallone
-Brooks Memorial Hospital CEO Mary LaRowe

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The agenda used to guide the roundtable discussion is copied below.
ROUNDTABLE AGENDA
• 1:00 PM – 1:05 PM: Opening
o Kickoff Remarks — Rep. Reed (2.5 minutes)
o Remarks From NYS — Governor Cuomo & Staff (2.5 minutes) [NO STAFF JOINED]
• 1:05 – 1:20 PM: Topic 1: NYS’ Twice Weekly Testing Order (15 minutes)
o Overview — Rep. Reed (1 minute)
o Points For Group Discussion (14 minutes):
 Costs & Coverage Of Testing
 Testing Of State Employees
 Recommended Testing Rates
 Prospect Of Duplicative Testing
 Impact Of Order On Staffing, Hospital Capacity
• 1:20PM – 1:35PM: Topic 2: COVID-positive Patients In Nursing Homes (15 minutes)
o Overview — Rep. Reed (1 minute)
o Points For Group Discussion (14 minutes):
 CDC/CMS’ March Guidance
 Impact Of NYS’ March Orders
 Other States’ Interpretation Of Federal Guidance
 Stakeholder Feedback During Crisis
• 1:35PM – 1:50 PM: Topic 3: Solutions Moving Forward (15 minutes)
o Overview — Rep. Reed (1 minute)
o Points For Group Discussion (14 minutes):
 Facility Review
 Designation Of Specific Sites Or Wings To Treat COVID-positive Residents
 Staff Testing
 PPE Support
 Additional Solutions
• 1:50 PM – 2:00 PM: Closing Remarks