Minnesota ramps up COVID-19 testing in nursing homes

As COVID-19 deaths continue to rise in nursing homes, state health officials are ramping up efforts to test everyone who lives and works in facilities with outbreaks of the deadly virus.

In response to growing public pressure, teams made up of public health personnel and the Minnesota National Guard have been deployed across the state to facilitate comprehensive testing in nursing homes and assisted-living facilities. As a result, more than 10,000 residents and staff at about 40 long-term care communities have undergone coronavirus testing in the past few weeks, and dozens more facilities are scheduled to launch testing by mid-June, according to state data released this week.

The dramatic expansion of testing is part of a broader strategy unveiled early this month by the administration of Gov. Tim Walz to address the devastating death rate in Minnesota's long-term care communities, which account for 81% of the deaths from COVID-19, the deadly respiratory illness caused by the virus. While criticized by some as inadequate, the ramped-up testing is expected to offer a clearer view of how far the virus has spread in these homes and help alleviate widespread anxiety among vulnerable residents and families.

The demand for COVID-19 testing among senior living communities has soared as the pandemic has tightened its grip on a vulnerable population. Large and deadly clusters of the virus have shaken care centers across the state, from Winona to Duluth. All told, about 470 nursing homes and assisted-living facilities have requested state assistance with COVID-19 testing; another 134 facilities have begun testing on their own, according to the State Emergency Operations Center (SEOC) in St. Paul.

"What testing allows you to do is have a sight picture and be able to trace and isolate and make sure they do not spread [the virus] to others," Walz said at a news conference this month announcing the expanded testing.

The Walz administration had come under sharp criticism from some lawmakers and elder-care advocates for not doing enough to support testing in long-term care homes. For months, senior homes were testing residents and staff only if they had high temperatures or other symptoms, though research shows that asymptomatic people can spread the virus without being aware they are infected.

Many senior homes lacked access to testing materials or could not find private labs to handle the volume of tests they were seeking, say representatives of the long-term care industry.

Even with the expanded efforts, the testing is still seen by some as inadequate and lacking in clear guidelines.

So far, the testing in long-term care communities has been voluntary — meaning providers themselves have chosen whether to pursue testing. However, the state has provided support to certain senior homes that request it, prioritizing those with recent outbreaks of the virus. In the past two weeks, the Minnesota National Guard has helped conduct tests at 26 facilities; another 30 facilities are scheduled for tests in the next two weeks, the SEOC said.

Sen. Karin Housley, R-St. Mary's Point, chairwoman of the Senate Family Care and Aging Committee, said that many long-term care providers have struggled to implement facilitywide testing because they aren't sure how to pay for it. In many cases, she said, staff at nursing homes are being asked to get COVID-19 tests on their own and then have their insurance plans cover the cost. Some staff are paying out-of-pocket costs and are concerned their insurance premiums will go up if they get tested, she said.

Housley has argued that weekly, on-site testing should be offered at all 1,700 long-term care facilities across the state. She is preparing legislation that would mandate the state to pay for the testing with the $1.87 billion in federal funds Minnesota has received to cover corona­virus-related costs. Such testing among senior care residents should take priority over the sort of free tests that were offered earlier this month at National Guard Armory locations across the state, Housley said.

"This virus is running rampant in our long-term care communities. But instead of testing staff and residents of those facilities where people are dying, we are offering free tests to members of the public who show no symptoms at all," she said. "It makes no sense."

Anxiety and confusion around coronavirus testing remains widespread in senior living communities.

Cheryl Hennen, Minnesota's long-term care ombudsman, said her office has received nearly 400 calls in the past month concerning COVID-19. Between 60 and 75% of the calls are from senior care residents or their families, asking questions about testing. Many of the questions surround when testing will occur, why testing has taken so long to administer, and what happens if they test positive for the virus, she said.

"People have been living with a lot of ambiguity and want some assurance they are safe," Hennen said. "Without having a test, you have no idea of whether you have the virus — and whether or not people caring for you have it."

For many families, the arrival of more testing has brought an end to weeks or months of anxiety over whether their loved ones have the illness.

Lynne Powers of Excelsior said she had been pushing for COVID-19 testing of her 82-year-old mother, who has Alzheimer's disease and lives at a nursing home, since early April. Her pleas intensified after some residents on her mother's memory-care unit tested positive for the illness.

On May 14, Powers finally got word that her mother had been tested and did not have the virus. She is awaiting the results of a follow-up test conducted this week.

"In my opinion, testing in long-term care should have been a focus from the beginning" of the pandemic, she said. "It relieves so much stress just knowing my mom is OK."