President Trump Monday urged states to universally test all nursing home residents and staff, and suggested that such testing should have happened earlier. 

He issued the recommendation during a press briefing after being asked why the federal government has yet to mandate widespread testing in nursing facilities. During a call with governors earlier Monday, Vice President Mike Pence announced that the White House is recommending that all states test nursing home residents and staff members for COVID-19 over the next two weeks.

Trump also said during the Rose Garden briefing that widespread testing in facilities should have been conducted immediately following the outbreak at a Washington state nursing home in early March. 

“I would certainly consider that. I will mandate it if you’d like. I think it’s important to do and I think frankly some of the governors were very lax with respect to nursing homes,” Trump said Monday afternoon. 

“[The states] have the capacity to do it. They should be doing nursing home [testing]. That is a real vulnerability,” he added. 

White House coronavirus task force coordinator Deborah Birx, M.D., also told governors Monday morning that the federal government will help if necessary, but the administration’s position is that states must take the lead. 

While the American Health Care Association praised the universal testing recommendation, LeadingAge did not think the move went far enough in solving nursing homes’ problems.  

“We applaud both the effort to test everybody and the equipment that is being sent out to nursing homes that was announced last week,” AHCA President and CEO Mark Parkinson told McKnight’s Long-Term Care News

While the announcement shifts the responsibility to states to generate resources for testing, just having the administration recommendation helps the effort in a major way, Parkinson said.  

“As a former governor, I know there is power in the bully pulpit of the administration,” he said. 

In a statement, he urged states to follow New Jersey, Massachusetts, West Virginia and Florida, which have directed their state’s National Guard to help with testing in the immediate term at nursing home facilities. He also continued to push for $10 billion emergency in emergency relief funding for staffing and testing. 

Even more needed

Ideally, facilities should conduct daily testing of staff and visitors, he told McKnight’s.

“It exists but not in the quantities we need,” he said. “That’s the only surefire way we can keep COVID out of buildings.” 

LeadingAge President and CEO Katie Smith Sloan questioned how the administration will help provide the testing. 

“There is no clarity on how this help is coming — two months after the start of the pandemic that requires testing to limit its spread,” she said in a statement. “We need test results in minutes, not days to contain the virus and to ensure that we do not lose staff while waiting for results. We also need ongoing testing, not just a bandaid.

“The time to start leading was months ago at the beginning of the crisis, when it was clear that millions of vulnerable older adults were in mortal danger. And we still don’t have the leadership we need.”

Meanwhile, during LeadingAge’s daily coronavirus conference call, Director of Nursing Home Policy Jodi Eyigor urged providers to get their plans ready for testing now.

“If you’re testing all residents and testing all staff, there are two main things you need to have in place: What are you going to do to cohort or to isolate residents when they test positive and what are you going to do to replace staff who are either isolated because they have tested positive or they are being quarantined because they’ve had close exposure with someone who’s tested positive?” she explained. “Start working on those two things now so you’ll be ahead of any type of recommendation that your governor makes or CMS eventually makes.”

Eyigor also asked providers to carefully track whether pending shipments of personal protective equipment from the Federal Emergency Management Agency measure up to actual needs. “Are the numbers FEMA is sending out consistent with what you’re using in a one-week period?” she asked.