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Claudia Deeg,
CALPIRG

Report: Nursing homes endure massive PPE shortages

Seven months into COVID-19 pandemic, California’s nursing homes still at risk
For Immediate Release

OAKLAND-- California nursing homes, along with thousands nationwide, are dealing with horrific shortages of masks, gowns and other items they need to protect residents, workers and the broader community from COVID-19, according to “Nursing home safety during COVID: PPE shortages,” a report by the CALPIRG Education Fund and Frontier Group.

When nursing homes don’t have enough personal protective equipment (PPE), it can lead to outbreaks among residents and staff, worker quarantines and shortages, and more risk to workers’ and residents’ families and neighborhoods. The ongoing shortages are particularly concerning as the country is expected to see a winter surge of the COVID-19 virus.

California has had nearly 6,000 deaths from residents and staff at nursing homes and assisted living facilities, more than one third (34%) of total deaths in the state.

“It’s unconscionable that we are dealing with severe PPE shortages at this point in the pandemic, especially in our nursing homes where some of our most vulnerable community members live.” said Claudia Deeg, CALPIRG Education Fund Associate. “Without proper PPE, nursing home cases can spread rapidly, putting others at risk inside and outside the facility.”

The report analyzed data submitted to the Centers for Medicare & Medicaid Services by the nation’s 15,000 nursing homes, including 1,185 in California, through August 23, 2020. Key takeaways from the report include:

  • PPE shortages in nursing homes nationally tripled from mid-July to late August 2020.

  • There were 226,495 residents at heightened risk of contracting COVID-19 nationally in August because their nursing homes were out of or were dangerously low on one or more types of PPE such as N95 masks, gowns or hand sanitizer. 

  • Eight percent of nursing homes nationally were completely out of one or more types of PPE in late August; 20 percent of facilities had less than a one-week supply of one or more types of PPE, which represents a critical shortage by industry standards.

  • In California, 7.3% of nursing homes had no supply or a critical shortage of N95 masks in August.

  • A larger percentage of California nursing homes had no supply or a critical shortage of gloves and hand sanitizer compared to the national average.

Deeg added that experts believe PPE shortages have continued to get worse since late August. One group, GetUsPPE, a grassroots movement founded by medical professionals on the COVID frontlines, said more facilities across all sectors were complaining of shortages in September. 

“Having less-than-one-week supply is regarded as a critical shortage in our industry. It's considered the minimum acceptable. If a home has an outbreak, it can burn through its limited supply in a day or two,” said María Carmen, certified nursing assistant from Bay Vista. “In addition, a home may have no idea when its next shipment of PPE may arrive. Homes with less than one week’s supply often ration, forcing workers to improvise, re-use PPE or go without.”

Medical experts believe the shortage of PPE is a key reason that outbreaks and deaths from COVID-19 are disproportionately high in nursing homes. California recently adopted the nation’s first law requiring healthcare facilities to maintain a 45-day stock of PPE, Senate Bill 275 by state senator Dr. Richard Pan. This bill will ensure California is prepared for future public health crises, but does not go into effect until 2023, meaning additional action is needed to address current PPE shortages. 

“The COVID-19 pandemic showed serious flaws in our PPE supply system, and it’s shameful that seven months into the pandemic we are still seeing critical shortages of PPE in nursing homes in California and across the country,” said Dr. Richard Pan, state Senator. “SB 275 will ensure that California is prepared for future public health crises, but we need national leadership and more action to protect nursing home workers and seniors who are in danger now.”

In the report, CALPIRG Education Fund calls for a number of policy actions to improve the supply and availability of PPE, including for the federal government to fully implement the Defense Production Act so more PPE is available and sold at reasonable prices; congressional action to streamline the supply chain; and multi-state consortiums to reduce competition and stabilize prices.

CALPIRG Education Fund has also released a consumer guide, “20 questions to ask your nursing home to make sure it’s protecting against COVID-19,” and an explainer video on how to find information (PPE shortages, staff shortages, outbreaks) about a specific nursing home. 

The PPE shortage is among the problems brought to light by the Centers for Medicare & Medicaid Services data on nursing homes. We will explore various issues in a series of reports in the months ahead.

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