The state Department of Health and Human Services has been negotiating with COVID-19 testing labs to run the state’s regular testing of nursing home staff, but announced last week that nursing homes will soon have to organize those tests themselves.
Each facility will make its own contracts with testing labs, Health and Human Services Commissioner Lori Shibinette told nursing home administrators in a phone conference last week, and the state will reimburse up to $100 per test.
“It still provides the funding and the support that is needed to have a good surveillance program,” Shibinette said.
In the event of another outbreak at a nursing home, Shibinette said, the state will again organize and pay for testing. The state provided nursing home administrators with a list of labs that can process tests and contact information for each, and Shibinette expects most nursing homes to have contracts and be running their own testing programs in two weeks.
Shibinette said she hoped turning over that responsibility to nursing homes would free up the state’s capacity to organize regular testing in other congregate living settings, including homeless shelters and jails, to detect more cases early.
The state still dictates how often the tests need to be conducted, what kinds of tests are used and how many staff need to be tested.
Every fourth week, all nursing homes will have to test their entire staff. On the other weeks, nursing homes will randomly pick 10% of their staff to get tested.
But the cost of testing can vary. Dartmouth-Hitchcock Medical Center charges $102 for COVID tests, according to the hospital’s website. A review of COVID test prices by the Peterson Center on Healthcare and the Kaiser Family Foundation https://www.healthsystemtracker.org/brief/covid-19-test-prices-and-payment-policy/ found wide variation in how much tests cost. Some providers charge less than $50 per test, while others charge more than $300 per test.
Some nursing home administrators, like Tom Argue of the Webster at Rye, said they worry about getting the tests for $100 — particularly because smaller nursing homes do not have the same kind of bargaining power as the state.
Argue said Webster at Rye has paid $175 for tests through providers like Convenient MD. The $75 difference between what some providers charge for tests and the reimbursement amount could cost Webster at Rye about $188,000 per year.
“Where we’re supposed to come up with that money, I have no idea,” Argue said. He guessed the shortfall for bigger county nursing homes could be $400,000 or more.
But other administrators, like Anne Purington, CEO of Presidential Oaks in Concord, said she is hopeful the state’s reimbursement will cover the cost of testing.
“If that’s not the case, that would be quite a burden,” Purington said.