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Nursing homes search for faster testing labs

As nursing homes fight to keep COVID out, a seemingly small decision has turned out to be critical to success or failure.

The labs they use to test workers can give them an early warning of the virus or tell them about infections so late that the virus could have spread widely.

In July, Lab Corp. began to get overwhelmed with COVID tests. Results that used to arrive in no more than three days were now taking more than a week.

At Fort Hudson, officials took action. They complained to the lab, which said it was no longer going to take any nursing home tests. So Fort Hudson got a list of other labs from the state Department of Health and transferred to one in Boston.

The whole process took about two weeks.

Centers Health Care was also using Lab Corp. It switched to Med Labs, which is owned by Centers. But Med Lab couldn’t keep up with the number of tests.

“That lab couldn’t handle the volume, so they outsourced to someone who could handle part of the volume,” said Centers Regional Director Grace Pfordresher.

The last batch of tests before the switch included tests from two Essex Center employees who did not know they had the virus. For 19 days, those employees continued to work without symptoms. By the time the test results came back — positive — the facility had a full-blown outbreak.

Now, most of the Centers-owned nursing homes are getting results within 72 hours. But that is still not happening everywhere.

The Landing in Queensbury, which just had two workers test positive, is getting tests back in about seven days. Glens Falls Center, which is not using Med Labs, was getting quick results for weeks but now is at a wait of about 12 days, because the lab took on contracts to test for local colleges and can’t get Glens Falls Center’s tests back as quickly as usual.

Administrators said the delays can be disastrous.

“Until we get to a 24-hour turnaround, we’re not going to be able to keep COVID away,” Pfordresher said.

At Fort Hudson, which had an outbreak in April, CEO Andy Cruikshank is frustrated the state seems unwilling to regulate labs to make sure they get results out quickly.

“The nursing home is the highest-risk environment,” he said. “Turnaround time with testing is of paramount importance. It is useless to get tests back after seven days. And it’s not helpful to get it past even a couple days.”

Cruikshank first turned to Lab Corps., to no avail.

“They were up to seven, eight, nine days. We had pushed to them: ‘Listen, this is not good,'” he said. “It’s unacceptable to wait that long.”

When Lab Corps. responded by asking nursing homes to find new labs, Cruikshank asked the state Department of Health for help. The agency gave him a list of five labs. One told him it could not take on any more customers. The second said it would only take customers within 40 miles of New Jersey. Two others never responded. But the last lab on the list, Boston Heart Diagnostics, said if he could FedEx the tests daily, he could get results in 48 hours.

Quickly, workers entered employee information for 250 people into the new lab’s electronic system. The lab has been providing results for five weeks, usually hitting the 48-hour goal, occasionally taking 72 hours, Cruikshank said.

Pfordresher wants results even faster. The Centers for Medicare and Medicaid Services called her to ask what she needed in the outbreak at Essex Center. She told them she needed a machine that can give results quickly. Those are now at many labs.

“I want on-site machines,” she said. “Up north, we have to package up and overnight our tests. That adds to the delay. I want to process our tests on-site.”

CMS didn’t give her one of the machines, which are in short supply. Until she can test people immediately, she said, she won’t know who is truly safe.

“Remember a COVID test is only that moment in time,” she said. “You could take a COVID test today and be negative and take it tomorrow and be positive.”

State officials said there was no problem with testing delays, telling nursing homes to split up their tests if necessary.

“Based on the Department’s weekly monitoring of lab testing capacity there is clearly testing capacity available for specimens collected throughout the state, even though a particular nursing home might have needs that may limit the number of labs that can carry out testing for them,” spokeswoman Jill Montag said.

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