With COVID-19 resurgence looming, some Kansas nursing homes struggle with key supplies

As new cases of the coronavirus again climb in Kansas, dozens of nursing homes recently reported current or impending shortages of masks, gowns and gloves critical to keeping elderly and frail residents safe.

More than 60 nursing homes were close to running low on N95 masks and 11 didn’t have enough as of the first week of June. At least 55 were approaching insufficient supplies of gowns and 47 soon wouldn’t have enough surgical masks, according to federal data summarized by the Kansas Department of Health and Environment.

Nursing homes, which house some of the most vulnerable Kansans, are especially susceptible to COVID-19 outbreaks. Residents are often in close quarters, allowing the virus to sweep through buildings, making them the sites of the deadliest outbreaks in the state.

But three months into the pandemic, nursing homes and their professional associations say they’re still struggling to purchase enough personal protective equipment (PPE) on the open market as other health care providers, businesses and private individuals snatch up whatever is available. State officials said Kansas can provide aid, but nursing homes respond that obtaining government help involves navigating a bureaucratic maze.

“Personal protective equipment is in scarce supply for some nursing home providers. Not all nursing homes have enough should an outbreak occur, and many providers do not have access to testing resources,” Mark Schulte, Kansas Adult Care Executives Association legislative committee co-chair, told the Legislature’s Medicaid oversight panel on Monday.

A new, upward trend in the number of coronavirus infections statewide is lending fresh urgency to the problem. As remaining restrictions on gatherings and businesses are lifted, the virus is circulating more widely, making new cases in nursing homes almost inevitable.

In Kansas, as of June 8, there were 35 clusters of COVID-19 in long-term care facilities. Those clusters accounted for 756 cases and 126 deaths.

In Johnson County alone, nursing home deaths due to the coronavirus account for nearly 84 percent of the county’s total.

Hoeger House in Olathe has no cases but during three weeks in May and June it is listed in the federal data as having less than a week’s supply of N95 masks on hand.

Joanna Randall, the executive director, said staff members have always had enough PPE “to cover our needs.” But that means using surgical masks along with goggles or face shields when N95 masks are in short supply, a practice allowed under CDC guidelines.

“It was tight on the git-go,” Randall said. “They were wanting us to use so much up front. … It was really about getting an inventory built up.”

‘Bureaucratic process’

Olathe’s Villa St. Francis has had 66 cases and six deaths. According to the federal data, it was marked as having less than a week’s supply of N95 masks on hand for the weeks ending May 24 and May 31.

That was at the same time CEO Rodney Whittington implemented facility-wide testing because he feared the virus was present but involved asymptomatic cases. By May 26, results began to come back and 22 residents and 15 staff testing positive.

On Wednesday, Whittington said the nursing home currently has “ample” PPE.

“Now, the only way that would change is if we had a full-out, all-facility breakout where every single employee had to have a mask on everywhere,” he said.

LeadingAge, which represents non-profit and faith-based nursing homes, said in an unsigned statement to the Legislature’s Medicaid oversight committee that Kansas has a “multi-step, bureaucratic process” for requesting PPE and that the association had heard many reports of requests going unfilled.

Kansas’s top health officer, Lee Norman, said nursing homes are receiving protective gear from the state if they request it.

“We have not turned away a single skilled nursing facility or long-term care facility that has requested PPE to come to them” through the state Department of Emergency Management, Norman said.

A federal program called AirBridge, which delivers medical supplies to virus hot spots, has provided PPE to 319 Kansas nursing homes, Norman said. The deliveries have consisted of 8,000 cases of eyewear, 94,000 masks, 435,000 gloves and 84,000 gowns, he said.

But some of the federal supplies have been poor quality, nursing home advocates contend. Linda MowBray, president and CEO of the Kansas Health Care Association, during a presentation to lawmakers on Monday pulled out a gown she said had been shipped to facilities.

“For gowns, we have the ever-popular blue trash bag,” MowBray said as she showed off a plastic-looking gown that had a hole on one end and another hole for a head on the other.

She added that even the best infection control nurses hadn’t figured out how to take it off without contaminating themselves.

Norman acknowledged the quality of the gowns and masks from the Federal Emergency Management Agency were “atrocious” and said the state doesn’t generally push those out to health care providers.

This story was originally published June 25, 2020 at 5:00 AM.