staffing agencies , sharing staff between other local providers , and using emergency waivers to hire nurse aides who had yet to complete their certification . As of January 2021 , GAO continued to hear that staff are exhausted , face burn-out from emotional trauma , need to quarantine due to exposure to or illness from the virus , or stay home to take care of family members — all of which further strains staffing resources .
PPE
According to GAO ( 2021b ) reviews of data from the CDC and interviews with advocacy organization and national association officials from July 2020 to January 2021 , shortages of PPE in nursing homes have improved since the beginning of the COVID-19 pandemic but remain an issue . For example , CDC data show that , as recently as December 2020 , about 10 percent of nursing homes did not have a one-week supply of at least one of the following : N95 respirators , surgical masks , gloves , eye protection , or gowns ( a decrease from about 22 percent of nursing homes in July 2020 ). GAO heard that while challenges maintaining PPE supplies in reserve is an ongoing concern , supply shortages have become less severe over time .
Testing
GAO ( 2021b ) says that nursing homes ’ ability to use testing to identify infected residents and staff through testing protocols has improved over the course of the pandemic , but at a high cost to these facilities . Nursing homes have reported to CDC improved testing capacity ; specifically , the number of nursing homes testing for COVID-19 in both staff and residents has increased by 48 percentage points — from 35 to 83 percent — between Aug . 16 , 2020 , and Nov . 22 , 2020 , the last week complete data for overall testing were available . Although data reported in December 2020 by nursing homes found that less than 2 percent of these facilities would be unable to test all staff or residents within the week if needed , nursing home association officials note that the high cost of continuous testing is not sustainable indefinitely .
Vaccination
GAO ( 2021b ) notes that nursing homes face some emerging challenges related to vaccination efforts . A February 2021 CDC study estimated low rates of vaccine uptake among nursing home staff ( 38 percent ) compared to nursing home residents ( 78
Figure 1 : Number and Duration of COVID-19 Outbreaks in Nursing Homes , May 31 , 2020 , through January 31 , 2021
Data tables for Figure 1 : Number and Duration of COVID-19 Outbreaks in Nursing Homes , May 31 , 2020 , through January 31 , 2021
Number of COVID-19 outbreaks
Number of nursing homes
Percentage of nursing homes
No outbreaks |
1 outbreak |
2 outbreaks |
3 outbreaks |
4 or more |
|
|
|
|
outbreaks |
64 761 2,586 4,026 5,943
0.5 6 19 30 44
Source : GAO analysis of Centers for Medicare & Medicaid Services ( CMS ) data . | GAO-20-576R
percent ) participating in the Pharmacy Partnership for Long-Term Care Program . GAO says it heard about reluctance among some nursing home staff to receive the COVID-19 vaccine , in addition to hearing about uncertainty around certain aspects of vaccination distribution and requirements earlier in the year .
The Coronavirus Commission on Safety and Quality in Nursing Homes ( 2020 ) emphasizes the importance of balancing resident and staff safety and well-being in the wake of the pandemic : “ Rigorous infection-control practice and treatment needs require that residents that test positive for COVID-19 may need to be transferred to new locations within their nursing home , to other sites , and in and out of hospitals . In the early days of the pandemic , transitions at times were abrupt , and the resident and family had no prior awareness that such a transition might occur . In the future , when a nursing home contends with a widespread outbreak , rapid transitions may still be indicated . When transitions are not well-communicated , the result may be that care is not coordinated or handoffs are missed . The resident and family suffer from the trauma that relocation and / or isolation may cause — from the possible decline in care quality , as well as from missed opportunities for resident-cen-