NAHC’s Dombi: COVID-19 Tests Have Limitations, Shouldn’t Be Viewed as ‘Panacea’

Home health operators shouldn’t get overly excited about federal testing support just yet.

William A. Dombi — president of the National Association for Home Care & Hospice (NAHC), a Washington, D.C.-based advocacy group — is cautioning providers to take a measured view of the conversation regarding potential COVID-19 tests being sent to the home health space.

The conversation started last month when U.S. Department of Health and Human Services (HHS) Adm. Brett Giroir mentioned in a call with members of the media that the government had secured 150 million rapid COVID-19 tests — and had plans to send some to home health staff.


Schools, senior centers and assisted-living facilities would also receive COVID-19 tests, made by lab company Abbott, according to Giroir.

As of Thursday, multiple home health agencies contacted by Home Health Care News were still unaware of those federal efforts.

While home health industry advocates have been vying for more testing, it won’t be a magic, all-encompassing solution to COVID-19 in home health care, Dombi noted.


NAHC’s president addressed the topic on Thursday during a webinar hosted by law firm Littler Mendelson.

“While 100 million to 150 million tests sounds like a lot, when you distribute them to [assisted-living facilities], schools and [home health agencies], it diminishes quickly,” Dombi said on the webinar. “It’s a tool in the infection-control toolbox. It’s not a panacea. Overall, there are limitations to that rapid test’s quality and accuracy as well.”

Rapid tests do tend to have less accurate results, on average, but the turnaround time arguably makes up for that.

“For congregate care settings, like nursing homes or similar settings, repeated use of rapid point-of-care testing may be superior for overall infection control compared to less frequent, highly sensitive tests with prolonged turnaround times,” the U.S. Food and Drug Administration said in an FAQ updated August 24.

Dombi said he expects providers will receive more guidance from federal officials on which organizations will qualify to receive testing over the next week or so.

The rapid tests — which deliver results within about 15 minutes, according to the HHS — come from a $760 million contract with Abbott.

Updates from Washington

Testing aside, there are a variety of other issues for home-based care agencies to pay attention to from a legislative perspective over the next few weeks, particularly in what now is being dubbed the “stimulus 4.0 package.”

There is the consideration for the extension of the Paycheck Protection Program (PPP), which a slew of providers took advantage of when funds became available. At-home care businesses across the country received more than $666 million in loans under $150,000 from the PPP, while dozens of others received loans exceeding $5 million.

Democrats and Republicans disagree on how much more funding should be granted to the PPP, with Democrats arguing that more was required, according to Dombi.

In addition, there is some momentum for child care support for essential workers, which could benefit home-based care agencies.

“It’s a little bit gray as to what it will be conceptually, [but it is] something clearly that could benefit home care,” Dombi said. “But [who knows] if it will be enough to make a difference.”

Another point of contention between Democrats and Republicans is the concept of liability protection for home health care providers during COVID-19, which NAHC is working with Senate Majority Leader Mitch McConnell’s (R-Ky.) office on.

Dombi ultimately believes that home health providers will get some sort of liability protection, and that the issue is simply being used as a bargaining chip in negotiations.

“The Democrats do not like the liability protection element, but I still believe that it is a chip in the game and that there will be a compromise regarding liability,” Dombi said. “But that’s only if the Democrats get some more stimulus dollars to be directed in a number of ways, including to workers and to health care.”

The bridge between the two parties is currently substantial, according to Dombi. The White House is willing to give $1.3 trillion or $1.4 trillion, but the Democrats in the House want over $2 trillion to be distributed.

On its end, NAHC has been advocating for Provider Relief Fund money to be sent to non-Medicare, non-Medicaid home care providers.

Sending Provider Relief Fund money to senior care entities outside of the Medicare and Medicaid programs isn’t unrealistic. For example, HHS announced recently that it would be distributing more funding to assisted-living facilities, which are considered COVID-19 hot spots.

“They’re one of the hotspots for COVID-19 infection, as well as fatalities,” Dombi said. “But we’ve returned back to HHS with a message saying, ‘Don’t forget about us. We’re more health care than the [assisted-living facilities] are. And in fact, much of the care in those facilities is provided by [home-based care providers].”

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