Nursing homes endure massive PPE shortages

Seven months into COVID-19 pandemic, 226,000 nursing home residents nationwide at risk

PennPIRG Education Fund

PHILADELPHIA– Thousands of nursing homes nationwide are dealing with horrific shortages of masks, gowns and other items they need to protect residents, workers and the broader community from COVID-19. When nursing homes don’t have enough personal protective equipment (PPE), it can lead to outbreaks among residents and staff, worker quarantines and shortages, and more risk to workers’ and residents’ families and neighborhoods.

Seven months into this pandemic, PPE shortages have become much worse, according to “Nursing home safety during COVID: PPE shortages,” a report by the PennPIRG Education Fund and Frontier Group. Our analysis of data submitted to the Centers for Medicare & Medicaid Services by the nation’s 15,000 nursing homes shows:

• There were 226,495 residents at risk in August because they were in homes that were out of or were dangerously low on one or more types of PPE such as N95 masks, gowns or hand sanitizer. 

• Eight percent of nursing homes were completely out of one or more types of PPE in late August; 20 percent of facilities had less than a one-week supply of one or more types of PPE, which represents a critical shortage by industry standards.

• In May, 2 to 4 percent of homes were totally out of N95 masks, surgical masks, gowns and eye protection. That improved in June, but shortages started soaring in mid-July and more than tripled by late August.

• In 20 states, at least 20 percent of nursing homes were out of or critically low on N95 masks in August. At least 10 percent were out of or critically low on gowns in 26 states.

Pennsylvania has 690 nursing homes across the state. Having less than one week worth of supplies is considered a critical shortage. The most concerning critical shortages in the state include: 

• 17.2 percent of nursing homes did not have a one-week supply of N95 masks.

• 15.5 percent of nursing homes did not have a one-week supply of gowns.

• 13.9 percent of nursing homes did not have a one-week supply of eye protection.

• 13 percent of nursing homes did not have a one-week supply of surgical masks.

Around eight percent of nursing homes had entirely run out of N95 masks, surgical masks, eye protection, and gowns. 

“As a nurse who has worked in long-term care, I know how vital PPE is to protect the health and safety of our patients and critical frontline workers,” said Sen. Maria Collett, Democratic Chair of the Senate Aging and Youth Committee. “That’s why I’ve introduced legislation to prioritize PPE for our essential workers, and to develop a meaningful stockpile of PPE to respond to this and future pandemics. As cases continue to rise in the Commonwealth, I join PennPIRG in calling on our federal leaders to invoke the Defense Production Act and to make sure that the PPE supply chain stays open.”

“Over the past seven months we’ve seen nursing home caregivers wrap themselves in garbage bags, reuse soiled masks, and clean up residents without gloves. They have risked their own lives, the health of their families, and watched residents and coworkers die, all because of a failed federal response that leaves our most vulnerable citizens and those who care for them unprotected far too often,” said Matthew Yarnell, President of SEIU Healthcare Pennsylvania, which represents of 45,000 healthcare workers across the state. “It’s not enough to call them ‘heroes’ – We need leaders who will make sure Essential Workers get the protections they need.”

“It’s unconscionable that Pennsylvania and the United States are dealing with severe PPE shortages at this point in the pandemic. It’s affecting everyone, including hospitals, businesses and schools,” said Emma Horst-Martz, PennPIRG Education Fund Advocate. “It’s even more appalling that this is how we treat our most vulnerable — our senior citizens and people recovering from a major surgery or illness.

“Among all of the gut-wrenching findings, I’m most shocked that the number of nursing homes out of PPE actually tripled between July and August. We can and must do better,” Horst-Martz said.

Horst-Martz added that experts believe PPE shortages have continued to get worse. One group, GetUsPPE, a grassroots movement founded by medical professionals on the COVID frontlines, said more facilities across all sectors were complaining of shortages in September. 

Medical experts believe the shortage of PPE is a key reason that outbreaks and deaths from COVID-19 are disproportionately high in nursing homes.This issue becomes even more urgent with talk of a herd immunity strategy that would allegedly safely cordon off nursing home residents and other at-risk populations while COVID tears through the rest of society. In reality, evidence suggests that until we have a vaccine, without a stronger adherence to spread-prevention practices that usually involve PPE, infection will likely run rampant.

PennPIRG is calling for a number of policy actions to improve the supply and transparency of PPE, including the federal government fully implementing the Defense Production Act so more PPE is available and sold at reasonable prices; congressional action to streamline the supply chain; and multi-state consortiums to reduce competition and stabilize prices. Pennsylvania has joined the Northeast seven state buying consortium led by Governor Cuomo. 

The PPE shortage is among the problems brought to light by the CMS data on nursing homes. We will explore various issues in a series of reports in the months ahead.

Find resources for consumers to find out if a nursing home is safe for their loved one on our site. 

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The PennPIRG Education Fund, the Pennsylvania Public Interest Research Group Education Fund, is a consumer group that stands up to powerful interests whenever they threaten our health and safety, our financial security, or our right to fully participate in our democratic society. PennPIRG is part of The Public Interest Network, which operates and supports organizations committed to a shared vision of a better world and a strategic approach to social change.