Report: More than 10% of Texas nursing homes have no N95 masks

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

TexPIRG Education Fund

AUSTIN– Hundreds of nursing homes across Texas 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 TexPIRG 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:

• In Texas, 12.7% of nursing homes had a critical shortage of N95 masks, of which 10.9% had none at all, higher than the national average

• 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 across the country 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.

“It’s unconscionable that Texas is dealing with severe PPE shortages at this point in the pandemic. It’s affecting everyone, including hospitals, businesses and schools,” said Bay Scoggin, TexPIRG Education Fund state director. “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,” Scoggin said.

Scoggin added that experts believe PPE shortages have continued to get worse. One group, Get Us PPE, a grassroots movement founded by medical professionals on the COVID frontlines, said facilities across all sectors, with the exception of acute care hospitals, were complaining of more severe shortages in September. 

“As the supply chain repaired itself to some degree over the summer, large hospital systems have been able to stock up on PPE in recent months,” says Dr. Shikha Gupta, Executive Director of Get Us PPE, “but smaller facilities, especially in under-resourced communities, are still unable to find affordable PPE. About a third of long term care facilities, which includes nursing homes and assisted living centers, that we spoke with between August and October reported having confirmed cases of COVID-19 and being completely out of at least one type of PPE.” 

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.

In the report, TexPIRG Education Fund calls 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.

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.