To help Californians and state policymakers understand evolving demands on the state’s health care system during the COVID-19 pandemic, CHCF is working with survey firms on two fronts. CHCF and global survey firm Ipsos are assessing residents’ desire for COVID-19 testing and their access to health care services. CHCF and Truth on Call, a physician market-research firm, are surveying different types of health care providers about availability of testing, personal protective equipment, and their experience in California’s health care delivery system. Download the charts and data for your own presentations and analyses.

July 16, 2020 — Seventy-six percent of certified nurse assistants and other frontline employees at California skilled nursing facilities say they have had known or suspected COVID-19 cases among staff at their facility, according to a statewide survey from CHCF and Truth on Call. These numbers are higher in facilities located in Los Angeles County and in those with a majority of residents who are Black or Latino.

The survey, conducted June 5–July 12, 2020, among 353 employees at California skilled nursing facilities, included 285 certified nurse assistants, who typically perform the most patient care tasks in nursing homes. Other survey participants included people in food service, janitorial staff, housekeeping, and laundry. Questions were asked either in English or Spanish. SEIU Local 2015, which represents long-term care workers, sent the poll to its 20,000 members employed by skilled nursing facilities on behalf of CHCF and Truth on Call.

Eighty-nine percent of respondents in Los Angeles County report known or suspected cases among staff. Sixty-nine percent of people who work at a California nursing home outside Los Angeles County report staff cases of COVID-19. These findings are consistent with data reported by the California Department of Public Health (CDPH). In addition, 81% of those who say they work in facilities with a large proportion of Black and Latino residents report known or suspected cases among staff.

Sixty percent of respondents statewide say their facility has had known or suspected COVID-19 cases among residents. Among those working in Los Angeles County, 76% report infections among their facility’s residents compared to 50% of those who work elsewhere in California. Again, this is consistent with the CDPH data.

Sixty-six percent of those who work in facilities with half or more Black or Latino residents report cases among residents compared to 50% of respondents where less than half of residents are Black or Latino. These poll findings are in line with other data showing that the disease is having a disproportionate impact on people who are Black or Latino. These higher rates of COVID-19 are occurring despite the fact that Black and Latino Californians report compliance with prevention measures — like wearing masks, handwashing, and social distancing — at above-average rates.

Nearly half — 47% — of those surveyed say they think that COVID-19 is spreading among residents and staff at their facility. The rate is slightly higher for those who work in Los Angeles County, where 54% believe COVID-19 is spreading at their facility compared to 42% of those who work at a nursing home elsewhere in California.

More than 9 in 10 respondents are worried about contracting the disease while working, with 51% “extremely concerned,”28% “very concerned,” and 14% “somewhat concerned.” The rate of concern is similar whether respondents worked in Los Angeles County or elsewhere in the state. Fifty-five percent of respondents in facilities where half or more residents are Black or Latino report being extremely concerned about contracting the virus while working, compared to 45% of those in facilities where less than half the residents are Black or Latino.

More than 8 in 10 respondents say both patients and staff are being tested for COVID-19 when needed at least “most of the time.” Eighty-two percent of respondents reported residents were generally tested as needed compared to 85% who said staff were generally tested as needed.

While 77% report adequate personal protective equipment (PPE) at their facility, 23% say PPE is not adequate. There are not substantial differences in PPE availability by geography or facility demographics.

A key strategy to containing a COVID-19 outbreak in a nursing home is to quarantine residents who may have been exposed and to “cohort,” or group together, those who have the illness. When asked if their facility could quarantine or cohort residents, 88% say their facility has that capability.

Nearly three in four respondents (74%) say they are “very confident” or “somewhat confident” in their employer’s ability to respond to current or future COVID-19 infections among residents or staff, while one in four say they are not confident.

Methodology: This survey was conducted online with Truth on Call, a health care market research firm. The study consisted of 353 employees at California skilled nursing facilities. Truth on Call is a division of Slingshot Insights. Responses were collected June 5–July 12, 2020. SEIU Local 2015 assisted in this survey by soliciting responses over email from its membership who work in California skilled nursing facilities.

Kristof Stremikis

Kristof Stremikis is director of CHCF’s Market Analysis and Insight team, which promotes greater transparency and accountability in California’s health care system. Read More

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