The Paramus Veterans Memorial Home in New Jersey has been among the hardest hit by the coronavirus pandemic, with more than two dozen deaths. (VA)

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WASHINGTON – The coronavirus has taken hold in long-term care facilities across the country and caused thousands of deaths – including state-run homes for aging veterans and their family members.

Veterans homes in 16 states had reported at least one case of the virus as of Tuesday, said Mark Bowman, president of the National Association of State Veterans Homes. The association, with 157 members, provides support for state veterans homes, which receive payments from the Department of Veterans Affairs based on the number of residents.

Bowman said it was hard to get a full accounting of the positive cases among residents and staff of veterans homes, which have proven to be ideal places for the virus to spread. While he’s asked members to alert him to cases in their facilities, Bowman believes some have not yet reported because they’re busy responding to crises.

“This thing is going so quick,” Bowman said. “When it strikes a state veterans home, their sole purpose is making sure residents are safe. Other communication doesn’t come as quick.”

At the Holyoke Soldiers’ Home in Massachusetts, 36 residents had died of the virus as of Tuesday. The state government and the U.S. Justice Department are investigating whether leadership failed in its response.

According to local news reports Wednesday, there were 45 positive cases of the coronavirus in two of Alabama’s four veterans homes, as well as two deaths. In New Jersey, the Paramus Veterans Memorial Home was overwhelmed with sick residents, and more than two dozen had died as of Tuesday.

National Guard members and medical staff from the Department of Veterans Affairs had been sent to help residents of veterans homes in multiple states, including Massachusetts and Rhode Island.

That’s just a snapshot of the coronavirus clusters in long-term care homes nationwide. The New York Times reported Tuesday that about 3,800 residents and employees at U.S. nursing homes had died – a likely undercount, the report said.

The Centers for Disease Control and Prevention issued special guidance for nursing homes. It advised restricting all visitors, canceling group activities and communal dining, and actively screen residents and employees for signs of the virus.

While state veterans homes are always prepared and stocked for an infectious outbreak, such as the flu, they never accounted for a pandemic of this magnitude, Bowman said.

Some veterans homes have reported shortages of personal protective equipment, he said. Through “town hall” meetings arranged by the National Association of State Veterans Homes, facility leaders have shared ideas. One home was using sanitizer made by a local distillery until they could get more through regular channels, Bowman said. Another was accepting donations of cloth masks made by local veterans organizations.

“Nobody saw the enormity of this,” he said. “While you think you’re prepared on PPE and stuff, this type of volume is a game-changer. That’s one of the biggest revelations – like, ‘OK, wow, we’ve really got to make sure that we have enough to take care of our veterans going forward.’”

In terms of keeping supplies stockpiled in the future, Bowman said, “I don’t think health care as we know it will ever be the same.”

Bowman, the executive director of the Kentucky VA, said there were no cases of the virus in the four veterans homes he oversees. His and other veterans homes across the country – regardless of whether they have found positive cases – have prohibited visitors, canceled group activities and dining, and implemented regular temperature checks on residents and employees, he said.

Most facilities have stopped admitting new residents. The lack of new residents, combined with the cost of protective gear and overtime pay, has come at a tremendous cost, Bowman said. The association was looking to states and the federal government for support.

“We’re working on different avenues to get financial assistance where possible to continue to get the PPE, provide overtime and get everything required for isolating residents,” Bowman said. “Unfortunately, this circumstance is going to have a huge cost.”

The payment rate from the VA increases every October to account for inflation. Early in the pandemic, the VA moved up the October increase to April, raising the per diem rate by nearly 3%, Bowman said.

For fiscal 2020, nursing homes received slightly more than $112 a day per veteran. That increased to about $115.

While it won’t mitigate the entire cost of the pandemic, Bowman said, the boost was an “immediate infusion of cash” that started going to facilities this month.

As states continue their stay-at-home orders and the number of Americans affected by the virus increases, it’s uncertain when states’ veterans homes may be able to admit new residents or relax their social distancing policies. It will likely be a very slow, cautious process, Bowman said.

For now, his association is planning a second town hall meeting to hear from some of the 16 states who have reported cases and are on the front line of the pandemic.

“To see everybody rise to the mission and come to the aid and support of each other during these difficult times makes you proud,” Bowman said. “We all want to get through it together and come out on the other side.”

Wentling.nikki@stripes.com Twitter: @nikkiwentling