The Corner

Politics & Policy

Bad State Decisions about Nursing Homes Are Heavily Driving the Coronavirus Outbreak

(Thilo Schmuelgen/Reuters)

Coronavirus outbreaks in nursing homes have been particularly deadly in California, Illinois, Michigan, Pennsylvania, New Jersey, and New York.

You could make a strong argument that the country’s deadly coronavirus problem is largely a nursing home problem, dangerous everywhere but far more prevalent in a half-dozen or so of the country’s more heavily and densely populated states. What’s more, many of these states enacted coronavirus response policies that likely put nursing and assisted-living home residents at higher risk for infection.

Notice the California policy described by the San Jose Mercury News:

Even as senior care centers have been particularly hard hit by the coronavirus — with patient and staff deaths accounting for nearly 40 percent of all COVID-19 deaths across California — the state is calling on assisted living facilities to house infected patients in exchange for money.

A letter from the state Department of Social Services sent to licensees of senior and adult care residential facilities on Friday urged them to temporarily take in patients who have tested positive for the virus — for up to $1,000 a day — to make room in hospitals for people who become critically ill and require acute care.

But health experts and advocates say the plan risks introducing the virus into facilities that have been spared or those already dealing with their own outbreaks.

That need continues to grow. As of May 3, nearly 10,000 patients and staff in long-term care facilities in the state of California have tested positive for the virus, and 926 of them have died, according to figures released by DSS, which oversees assisted living, and the California Department of Public Health.

Notice the complaints described by Health News Illinois: “The Illinois Health Care Association and the Health Care Council of Illinois, the state’s two largest nursing home associations, say they have been asking for more testing for weeks. And that personal protective equipment has been hit or miss across facilities, with some operating on a day-to-day supply.”

Chicago’s WGN reports, “More than 40 percent of COVID-19 deaths in Illinois have been at nursing homes and long-term care facilities” — more than 1,000 lives.

Notice the Michigan policy described by Detroit’s WXYZ:

A Sterling Heights senior care center saw a spike in COVID-19 cases among residents after accepting two dozen positive patients recently discharged from area hospitals.

The move followed an executive order by the Governor outlining rules for treating COVID-19 patients at long-term care facilities after they were discharged from hospitals. Patients would be isolated, the order required, and staff were required to wear appropriate personal protection equipment.

And by Bridge Michigan:

Despite promises from Gov. Gretchen Whitmer for better transparency on senior care during the pandemic, Wilson’s mother lives in an assisted-living facility — and Michigan doesn’t collect information about coronavirus at the home or 4,000 others like it statewide.

Notice the Pennsylvania policy described by the Morning Call of Allentown:

The escalating tragedy in Pennsylvania nursing and personal care homes, which have more than two-thirds of the state’s coronavirus deaths, has prompted lawmakers to point fingers at the Wolf administration.

“There is no excuse for what is going on, OK?” said Chester County state Sen. Andrew Dinniman, who like Gov. Tom Wolf is a Democrat. “The Department of Health has failed our nursing homes.”

A total of 3,416 coronavirus deaths has been reported statewide through Thursday. Of those, 2,355, or nearly 69%, were associated with nursing or personal care homes.

But about 80% of deaths newly reported by the state Thursday ― 247 out of 310 ― were at the facilities. In the Lehigh Valley, the state reported 177 deaths in such facilities, with 77 in Lehigh County and 100 in Northampton County. The region has seen 263 deaths overall.

This week, the nursing homes operated by Lehigh and Northampton counties, Cedarbrook and Gracedale, respectively, both reported sharp increases in deaths.

Health Secretary Dr. Rachel Levine, testifying Thursday before two Senate committees, said the state focused its response in the early days of the Pennsylvania crisis on hospitals because it wanted to be prepared for a potential surge of patients.

Notice the New Jersey policy described by InsiderNJ:

Senator Joe Pennacchio has obtained a letter sent by the New Jersey Department of Health dated March 31 directing hospitals and nursing care facilities not to inhibit transfer of hospital patients with COVID-19 entering post-acute care settings such as long-term nursing and rehabilitations facilities.

The letter also states “post-acute care facilities are prohibited from requiring a hospitalized patient/resident who is determined medically stable to be tested for COVID-19 prior to admission or readmission.

“New Jersey has continually cited testing as a way to identify and respond to COVID-19.  Therefore, it doesn’t make sense that we would specifically not want to test patients who would enter isolated nursing homes containing our most vulnerable population,” said Pennacchio (R-Morris, Essex, Passaic).

“The State of New Jersey has direct regulatory oversight over these nursing facilities.  Although the population of nursing homes makes up less than 0.7% of the Garden State’s population, the 4,151 deaths in these facilities accounts for half of all New Jersey’s COVID-19 deaths,” concluded Senator Pennacchio.

Notice the New York state policy described by the New York Post:

The new Health Department info released late Monday adds 1,700 presumed coronavirus deaths to the grim total, suggesting that COVID-19 complications have killed 4,813 residents of nursing homes and adult-care facilities — and that doesn’t include those who died in hospitals.

Cuomo downplayed the count Tuesday: “I would take all of these numbers now with a grain of salt,” since “what does a ‘presumed death’ mean, right?”

So why on earth did his health commissioner, Howard Zucker, force nursing homes to take in virus-positive patients starting March 25?

The Post contrasted New York’s policies with those of Florida:

No Sunshine State patient can be discharged from a hospital into a nursing home without a negative test result. Florida hospitals had already refused to send coronavirus-positive patients back; the new rule means even those who show no symptoms must be tested and confirmed negative.

A defensive Cuomo on Tuesday claimed the state had done “everything you can” to keep the coronavirus from spreading among New York’s seniors. But that’s just not true.

Right now, a lot of people really want to believe that as bad as the coronavirus outbreak is, the consequences have been mitigated by good decisions made by governors like Gavin Newsom, J. D. Pritzker, Gretchen Whitmer, Tom Wolf, Phil Murphy, and Andrew Cuomo. But those governors, whatever their other strengths, all presided over state governments that served their nursing homes and assisted living facilities poorly — either through an inability to provide protective equipment (Illinois), insufficient attention (Pennsylvania), or by sending recovering but still contagious patients back into buildings with lots of other vulnerable elderly (California, Michigan, New Jersey, and New York).

The national media have paid copious amounts of attention to the risk of spreading the coronavirus in places like the beaches of Florida and the reopening of businesses in Georgia. A refocus of the national media’s attention and criticism upon the nursing homes in states like California, Illinois, Michigan, Pennsylvania, New Jersey and New York is long overdue. A lot of people have relished accusing the anti-lockdown protesters of “killing grandma.” It is time we took a more serious look at what lawmakers’ decisions led most directly to the deaths of so many grandmothers and grandfathers.

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