State Changes Policy On Sending COVID-19 Patients To Nursing Homes - 27 East

State Changes Policy On Sending COVID-19 Patients To Nursing Homes

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The Hamptons Center for Rehabilitation and Nursing in Southampton Village.

The Hamptons Center for Rehabilitation and Nursing in Southampton Village.

authorMichael Wright on May 14, 2020

Hospitals will no longer be able to discharge a COVID-19 patient to a nursing home until the person tests negative for the coronavirus, Governor Andrew Cuomo announced this week, reversing a much-criticized policy that some have said contributed to the soaring death toll in the state’s nursing homes.

The governor, who has ordered an investigation of nursing homes where thousands have perished in the last eight weeks, also ordered that all nursing home staff now be tested for the coronavirus at least twice a week and reiterated the directive that nursing homes must be able to isolate coronavirus infected patients and the staff that care for them or discharge them to another facility.

“We’re just not going to send a person who is positive to a nursing home after a hospital visit — period,” the governor said on Sunday during a press conference in Albany.

The state’s death toll from the coronavirus epidemic approached 22,000 this week, more than 4,800 of whom have died in nursing homes.

In Suffolk County, the death toll is 1,654 in all and 719 in nursing homes. Of the 398 deaths from the disease recorded in Suffolk County in the last week, 88 were within nursing homes themselves.

The South Fork’s two nursing homes have now seen at least 32 patients and residents die as a result of the epidemic — the Westhampton Care Center this week reporting four additional deaths.

The state statistics that are being made public still only account for those residents who died at the nursing home itself and not those who were transferred to a hospital before dieing.

Neither facility has publicly blamed the spread of the coronavirus on patients brought in from hospitals, but the Hamptons Center for Rehabilitation and Nursing in Southampton has implied that patients transferred into the facility could have introduced it.

Administrators from the facility and the parent company that operates it did not respond to a request for comment this week.

But the families of residents at the Hamptons Center were told this week that there have been 31 total confirmed cases of COVID-19 among its residents and said that some patients were transferred to the facility already suffering from the virus.

“We want to inform you that, cumulatively, The Hamptons Center has 31 confirmed cases of COVID-19 in the facility,” a message sent to families on Saturday said. “This number includes residents who were admitted from the hospital with the virus. The majority of these residents are being isolated in one area of the facility away from the general population. On our dementia units, where we still have a handful of cases, we are endeavoring to maintain isolation in resident rooms and a separate day-room area to the best of our ability.”

The facility has reported 19 deaths, according to data the state has made public, five of whom were confirmed to have had the COVID-19 disease and 14 of whom were suspected of having it when they died. It is not known whether the facility is now testing all residents who are suspected of having a coronavirus infection.

The Westhampton Care Center has told families it has had at least 25 cases of coronavirus infections, and that while infections had been found in separate wings of the facility, they are all now confined to a single unit. The care center has reported 13 total deaths from COVID-19 to the state.

Early in the epidemic, the state had imposed a number of requirements on nursing home operators, including restricting visitation, requiring staff to wear protective garb when interacting with residents who have, or are suspected of having, the virus and requiring staff to have their temperature checked and be surveyed for other symptoms every 12 hours.

The state also issued a directive on March 27, however, that said nursing homes must accept patients who were confirmed to have the coronavirus but were no longer in need of specialized hospital care.

At the time, the state and hospital staff were laboring to expand the number of hospital beds available as the number of people in need of hospital care climbed by more than 1,000 per day. Hospitals and the Army Corps of Engineers were scrambling to create more bed space and many nursing homes were looked at as relief valves where patients without the most severe illnesses could be housed.

As the scale of the impact in nursing homes became apparent and horror stories about dozens of dead residents in some facilities spread, the governor clarified the state’s directive, saying that nursing homes were only required to accept patients if they could treat the patient safely and with proper protections for their staff and other residents. Mr. Cuomo and members of the state’s coronavirus response task force further clarified the policy, saying that all confirmed COVID-19 patients should be isolated from other patients and that staff members should not mix between rooms or units containing COVID-19 patients and those that did not.

Nursing home industry advocates have pushed back, saying that the dangerous seeds of the outbreaks that sparked or accelerated deaths in their facilities were foist upon them by the state, while they were left to fend for themselves in terms of securing protective equipment and other supplies.

The governor said late last month that the state had distributed more than 1 million face masks, gloves and gowns to nursing homes statewide. The state also agreed last week to partner with New Jersey in an effort to purchase more personal protective equipment for nursing homes.

Most nursing homes are privately owned, for-profit facilities and some have been accused of cutting corners with staffing and equipment that made the spread of the disease more likely. The governor has ordered that investigations be conducted to determine whether any operators shirked health and safety measures to avoid costs.

While the impact of the virus on nursing home facilities is a national problem, New York has the highest population of nursing home residents of any state in the country, with 101,518 residents in care facilities. Despite that, New York’s percentage of deaths in nursing homes is the 34th highest percentage of any state in the country.

Governor Cuomo said it is incumbent on nursing home providers to contact the Department of Health in the event they are unable to properly care for a resident, which has always been the case, he said, with the state able to transfer that resident and offer care at a facility that can offer treatment. This includes if a facility is unable to properly care for a COVID-19-positive patient with protective measures in place for all residents and staff of a facility.

Moving forward, Governor Cuomo said all nursing home staff must now be tested twice a week.

“That is not just a temperature check, that is a diagnostic test,” he said, noting the state has the tests available.

“That is a rule — it’s not an ‘I’d appreciate it if you did it. Remember, and I want nursing home operators to understand this, we have alternate facilities for nursing home patients, COVID or non-COVID,” said Governor Cuomo, noting New York created an additional 40,000 hospital beds in response to the virus outbreak.

“We are not reducing the number of hospital beds available,” he said.

Nursing home operators who do not follow these procedures, said the Governor, will lose their license.

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