By Chris Serres
 |
| Jeff Johnson and his mother, Kathy Johnson, are visiting their father, Michael Johnson, who is 71, at the North Ridge Health and Rehab nursing home in New Hope. The Johnsons are worried that North Ridge's policy of accepting COVID-19 |
Despite the devastating
death toll, Minnesota nursing homes are still being allowed by state
regulators to admit coronavirus patients who have been discharged from
hospitals.
Early
in the pandemic, the Minnesota Department of Health turned to nursing
homes and other long-term care facilities to relieve the burden on
hospitals that were at risk of being overwhelmed by COVID-19 patients.
Minnesota hospitals have since discharged dozens of infected patients to
nursing homes, including facilities that have undergone large and
deadly outbreaks of the disease, state records show.
Now
that practice is drawing strong opposition from some lawmakers,
residents’ families and health watchdogs, who warn that such transfers
endanger residents of senior homes that are understaffed and
ill-equipped to contain the spread of the coronavirus. They are calling
for more state scrutiny over transfers, including stricter standards
over which nursing homes should be allowed to accept COVID-19 patients
from hospitals.
Currently,
even poorly rated nursing homes with large and deadly clusters of
coronavirus cases have been allowed to admit COVID-19 patients from
hospitals. One such facility, North Ridge Health and Rehab in New Hope,
has accepted 42 patients from hospitals and other long-term care
facilities since mid-April even as the coronavirus has raged through its
320-bed nursing home, killing 48 of its patients and infecting scores
more.
“It
makes no sense to bring more COVID-19 patients into facilities that
have already failed to protect them,” said Sen. Karin Housley, the
Republican chairwoman of the Senate Family Care and Aging Committee. “If
it were my mom or dad in one of these facilities, I would be really
worried.”
State
health officials and long-term care industry representatives have
defended the practice of discharging some COVID-19 patients to nursing
homes, saying it is part of a broader strategy to conserve critical
hospital beds during the pandemic. Long-term care facilities can provide
treatment for coronavirus patients who still need care, but have
stabilized enough that they no longer require hospitalization, officials
said.
So
far, 11 facilities statewide have been designated as “COVID support
sites,” with separate units or wings to handle coronavirus patients.
These specialty sites have gone through a vetting process by the state
to ensure they have adequate staffing, supplies and infection-control
standards.
However,
other nursing homes have been allowed to admit COVID-19 patients under
private arrangements with hospitals. The practice is widespread. The
state Department of Health has reviewed the cases of about half the
patients hospitalized for COVID-19 statewide. The agency found that 27%,
or about 268 patients, were discharged to long-term care facilities
since the pandemic began.
“Hospital
beds are a key resource during this pandemic, and they must be
preserved for those who are in need of acute care,” the Minnesota
Department of Health said in a statement. “For COVID-19-positive
patients whose care requirements are below that level, the goal is to
get them out of the hospital and into an appropriate setting for their
next stage of care — one that can provide the services they do need
while minimizing the risk of transmission.”
But
the fear that moving coronavirus patients to nursing homes might
trigger more infections has been compounded by the alarming death toll
in such facilities.
Statewide,
the respiratory disease caused by the coronavirus has killed more than
600 Minnesotans at nursing homes and assisted-living facilities. That is
a staggering 81% of the deaths from the pandemic statewide. No other
state in the nation that reports such data has such a high percentage of
deaths in long-term care, according to an analysis
by a Texas-based nonprofit. Nationwide, outbreaks in long-term care
facilities have claimed 33,000 lives — more than a third of all deaths
nationwide, according to the Associated Press.
“To
be sending more contagious people into these settings is a serious
cause for concern,” said Rep. Jeremy Munson, R-Lake Crystal, a member of
the House Long-Term Care committee.
Jeff
Johnson of Maple Grove said his 71-year-old father has been a patient
at North Ridge since he suffered severe injuries in a car crash in
March. He was surprised when a staff member at the facility informed him
that COVID-19 patients were being admitted to the facility from area
hospitals. While his father remains symptom-free, Johnson said he is
concerned that staff might carry the virus from the newly admitted
patients.
“I
was absolutely shocked that [North Ridge] would risk exposing workers
and everyone else in a facility without asking for our input,” said
Johnson, a gymnastics instructor. “It seemed that we should have had
some say in the matter.”
Government
health records show that North Ridge has struggled in recent years to
adhere to basic standards of patient care. The facility has been fined
$117,000 by federal regulators and cited for dozens of health and safety
violations over the last three years. The nursing home earned just two
stars (“below average”) on the federal government’s five-star rating
system for overall care. The facility was also listed among the most-troubled nursing homes in the nation.
A
spokesman for North Ridge acknowledged that admitting patients with
COVID-19 has posed challenges, but said the facility has space and
enough trained caregivers to handle new admissions of COVID-19 patients.
Early in the pandemic, North Ridge set up separate units to isolate
COVID-19 patients from the rest of the clients and was able to provide
them with a full supply of protective equipment, he added.
“We
don’t regret caring for people in need for a second,” said Austin
Blilie, vice president of operations at North Ridge. “These are people
who are being turned away from other places that do not have the
capability to care for them.”
Although
there is no evidence that moving coronavirus patients to nursing homes
has caused infections to spread, the practice has come under increased
scrutiny nationwide. Officials in California and New York both ordered
nursing homes to accept coronavirus patients to help reduce potential
overcrowding in hospitals during the pandemic; but then both states
reversed those directives after an outcry from senior groups and the
medical community, according to news reports.
Already, one large Minnesota nursing home has suspended plans to take in coronavirus patients amid public opposition.
The
operator of Augustana Care Health and Rehabilitation in Apple Valley
had planned to create a separate, 28-bed unit for people recovering from
the virus, but pulled the plug in April after dozens of residents’
families and local officials voiced concerns in public Zoom calls.
Despite assurances that any new patients would be separated and cared
for by dedicated staff, many families expressed trepidation about
bringing COVID-19 into a facility that has not been infected, said Bob
Dahl, chief executive of Cassia, which operates the facility.
“We
thought it was a good idea from a public service perspective, but there
was significant pushback,” Dahl said. “What [families] couldn’t accept
was this idea of admitting someone with COVID when it was not in the
building, and why would we do that now? It was perfectly
understandable.”
Advocates
for nursing home residents and public health experts have argued that
facilities should not be allowed to decide on their own whether to admit
COVID-19 patients. And they want the homes to meet certain standards.
Facilities with low staffing levels and poor infection-control records
should be barred from accepting such patients, according to the Center
for Medicare Advocacy, a nonprofit legal assistance group for seniors in
Washington, D.C.
Across
the nation, there are examples of poor-performing nursing homes
accepting coronavirus patients with little or no oversight from state
regulators, said Toby Edelman, a senior attorney for the Center for
Medicare Advocacy. Some of these facilities have a one-star rating of
“much below average” from the government for staffing levels and quality
of care, Edelman said. “Without some minimum standards, this is a
recipe for disaster,” she said.
Joseph
Gaugler, a professor of long-term care and aging in the University of
Minnesota’s School of Public Health, said nursing homes should be
required to establish certain safeguards before accepting COVID-19
patients. These include demonstrating that they can isolate infected
residents, maintaining regular testing, and have a staffing plan to
handle an influx of new patients with the virus.
Full Article & Source:
Minnesota nursing homes, already the site of 81% of COVID-19 deaths, continue taking in infected patients
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