California, New Jersey and New York have made nursing homes accept Covid-19 patients from hospitals. Residents and workers fear the policy is risking lives.
Neal Nibur has lived in a nursing home for about a year, ever since he had a bad bout of pneumonia. Now, the 80-year-old man has not only his own health to worry about but that of his neighbors at the Poughkeepsie, N.Y., residence. Four new patients recently arrived from the hospital with Covid-19.
They were admitted for one reason, according to staff members: A state guideline says nursing homes cannot refuse to take patients from hospitals solely because they have the coronavirus.
“I don’t like them playing Russian roulette with my life,” said Mr. Nibur, who is on oxygen. “It’s putting us at risk. I am 80 years old with underlying problems. Everybody here has an underlying problem.”
The disease caused by the virus has killed more than 10,500 residents and staff members at nursing homes and long-term care facilities nationwide, according to a New York Times analysis. That is nearly a quarter of deaths in the United States from the pandemic. On Saturday, Gov. Andrew M. Cuomo of New York described nursing homes as a “feeding frenzy for this virus.”
But states are increasingly turning to nursing homes to relieve the burden on hospitals and take in Covid-19 patients considered stable enough to be released. Although there is no evidence so far that the practice has allowed infections to spread in nursing homes, many residents and advocates fear that it is only a matter of time. One lawsuit in New Jersey alleges that a worker was likely to have been sickened by a Covid-19 patient readmitted from a hospital.
At the epicenter of the outbreak, New York issued a strict new rule last month: Nursing homes must readmit residents sent to hospitals with the coronavirus and accept new patients as long as they are deemed “medically stable.” California and New Jersey have also said that nursing homes should take in such patients. Homes are allowed to turn patients away if they claim they can’t care for them safely — but administrators say they worry that refusing patients could provoke regulatory scrutiny, and advocates say it could result in a loss of revenue.
In contrast to these states, Connecticut and Massachusetts designated certain facilities for Covid-19 patients alone — considered the safest way to free up hospital beds. The Washington Health Care Association, which represents long-term care facilities in Washington State, has asked officials to adopt a similar policy; so far, they have not.
“It’s got to happen,” said Robin Dale, the association’s president. “Then we would not have this hodgepodge of every nursing home in the state having one or two positives and crossing your fingers that it works out.”
Beth Martino, spokeswoman for the American Health Care Association, which represents nursing homes and assisted-living facilities, said her association had heard that a number of states were considering measures similar to those in California, New Jersey and New York. But many others haven’t offered any guidance on the matter.
The fears that moving coronavirus patients to nursing homes might spark outbreaks is compounded by the lack of protective equipment at many facilities, as well as shortages in staffing, requiring workers to interact with more patients. And not all hospitals are testing to check whether stable patients are still infectious before releasing them.
In a national survey released on Thursday of almost 9,000 nursing homes, fewer than 10 percent said they were able to take in new Covid-19 patients from hospitals. The survey was done by CarePort Health, a company that works with hospitals to manage the release of patients to long-term care facilities.
Jay Lawrence, spokesman for the Grand Healthcare System, which has 17 homes in New York, including the one in Poughkeepsie, said the company was doing everything possible to meet state needs and keep residents safe. He said the virus had not spread from those initial four patients in Poughkeepsie to anyone else in the building.
Still, “with Covid being everywhere, it’s a very fluid situation,” he said. “People are trying to be as vigilant as they can. No one knows where and how this is going to rear its ugly head.”
The New Jersey lawsuit, filed on Wednesday against Alaris Health at Hamilton Park in Jersey City by a former nurse, alleges that another employee, a certified nursing assistant, was probably exposed to the virus from a patient readmitted from a hospital.
The assistant was not given protective equipment and not properly isolated while treating the patient, according to the lawsuit. It also said that workers and residents were not told about the patient’s Covid-19 diagnosis. The patient died around March 29, the lawsuit said. Cheryl Roberts, the nursing assistant, was put on a ventilator and died on April 5, said her brother, Darryl Roberts.
Kim Barker and Amy Julia Harris – New York Times – April 24, 2020.
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