Monday, May 25, 2020

70% of Pennsylvania’s Covid-19 deaths occurred in nursing homes, 80% in the state’s southeast counties. Nursing homes aren’t hospitals yet Pennsylvania mandated that virus-free nursing homes accept patients with active Covid-19

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Pennsylvania is among six states…where deaths in long-term care facilities account for more than half of overall coronavirus deaths.” On March 18, Pennsylvania Health Sec. ordered nursing homes to accept new patients, which may include “patients who have had the COVID-19 virus.”...On March 29, 2020, Pennsylvania Gov. Wolf ordered nursing homes to admit patients with active, contagious Covid-19. …In the hardest hit southeastern part of Pennsylvania, “long-term care residents account for as much as 80% of county deaths.” 

May 19, 2020, “Some central Pa. nursing homes plagued by COVID-19 infections and deaths, new data shows,” PennLive.com, David Wenner 

About 70% percent of COVID-19 deaths in Pennsylvania have involved residents of long-term care facilities, comprised largely of nursing homes and personal care homes.

The Pennsylvania Department of Health has faced criticism over its handling of the outbreaks, with critics saying the state should have done more to control outbreaks and protect residents, who are highly vulnerable because of their age and pre-existing health problems. 

“We have continued to do everything we can to help those facilities,” state Secretary of Health Dr. Rachel Levine said Tuesday....

She further said federal teams recently arrived in the state to help nursing homes deal with outbreaks, and the National Guard has been deployed to help at some homes…. 

Nursing home industry officials in Pennsylvania said homes are struggling against obstacles including staff shortages and shortages of protective equipment and coronavirus tests that interfere with their ability to prevent spread of infection.”…
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Added: Forcing contagious persons into virus-free nursing homes “was ordered “to alleviate the [alleged] increasing burden in the acute care settings,” according to the directive. But hospitals in most counties were never overwhelmed with coronavirus patients.” 

May 1, 2020, States ordered nursing homes to take COVID-19 residents. Thousands died. How it happened,” Bucks County Courier,” 

“Coronavirus has spread like wildfire through many nursing homes across the Northeast, and state officials are scrambling to better protect those most vulnerable. Yet the death toll has been devastating. 

On March 29, [2020] as Pennsylvania, New York and other states began ordering nursing homes to admit medically stable residents infected with the coronavirus, national trade groups warned it could unnecessarily cost more lives. 

The health directives put “frail and older adults who reside in nursing homes at risk” and would “result in more people going to the hospital and more deaths,” the American Health Care Association and affiliates said at the time. 

A month later, it appears government officials should have heeded the dire call to pursue different pandemic emergency plans… 

The death toll is devastating, according to interviews with nursing-home officials, patients’ families, health-care advocates, government officials and from an examination of state records by the USA Today Network Atlantic Group, a consortium of 37 Gannett-owned daily newspapers across the Northeast…. 

In Pennsylvania, about 65% of coronavirus deaths were nursing-home residents, and in counties in the hardest hit southeastern part of the state, long-term care residents account for as much as 80% of county deaths. 

New Jersey had 3,200 residents of long-term care homes die due to complications from the virus, about 40% of the statewide total. 

About 58% of the deaths in Delaware lived in nursing homes, and 46% of the fatalities in Maryland were at nursing homes, prompting Gov. Larry Hogan to order residents and staff members at nursing homes be tested for coronavirus…. 

“To have a mandate that nursing homes accept COVID-19 patients has put many people in grave danger, said Richard Mollot, executive director of the Long Term Care Community Coalition in New York…. 

Pennsylvania’s Department of Health has not updated its [mandate that nursing homes must accept contagious virus patients] guidance regarding nursing home admission [as of May 1]. 

Yet efforts have come too late for some family members, many of whom complained of being kept in the dark about risks at nursing homes since visitors were banned in March to combat the virus…. 

Central to the nursing home crisis was the early focus on preventing coronavirus patients from overwhelming hospitals…. 

On March 18, Pennsylvania Health Secretary Dr. Rachel Levine directed licensed long-term care facilities to continue admitting new patients, including those discharged from hospitals.“This may include stable patients who have had the COVID-19 virus,” according to a copy of the guidelines. 

Continued admissions was ordered “to alleviate the increasing burden in the acute care settings,” according to the directive. But hospitals in most counties were never overwhelmed with coronavirus patients…. 

On Friday, a state health spokeswoman said the department is reviewing its guidance for long-term care facilities to see if it needed to be updated…. 

Pennsylvania is among six states reporting long-term care infection data where deaths in long-term care facilities account for more than half of overall coronavirus deaths, according to the Kaiser Family Foundation, a national nonprofit that focuses on health care issues. 

On March 31, the New Jersey Department of Health told the state’s long-term care facilities that they could not deny admission or re-admission based on a confirmed diagnosis of COVID-19…. 

What we were encountering was that a resident would go to the hospital, be treated, recover, and (the nursing home) would not accept the resident back,” [New Jersey’s Health Commissioner Judith] Persichilli said at the time…. 

Persichilli on April 13 clarified that the state allowed for re-admission of suspected COVID-19 patients only if they could be placed in isolation…. 

Nursing home leaders contend state and federal officials have failed to provide adequate resources and guidance during the pandemic.

From insufficient coronavirus testing and personal protective equipment shortages, they said the dereliction of duty helped ignite and fuel the outbreak in nursing homes. 

“Frankly, I think we’ve been neglected, and we’re still neglected,” said Dr. Elaine Healy, vice president of the New York Medical Directors Association. 

“When the focus started being put on us through the efforts of the press, the response has been to sort of look at us in a negative way,” she said, citing New York authorities launching investigations into COVID-19 deaths at nursing homes…. 

Strikingly, Italian officials issued similar orders for nursing homes to admit coronavirus patients on March 8, a move under investigation by authorities for contributing to potentially preventable deaths, according to the Associated Press. 

Despite push back on state decisions to send infected patients into nursing homes, some administrators say there was no other option. [What about placing the infected patients in a third location, for example, in one of many vacant public schools?] Some experts have called on New York to pursue COVID-19 only facilities for infected nursing home residents, such as those in New Jersey, Massachusetts and Connecticut. 

Cuomo this week said some hospitals are designated as COVID-19 only, but the state has not released any details on them…. 

In Maryland, Gov. Larry Hogan enacted an executive order on Wednesday requiring universal testing of all residents and staff at Maryland nursing homes, regardless of whether they are symptomatic…. 

Impacted facilities are also required to provide regular updates to their residents, resident representatives and staff regarding COVID-19 infections, a measure that New York officials required this month amid calls for improved transparency. 

Under the executive order, any nursing home staff who test positive will be immediately discharged into isolation. It will also be mandatory for facilities to cooperate with strike teams deployed by the state…. 

Meanwhile, New York on Wednesday revised guidelines preventing COVID-19 positive nursing home employees who are asymptomatic from returning to work for 14 days from the first positive test date. 

Previously, the workers could return in seven days based on Centers for Disease Control and Prevention guidance, according to a letter issued by the health commissioner.”…
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Comment: Nursing homes aren’t hospitals. Their patients don’t “recover.” The only way “beds” become “available” in nursing homes is if someone dies. Frail elderly persons with, for example, dementia, pay to live in nursing homes not because they need a hospital, but because they need a safe environment with 24 hour supervision. How is it not premeditated murder to force nursing homes to accept active Covid-19 persons?




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