The state of the state in addressing COVID-19 epidemics yet to peak

Minnesota leads the nation in COVID-19 deaths in long term care facilities. It is the sole reason the state in recent weeks has exponentially increased the incidence of infection as the state eases its social distancing measures. The practice of transferring treated COVID+ patients from the acute hospital to skilled nursing in facilities that have not had a previously positive case is starting to get the attention of MN lawmakers.

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 step-down treatment for coronavirus patients who still need care, but have stabilized enough that they no longer require hospitalization, officials said.

The state’s effort to segregate such patients with respect to the demand side (skilled nursing facilites deemed as “COVID support centers”) upon discharge represents the most recent move adopted by MN to vet fecilities based upon their ability to render treatment in centralized sites, preserving appropriate manpower, care, and PPE to target resources amid a patient population that accounts for more than 2/3 of reported cases, having yet to reach a peak.

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 step-down treatment for coronavirus patients who still need care, but have stabilized enough that they no longer require hospitalization, officials said.

For now the onus on individual homes, or networks of facilities, to adopt standards regardless of their status. Relying on federal oversight – especially within this administration – to reach policy points to address subacute care in long-term care facilities in the wake of this pandemic is both futile and foolhardy.

Michael L. Douglas @doctorpundit

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