Blame governors for the coronavirus deaths in nursing homes: Goodwin

[Dashinka 23,405]

Blame governors for the coronavirus deaths in nursing homes: Goodwin

By Michael Goodwin

The states with the most nursing-home deaths, New York and New Jersey, didn’t make the list because of so many other deaths, yet more than 10,000 people died in their facilities. The 5,500 nursing-home deaths in New York are more than the total deaths in all other states except New Jersey

Many if not most could have been avoided. The earlier outbreaks in Asia and Europe demonstrated that the elderly were easy prey for the virus, doubly so when they have underlying health conditions. Everybody knew that.

Florida got the message and implemented a model response. Despite its vast enclaves of long-term care homes, it reported ­under 750 deaths in them, or slightly more than one for each of its 615 facilities.

The striking contrast between Florida on one hand and New York and New Jersey on the other can be traced largely to policy decisions by their governors. Gov. ­Andrew Cuomo of New York and Gov. Phil Murphy of New Jersey issued almost identical orders in late March requiring nursing homes to accept COVID-19 patients being discharged from hospitals. The orders barred the homes from even asking if the patients had the virus, lest they be discriminated against.

 

https://nypost.com/2020/05/16/blame-governors-for-coronavirus-deaths-in-nursing-homes-goodwin/

[yuna628 9,547]

In MD the majority of cases in nursing homes started because a relative, but most commonly an employee brought the virus in. The employees were working sick, policies of neglect continued, and those actions killed hundreds of our vulnerable. Some nursing homes took it upon themselves to secretly move infected individuals back into the facility against government orders.

 

Ultimately it will be that same reason that will cause our family friend to die. Two infected workers have now spread it to several other patients that are near death, but the home itself refused to send some of these people to the hospital when the situation became out of their control because that would admit they had a problem. These people should be strung up. I do not think it will be long now for our friend...

[Dashinka 23,405]

1 hour ago, yuna628 said:

In MD the majority of cases in nursing homes started because a relative, but most commonly an employee brought the virus in. The employees were working sick, policies of neglect continued, and those actions killed hundreds of our vulnerable. Some nursing homes took it upon themselves to secretly move infected individuals back into the facility against government orders.

 

Ultimately it will be that same reason that will cause our family friend to die. Two infected workers have now spread it to several other patients that are near death, but the home itself refused to send some of these people to the hospital when the situation became out of their control because that would admit they had a problem. These people should be strung up. I do not think it will be long now for our friend...

I agree, workers are probably the major route of spreading in a nursing home, but these workers could have caught it by one of the positive patients that were sent back at least in NY and NJ.  Our governor here in MI has a similar policy.

[90DayFinancier 910]

15 minutes ago, Dashinka said:

I agree, workers are probably the major route of spreading in a nursing home, but these workers could have caught it by one of the positive patients that were sent back at least in NY and NJ.  Our governor here in MI has a similar policy.

More than a few facilities, including the Lifecare center in Kirkland, WA, did not follow standard protocols that are required by law. The governor's did not discharge patients, doctors did. 

You can pin governor's and feds for flubbing the availability of tests, PPE, ventilators, but the protocols in place for the flu and Norovirus must be followed.

 

[yuna628 9,547]

17 minutes ago, 90DayFinancier said:

More than a few facilities, including the Lifecare center in Kirkland, WA, did not follow standard protocols that are required by law. The governor's did not discharge patients, doctors did. 

You can pin governor's and feds for flubbing the availability of tests, PPE, ventilators, but the protocols in place for the flu and Norovirus must be followed.

 

To be fair NY law states that a nursing home cannot refuse to accept a CV+ patient as long as 1) they follow guidelines and 2) they have the ability to provide care. In truth these policies exist to take the pressure off of hospitals that are always eager to dump patients out of a hospital on a good day, and they are desperate for room for the very sickest. From experience my dad was dumped out of the hospital far too early before specialists could see him this time because they had none available. They could have let him stay a while until they had time, but time is money, and taking up space needed.

 

What's not clear in some of these 'fearful' articles discussing patients being returned to nursing homes - are they 'recovered' patients with negative test results and simply needing long term care for the damage it's done to their body? The nursing home can reserve the right to refuse them under the claim 'they can't provide safe care', but of course why would a nursing home do that? Money. Clearly nursing homes are happy to let patients die and take the $s. The best practice should be to locate specific excellent facilities that would care for CV+ patients ONLY. I saw one hospital the other day announcing with joy they were discharging their 1000th? patient. The poor man weakly waved on his stretcher to the cameras, with a tube still connected to his throat. Stable to be discharged and fully recovered I wondered? Looks like they will need very long term care. All of this is not a product of fault of the governor's per say, but another product of a outdated and overworked health system. In the UK it's worse. They were dumping near death patients back in, or the patients were being left to die in the nursing home, never given an opportunity to get to a hospital.

 

The reality is: where are we to put these patients if there is no room? Not a single nursing home or even the VA has coped. I'm not just meaning the people actively sick but the ones that will need long term care afterwards.

Edited May 19, 2020 by yuna628

[Dashinka 23,405]

41 minutes ago, 90DayFinancier said:

More than a few facilities, including the Lifecare center in Kirkland, WA, did not follow standard protocols that are required by law. The governor's did not discharge patients, doctors did. 

You can pin governor's and feds for flubbing the availability of tests, PPE, ventilators, but the protocols in place for the flu and Norovirus must be followed.

 

I believed nursing homes are licensed by the states.

[TBoneTX 43,508]

1 hour ago, Dashinka said:

Our governor here in MI

Comrade Half-Whitmer.

[90DayFinancier 910]

1 hour ago, Dashinka said:

I believed nursing homes are licensed by the states.

And as such, they need to comply with the rules.

[Dashinka 23,405]

34 minutes ago, 90DayFinancier said:

And as such, they need to comply with the rules.

Assuming the rules make sense.

[90DayFinancier 910]

9 hours ago, Dashinka said:

Assuming the rules make sense.

Which rules don't make sense? This is not Covid-19 specific. Handling influenza and Norovirus has established protocols. Using Those same rules would have reduced caregiver to resident transmission, residents would be restricted to their rooms and EMTs who make multiple visits daily for resident care.

[Just Paul 4,591]

 

 

 

 

 

 

 

TLDR alert!

 

So here's my take.  Mary is a caregiver in a 4 unit facility with about 80 residents.  We ended up positive and unlike almost every facility in Arizona they put that "An Employee" tested positive on their website, notified all the patients and families.  At the time there was only one other facility that had any but quite a significant larger number of residents that also had higher infection and mortality rate.  Her facility was good at keeping their stakeholders updated and even updated their social media.

 

AARP wanted the governor to mandate public reporting and ultimately that never occured.  

 

By the time of the infection they had already contained each unit and really stepped up their cleaning.  Granted I wished they had done it sooner but at the time the state wasn't really advising staff and the limited outside care providers to be temperature checked, or anything else, and relied on self reporting. I'm totally with @90DayFinancier that the reporting should have be no different then the Flu or Norovirus.  The only thing I can tell is that they did report it to the county and maybe it went to the state that didn't do anything with it regarding the infection.

 

Mary's unit is "Memory Care" and mostly hospice needs.  3 other workers ended up positive. There were 13 patients, most tested positive, many were asymptomatic. 3 or 4 passed away over a 4 week period which about 1 more than a similar pre COVID19 period.  Last week marked two weeks with no new infections and yesterday they got to reduce some of the room isolation drapes and stopped requiring some of the PPE requirements.  There is still isolation between the units and sequestration of the staff, no outside visitors or events.   I think that the external accountability the company showed the openness that should have been shown by the other facilities and the state.   She got offers to move to other companies for almost double what she makes.  She passed since she is starting a nursing program June 1st and loves her residents.  The extra semi-monthly paycheck the company gave her unannounced went far.  Wished we had know that before she used up all of her sick and vacation time!  72 hours after being clear she was back at work and getting about 3 extra shifts a week to keep the number of employees in the unit down. For June and July hopefully will just work 3 or 4 eight hours shifts

 

SMH - I, on the other hand am immunocompromised, self quarantined since mid March and ended up in the ER twice. Last 3 days she made as much as I usually do, but I won't have billings like that now for a long time.

[Dashinka 23,405]

5 hours ago, 90DayFinancier said:

Which rules don't make sense? This is not Covid-19 specific. Handling influenza and Norovirus has established protocols. Using Those same rules would have reduced caregiver to resident transmission, residents would be restricted to their rooms and EMTs who make multiple visits daily for resident care.

Putting Covid positive people back into the most vulnerable populations when there is space available in more controlled environments.

[90DayFinancier 910]

6 hours ago, Paul & Mary said:

 

 

 

 

 

 

 

TLDR alert!

 

So here's my take.  Mary is a caregiver in a 4 unit facility with about 80 residents.  We ended up positive and unlike almost every facility in Arizona they put that "An Employee" tested positive on their website, notified all the patients and families.  At the time there was only one other facility that had any but quite a significant larger number of residents that also had higher infection and mortality rate.  Her facility was good at keeping their stakeholders updated and even updated their social media.

 

AARP wanted the governor to mandate public reporting and ultimately that never occured.  

 

By the time of the infection they had already contained each unit and really stepped up their cleaning.  Granted I wished they had done it sooner but at the time the state wasn't really advising staff and the limited outside care providers to be temperature checked, or anything else, and relied on self reporting. I'm totally with @90DayFinancier that the reporting should have be no different then the Flu or Norovirus.  The only thing I can tell is that they did report it to the county and maybe it went to the state that didn't do anything with it regarding the infection.

 

Mary's unit is "Memory Care" and mostly hospice needs.  3 other workers ended up positive. There were 13 patients, most tested positive, many were asymptomatic. 3 or 4 passed away over a 4 week period which about 1 more than a similar pre COVID19 period.  Last week marked two weeks with no new infections and yesterday they got to reduce some of the room isolation drapes and stopped requiring some of the PPE requirements.  There is still isolation between the units and sequestration of the staff, no outside visitors or events.   I think that the external accountability the company showed the openness that should have been shown by the other facilities and the state.   She got offers to move to other companies for almost double what she makes.  She passed since she is starting a nursing program June 1st and loves her residents.  The extra semi-monthly paycheck the company gave her unannounced went far.  Wished we had know that before she used up all of her sick and vacation time!  72 hours after being clear she was back at work and getting about 3 extra shifts a week to keep the number of employees in the unit down. For June and July hopefully will just work 3 or 4 eight hours shifts

 

SMH - I, on the other hand am immunocompromised, self quarantined since mid March and ended up in the ER twice. Last 3 days she made as much as I usually do, but I won't have billings like that now for a long time.

I am sorry this disease has touched you and your family. I pray you experience a full and (too late for speedy) timely recovery.

If it is any help, I think society will be looking hard at how we support and pay those who care for our parents and children after this.

 

[90DayFinancier 910]

2 hours ago, Dashinka said:

Putting Covid positive people back into the most vulnerable populations when there is space available in more controlled environments.

Which rule does that? We were talking about the rules licensed facilities have to comply with in all cases.

[yuna628 9,547]

8 hours ago, Paul & Mary said:

 

TLDR alert!

 

So here's my take.  Mary is a caregiver in a 4 unit facility with about 80 residents.  We ended up positive and unlike almost every facility in Arizona they put that "An Employee" tested positive on their website, notified all the patients and families.  At the time there was only one other facility that had any but quite a significant larger number of residents that also had higher infection and mortality rate.  Her facility was good at keeping their stakeholders updated and even updated their social media.

 

AARP wanted the governor to mandate public reporting and ultimately that never occured.  

 

By the time of the infection they had already contained each unit and really stepped up their cleaning.  Granted I wished they had done it sooner but at the time the state wasn't really advising staff and the limited outside care providers to be temperature checked, or anything else, and relied on self reporting. I'm totally with @90DayFinancier that the reporting should have be no different then the Flu or Norovirus.  The only thing I can tell is that they did report it to the county and maybe it went to the state that didn't do anything with it regarding the infection.

 

Mary's unit is "Memory Care" and mostly hospice needs.  3 other workers ended up positive. There were 13 patients, most tested positive, many were asymptomatic. 3 or 4 passed away over a 4 week period which about 1 more than a similar pre COVID19 period.  Last week marked two weeks with no new infections and yesterday they got to reduce some of the room isolation drapes and stopped requiring some of the PPE requirements.  There is still isolation between the units and sequestration of the staff, no outside visitors or events.   I think that the external accountability the company showed the openness that should have been shown by the other facilities and the state.   She got offers to move to other companies for almost double what she makes.  She passed since she is starting a nursing program June 1st and loves her residents.  The extra semi-monthly paycheck the company gave her unannounced went far.  Wished we had know that before she used up all of her sick and vacation time!  72 hours after being clear she was back at work and getting about 3 extra shifts a week to keep the number of employees in the unit down. For June and July hopefully will just work 3 or 4 eight hours shifts

 

SMH - I, on the other hand am immunocompromised, self quarantined since mid March and ended up in the ER twice. Last 3 days she made as much as I usually do, but I won't have billings like that now for a long time.

It's my opinion that nursing homes need to be aggressive in their approach to caring for patients and instituting proper cleaning at all times and protect all staff(including the cleaners) with equipment. CV isn't the hardest thing in the world to kill from surfaces compared to something like the very much dreaded C-Diff, but most places would have to enact extremely careful policies for thorough cleaning because CV is so contagious. The facility your wife is at seems like they had good control and cared, even with the loss of some patients. The facility my grandmother was once at was a 2000+ complex having both apartments and a hospice/mini hospital ward. Infections there were a mix of residents and staff at 13 people - and it never reached a nightmare scenario (can you imagine if all had contracted it?) . Other facilities had the disease spread through the entire population and they lost 100s of people at a time. Some of these places are disgusting and the practices frightening.. there was no way they would ever care for someone on a good day - and they just willingly let people die via negligence. All it took was five days in a facility for our friend to contract CV and now be near death. It was the staff that brought it in, so we know there is a facility that wasn't following the order to check workers.

 

I am sorry to hear what happened to you, and hope you are feeling better and that your wife stays safe.

3 hours ago, Dashinka said:

Putting Covid positive people back into the most vulnerable populations when there is space available in more controlled environments.

We don't know if they were still registering CV+ or if they were CV- but still recovering at the time they were put back in the home. Even if they were CV+ the home is allowed to refuse to take them if they cannot provide proper protection and care. It's on the home if they took them and did neither. There have been instances where a person was cleared as CV- but then ended up back in the hospital and CV+ later. My sister's coworker got CV from her dead grandmother. Despite her symptoms improving after 14 days she is still testing positive. We don't seem to have a clear answer on if that means the person still remains infectious or if as the South Koreans are trying to say they are just shedding dead cells.

54 minutes ago, 90DayFinancier said:

Which rule does that? We were talking about the rules licensed facilities have to comply with in all cases.

Do you think we should be taking the risk to put CV+ patients in a nursing facility vs remaining in a hospital? I kind of feel the same sort of leery way about this as I do about our rural hospital sending patients back home where they later died from lack of oxygen just because they didn't have the room. If I were a doctor I don't think I could bring myself to do that to people.... but I know the administrator makes these decisions to kick people out prematurely.