Q. My mother, Phyllis, is in a nursing home in Northern Virginia. I heard that across the country, they are moving coronavirus patients into nursing homes. I understand that my mom is quarantined to her room, but I still think that this a bad idea given that seniors (particularly nursing home patients) are among the most vulnerable to the deadly virus. And, sending them home to make room for other patients with COVID-19 would be an equally bad idea. Have you heard about this? Is this happening here, in the DC Metro area?
A. Most of us are aware that seniors are among the most vulnerable population when it comes to coronavirus. News sources have reported that outbreaks have been rapidly occurring in nursing homes across the country — leading nursing homes to ban visitors, confine patients to their rooms, and to create sterile wings to treat residents who have come down with the disease.
Currently, hundreds of long-term care facilities in the US now have residents who are infected with the virus. Soon, there may be more of such patients in nursing homes, because in California, for instance, nursing homes are being asked to admit coronavirus patients, a practice which could prove to be deadly for sick senior residents. With hospitals desperate to clear space for an expected wave of COVID-19 patients, they are discharging as many patients as possible, including many to nursing homes.
Nursing Homes in Certain States Are Being Forced to Take COVID-19 Patients
Due to space issues, hospitals across the country need to clear out patients who no longer need acute care to free up beds for the next wave of critically ill patients. Nursing homes of course don’t want to take patients discharged from hospitals for fear they’ll bring the coronavirus with them. Nursing homes are alarmed at the prospect of taking such patients, as the consequences could be dire for senior residents.
Some states, such as California,
have told skilled nursing facility operators that they MUST accept patients even if they have COVID-19. The directive from California Department of Public Health Deputy Director Heidi Steinecker says skilled nursing facilities “shall not refuse to admit or readmit a resident based on their status as a suspected or confirmed COVID-19 case.”
Nursing Home Administrators Call this a “Death Sentence for Residents”
Nursing home administrators fear a catastrophic result if the deadly pathogen gains a foothold in their institutions. “Sacrificing the lives of beloved nursing home residents is beyond unconscionable,” said Patricia McGinnis, executive director of California Advocates for Nursing Home Reform. “California’s directive is nothing less than a death sentence for countless residents. The state should instead look to alternative locations such as hotels and conference centers as much safer places to send COVID-19 patients for care,” she said.
Assisted living and other long-term elder care homes, which do not provide the same level of medical care, are regulated by the state’s Department of Social Services and are not subject to Steinecker’s directive.
In Connecticut, state officials a
re taking a different approach. They are reopening previously closed facilities to create separate nursing homes only for residents who are positive for COVID-19.
Washington, DC Area Not Moving Coronavirus Patients to Nursing Homes
The Washington region’s battle with coronavirus has intensified so much that the president has declared our area “a major disaster area,” allowing it to receive emergency federal funding to combat the spread and mitigate the effects of the coronavirus.
As of Thursday, April 9, the number of known Covid-19 cases in the District, Maryland and Virginia stood at 11,766, with 6,186 cases in Maryland, 4,053 in Virginia and 1,527 in the District. The number of virus-related deaths was 138 in Maryland, 109 in Virginia and 33 in the District, for a total of 280 fatalities. New data indicates the virus is not slowing its march across the region.
Coronavirus in Maryland Nursing Homes
Maryland is continuing its str
uggle to contain outbreaks that have so far struck 81 nursing homes and long-term care facilities. At one facility (Pleasant View in Mt. Airy), at least 99 residents and staff tested positive and 10 residents have died. According to the Washington Post on April 9, 2020, infections continue to spread through Montgomery County’s nursing homes as tests remain scarce. Officials announced a week ago that 10 of the county’s nursing homes have reported cases of coronavirus. A majority of the infected patients are still at the nursing homes and will not be moved unless they require a higher level of medical care. Maryland Governor Larry Hogan issued an emergency order requiring nursing home staff to wear protective gear and segregate infected patients to halt the spread of the disease following outbreaks in the state’s long-term care facilities. Governor Hogan requires nursing homes and similar elder-care facilities to create isolation areas for residents infected with or suspected of having the virus; designate teams of workers to tend to the patients; and send coronavirus test kits to a state lab for expedited testing. “We will use every tool at our disposal to protect the most vulnerable among us,” Hogan said.
Coronavirus in Virginia Nursing Homes
Virginia is also grappling with outbreaks in nursing homes. Deaths at Canterbury Rehabilitation & Healthcare Center in Henrico County near Richmond (which has an overall 2-star rating by the federal government‘s Nursing Home Compare website) have more than doubled in the past five days. Residents started contracting the virus in the middle of March and the center reported its 33rd death this past Wednesday. Officials at the 190-bed facility said it had tested all residents and most of the staff and found that 108 residents and 25 employees have been infected. Canterbury continues to suffer from a lack of personal protective equipment. Virginia Governor Ralph Northam and state health officials say a shortage of personal protective equipment (PPE) and testing capacity restraints are factors in outbreaks at long-term care facilities in the state, including Canterbury Rehabilitation and Health Care Center.
Sunrise of McLean, an assisted-living facility in Northern Virginia, also announced that coronavirus had been found at the center. Tom Kessler, Sunrise Senior Living’s regional vice president of operations, did not specify the number of individuals infected with COVID-19, or whether the virus is among the staff, residents, or both. In a statement, Kessler said that “In response to the virus, administrators have implemented a handful of containment measures, including rigorous screening protocols to identify potential symptoms among residents and team members, restricting new resident move-ins, and shifting to individual resident engagement activities.”
Coronavirus in Washington, DC Nursing Homes
As of Sunday, April 5, a projection from a University of Washington health research center said the District could reach peak “hospital resource use” as soon as April 15 and hit as many as nine deaths per day starting April 13. There haven’t been any cases reported in DC nursing homes, to date. However, DC Health recommends that all skilled nursing facilities take aggressive steps to keep undetected COVID-19 cases from entering their facilities through visitors and healthcare workers. DC Health also recommends that all skilled nursing facilities thoroughly prepare to receive patients who are confirmed COVID-19 cases, suspected COVID-19 cases, or being transferred from facilities with known COVID-19 cases. Click here to learn more.
Do you have a loved one in a nursing home during the coronavirus pandemic? If so, click here to read my recent article, “When Your Loved One is in a Nursing Home During the Coronavirus Pandemic.”
Plan Now for Loved Ones Who Will Need Nursing Home Care
If you have a loved one who needs nursing home care or even if your loved one is already in a nursing home, if you haven’t done so already, the time to plan is now! Please contact us as soon as possible to make an appointment for an initial consultation. We offer phone appointments or video conference appointments in lieu of in-person meetings (but we are still open for in-person meetings, using safe social distancing and disinfectant practices):
Elder Care Fairfax: 703-691-1888
Elder Care Fredericksburg: 540-479-1435
Estate Care Rockville: 301-519-8041
Elder Care DC: 202-587-2797
About Evan H Farr, CELA, CAP
