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Editorial: State must do more to ensure safety of nursing homes

The Detroit News

To protect those in our state most vulnerable to the virus, and to ensure that months of state-wide social distancing aren’t all for nothing, Gov. Gretchen Whitmer must clarify her policy on how nursing homes deal with COVID-19-affected residents. 

Nursing homes and assisted-living facilities have been some of the hardest hit by the pandemic and deserve extra attention and care.

Last month, as hospitals neared capacity and as the number of virus cases climbed in Southeast Michigan, nursing homes feared a mandate requiring them to readmit infectious residents discharged from hospitals — a measure which would put all other residents at risk of contracting the deadly virus.

To address this problem, Whitmer signed Executive Order 2020-50 on April 15, which called for the establishment of “regional hubs” — existing nursing homes with dedicated and isolated units — to which nursing homes unequipped to deal with the virus could send their infected residents.

This move was a reasonable answer to the problems facing Metro Detroit at the time, says Melissa Samuel, president of the Health Care Association of Michigan.

More than 23,000 people have died in long-term care and nursing home facilities since the first coronavirus outbreak in a nursing home in a Washington facility in February, according to a tally from the AP

But the order, which expired Wednesday and which was immediately replaced by an identical order, is far from perfect. It mandates that nursing homes with less than 80% capacity must create dedicated isolation units for COVID-19-affected residents.

It also mandates that nursing homes with dedicated isolation units may not prohibit admission or readmission of residents based on COVID-19 test results.

Translation: Capable nursing homes must admit infected residents.

“These were areas that we immediately brought to the attention of the state and said you shouldn’t be implementing this in this manner,” says Samuel. “It was our understanding from the [state health] department that we should stand down on those provisions until we received further guidance from the state.”

That guidance has yet to be provided. And while HCAM was able to share its understanding from the state with its members, nursing homes outside of its membership were left to discern for themselves their obligation to infected residents.

That could be what led to the virus spreading in a Sterling Heights nursing home, reported last week by WXYZ Detroit. Lakeside Manor was not one of the designated regional hubs, but staff said they were following guidance from Whitmer’s order in accepting infected residents.

“If Lakeside Manor is able to follow transmission-based precautions and all CDC and MDHHS [Michigan Department of Health and Human Services] guidance, they are able to accept COVID-positive residents,” Tiffany Brown, spokesperson for the governor's office, said in an email.

The state Senate Oversight Committee on Wednesday questioned the MDHHS director about the executive order, and lawmakers should keep demanding answers. . 

More:Republican lawmakers press Whitmer on nursing home order

More:Can nursing homes dedicated to virus patients stop spread?

Regardless of enhanced precautions, personal protective equipment and best practices, putting infected residents back into nursing homes with non-infected residents is not a winning strategy.

Michigan is far from the only state that’s struggled to find the right path for protecting nursing home residents. New York, which had a similar policy to Michigan's, has since backed away from it after facing backlash.

Whitmer should look to states that are doing this right, like Connecticut and Massachusetts, which are designating entire nursing home facilities to care solely for COVID-19 residents.

Luckily, in Michigan, we have several field hospitals that were built to handle an overflow of COVID-19 patients that never came. Before we resort to sending infected residents back to nursing homes, we should consider putting that extra capacity to good use. 

Fixing this issue must be a top priority.