Health Care Association of Michigan

How nursing facility providers are responding to COVID-19

Through rapidly changing circumstances, protecting residents and staff remains priority number one.

Health Care Association of Michigan
A COVID-19 recovery is celebrated at MediLodge of Shoreline.

Our country is facing the most severe public health crisis in a century. Michigan has been particularly hard hit with over 40,000 reported cases and nearly 4,000 deaths at the time of this writing.

Nursing facility providers are now engaged in an outright, full-scale war with an unrelenting and merciless enemy that is most unsympathetic to the elderly we serve and has sadly taken the lives of too many of our residents and caregivers. This is what we know about the virus, its impact on residents and staff, and how we are responding.

The spread of COVID-19

The country was woefully unprepared to quickly and effectively respond to this virus – in large part because of a lack of understanding of how it was transmitted and, therefore, how best to prevent its spread. Although the first reported case in the country was in Washington state on January 21, the World Health Organization was continuing to state publicly in mid-January that there was no clear evidence of human-to-human transmission of the novel coronavirus.

The Centers for Disease Control and Prevention (CDC) and the Centers for Medicare and Medicaid Services (CMS) initially treated coronavirus like influenza. Nursing facilities were told to screen for symptoms, including fever and cough, and ask about recent travel.

As the days and weeks passed and we gained more experience with this novel coronavirus, we now know that the world’s understanding of this virus was flawed and initial attempts to mitigate its spread were ineffective. Most revealing is data from the CDC, indicating that over half of all elderly people who test positive for COVID-19 show no symptoms, and these individuals likely spread the virus to others for days before showing symptoms if they do eventually occur. Even more alarming is further data showing a growing number of asymptomatic individuals, regardless of age, testing positive for the virus – this includes health care workers in nursing facilities.

The only effective way to prevent the spread of COVID-19 into facilities is through universal testing of staff and residents. Unfortunately, as the outbreak hit Michigan in early March, there were not enough tests available to implement this necessary protocol.

To make matters worse, our governments’ stockpiles of personal protective equipment (PPE), which is essential to preventing the spread of the virus to residents and staff, were woefully inadequate. This supply was barely enough to meet the hospital demand, and for nearly a month into the outbreak Michigan nursing facilities did not have adequate access to these necessary supplies and are still struggling to get supplies today.

And while the initial response was understandably focused on hospital capacity, not enough attention was given to the population most at risk to the coronavirus. In Michigan, the average age of those who have succumbed to COVID-19 is 74, and those with underlying conditions are especially vulnerable to the virus. These characteristics apply nearly universally to the residents we serve. The average age of a nursing facility resident in Michigan is 82, often with weakened immune systems and other severe medical complications.

A resident at the SKLD nursing facility in Michigan speaks with loved ones, thanks to video chats facilitated by the center.

Our response to protect residents and staff

Nursing facilities follow all state and federal guidance related to COVID-19 to protect residents and staff, even as this guidance has evolved. This included enhanced infection control protocols, expanded use of PPE such as masks and gowns, restricting visitors, screening staff and eliminating communal activities. Despite these and numerous other efforts, we have not been able to completely prevent the spread of COVID-19 into our facilities.

These essential measures add significantly to the workload and exact an emotional toll on staff, residents and family members. Regardless, the response continues to be inspirational.  Nursing facility staff risk their health each and every shift. They are the soldiers on the frontline of this war against COVID-19, and tragically some have lost their lives.  

In spite of this situation, staff do all they can to provide care, comfort and protection for residents. They have purchased iPads and other devices so residents can video chat with loved ones. We have seen a myriad of heartwarming stories including window waves, letter writing campaigns and birthday celebrations.  But the battle to protect residents and staff continues on an hourly basis. Testing, personal protection equipment and financial support from government continues to be critical in our efforts to reduce the number of COVID-19 cases and deaths in our facilities.

None of us created this pandemic or chose to have it come upon us. Nursing facilities, along with other healthcare providers at the direction of our state and federal governments, are doing everything possible to address this crisis. There is no blame, or scapegoats or finger pointing. We are providing all the support possible to residents and staff to save as many lives as possible. Our profession is people caring for people, and we are immensely proud of our heroic staff that have risen to the occasion.

Members of the Health Care Association of Michigan Board of Directors

Mark Berger, Villa Healthcare

Michelle Berryman, Prestige Health Care

Henry Boutros, Illuminate HC

Pete Brogger, Trilogy Health Services

Gail Clarkson, NexCare/Wellbridge Group

Darren Gee, Prestige Health Care

Laura Hamann, Bronson Commons

Don Haney, Thornapple Manor

Margaret Lightner, Beaumont Health

Christina Matzke, Sunset Retirement Communities

Mike Perry, NexCare/Wellbridge

Doug Postlewait, HCR Manorcare

Richard Prestage, NexCare/Wellbridge

Jeff Pries, Advantage Living Centers

Jeff Schade, The Peplinski Group

Harry Schayer, Illuminate HC

Richard Shook, HCR ManorCare

David Stobb, Ciena Healthcare

Tricia Tomkinson, Ciena Healthcare

Paxton Wiffler, Villa Health Care

Frank Wronski, NexCare/Wellbridge

HCAM is a statewide trade association representing proprietary, not for profit, county medical and hospital-based long-term skilled nursing and rehabilitation facilities.