The Dangers of Discharging Coronavirus Patients to Nursing Homes

Nursing homes have become notorious hot spots for the coronavirus. Residents are particularly vulnerable to the disease known as COVID-19. If the virus gets into one of these facilities, it could easily spread among other residents, forcing them to be admitted to local hospitals.

As the outbreak continues to spread, some hospitals have started discharging elderly patients who have tested positive for the virus to local nursing homes to increase capacity. Several states have even ordered nursing homes to accept residents with COVID-19, but several health officials have warned this policy could lead to disaster.

If you work in a nursing home and your facility is asked to accept elderly patients who have tested positive for the virus, here’s what you need to know.

Increasing Capacity vs. Protecting the Vulnerable

For some healthcare facilities, discharging elderly coronavirus patients to local nursing homes can be a difficult decision. If hospitals are running low on capacity as the virus continues to spread, they may have no choice but to send these patients back to the nursing homes they came from or put them in assisted living facilities until they recover from the virus.

We’ve already seen multiple outbreaks at nursing homes across the country, including most memorably at the Life Care Nursing Home in Kirkland, just outside of Seattle, WA, one of the first epicenters of the epidemic. The facility reportedly threw a Mardi Gras party in late February despite concerns regarding the growing pandemic, even though, at the time, most of the reported cases were still in China. The facility has since been linked to over a hundred infections, including staff members, residents, and visitors, as well as 37 deaths, and is now facing up to $600,000 in fines for its alleged negligence.

Some of the largest and hardest-hit states, including New York and New Jersey, have issued orders that local nursing homes must accept patients that have tested positive for the virus to increase capacity at hospitals. California issued a similar order back in March, but it has since softened the wording of the directive. Facilities in CA can now expect to receive coronavirus patients if they meet certain infection prevention guidelines.

Despite the need to make room for other infected patients, several health officials, including those from the Society for Post-Acute and Long-Term Care Medicine, have pushed back against these policies, warning they could lead to new outbreaks and a surge in hospitalizations and readmissions.

Dr. Michael Wasserman, the head of the California Association of Long Term Care Medicine, recently told NPR, “If you push folks out of the hospitals to make space and you push them into nursing homes a couple weeks later, for every one of those you send to the nursing home, you may get 20 back in the hospital.”

Some nursing homes have been spared from the coronavirus thus far. If hospitals must discharge elderly patients to local elderly care facilities, they should try to send them to facilities that are already caring for virus patients. Introducing the virus to facilities that have yet to report any cases could be put these communities at risk.

What to Do If You Are Asked to Admit a Resident with COVID-19

If you work at a nursing home and are asked to make room for patients that have tested positive for the virus, you need to follow certain incubation and infection prevention procedures. The CDC has issued guidelines for nursing homes and long-term care facilities accepting coronavirus patients. Read their full recommendations to protect your facility from infection.

The CDC recommends housing suspected and confirmed cases in a separate area, closely monitoring symptomatic and asymptomatic patients for severe illness, implementing sick leave policies for staff members, and saving personal protective equipment, such as facemasks, for healthcare providers. Visitors should wear cloth face coverings instead of pulling from the facility’s supply.

You may decide to limit visitation hours and do away with them entirely for some patients, especially if they have tested positive for the virus. Scientists are still trying to determine whether individuals can pass the virus onto others even if they seem to have fully recovered from COVID-19.

If your facility is having trouble following these specific infection control guidelines while caring for coronavirus patients, reach out to your local health department for assistance. If your facility is stretched thin as it is and you are not prepared to accept these patients, try having them sent to another facility instead, if possible.

Taking care of our nation’s most vulnerable can be stressful, let alone responding to a global pandemic. Do your best to make room for coronavirus patients at your facility to increase capacity at local hospitals without endangering the rest of your residents.

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