Nursing homes eye visitors -- if virus testing if expanded
The leader of a nursing home group told Michigan lawmakers Tuesday that expanded coronavirus testing is crucial to reopening the facilities to visitors, saying the state may be close to relaxing restrictions in a phased way.
Melissa Samuel, president and CEO of the Health Care Association of Michigan, said some initial “baseline” testing of all residents and staff is underway with help from the Michigan National Guard. But it is not complete, and there is not yet resolution on how to pay for ongoing testing or its frequency.
“We certainly recognize the difficulties that ... visitation policies have caused for both family and residents,” she said, adding that facilities in the last several weeks have to tried connect residents and loved ones through remote technology. She said interest groups are working with the state Department of Health and Human Services to prepare reopening plans for congregate settings.
“I think we’re getting very close. It does have to be a phased-in approach,” Samuel told the House subcommittee that handles the health and human services budget. “It’s all predicated on testing — establishing baseline testing, establishing a 14-day period where you’re clear and then from there moving into phased-in approaches.”
Since March 14, Gov. Gretchen Whitmer has prohibited visitors from entering congregate care facilities to curb the spread of COVID-19 except in limited circumstances — when a resident is in critical condition or hospice care, for instance. Samuel asked legislators to make nursing homes, which now have 32,000 to 33,000 residents statewide, a priority to receive testing supplies, personal protective equipment and funding.
“We have individuals who are so vulnerable. Their family members were banned from coming to see them, totally affecting the quality of their life,” said Rep. Mary Whiteford, a Republican from Allegan County’s Casco Township who asked when visitations might resume. “We’re going on three months now.”
The state on Tuesday reported 25 additional COVID-19 deaths for a total of 5,943 confirmed or probable deaths. There were 108 more cases, bringing the total to about 65,000. The seven-day average continued to drop and was at its lowest point since March.
Lynn Sutfin, spokeswoman for the state health department, said 132 of Michigan’s 463 nursing homes had undergone testing or had been providing testing kits by the National Guard in the Upper Peninsula and 19 counties in the Lower Peninsula as of last week. That covered nearly 24,000 residents and staff. The guard is testing in 10 counties this week.
As of last Thursday, nursing home residents accounted for 1,505, or 25%, of all coronavirus-related deaths in Michigan, though the figure was likely higher. The Democratic governor has faced criticism from lawmakers over people recovering from COVID-19 being admitted to “hub” nursing homes with uninfected residents. She later changed an order to give the homes more flexibility to decide if they can safely isolate people.
“This seemed to me to be a practice that’s ill-advised,” said Rep. Leslie Love, a Detroit Democrat who asked about the industry’s role in the policy. “In advance of this pandemic, we knew that the staffing levels were difficult to maintain. ... Since the hubs were created, even medical care workers don’t want to work with that population.”
Samuel reminded lawmakers how quickly the virus hit the Detroit area and cited subsequent university studies showing the No. 1 reason COVID-19 enters nursing homes is its prevalence in the surrounding community.
“We had capacity building in the hospital systems, and there was tremendous pressure to discharge individuals back into long-term care settings,” she said. “PPE at the time was not a priority for long-term care settings and neither was testing at the time. We felt a reasonable approach was to work with facilities who could dedicate a floor or a wing or a part of the building if they had appropriate levels of PPE, if they had the staff that was needed.”