The decision of the governors of five states to order patients with COVID-19 to be put in nursing homes is coming under intense scrutiny for potentially putting patients at risk.
The U.S. Department of Justice announced August 26 it is requesting data from the governors of Michigan, New Jersey, New York, and Pennsylvania regarding government orders that “may have resulted in deaths of elderly nursing home residents.” The Department’s Civil Rights Division will examine the data to determine if state actions warrant further investigation.
More than 6,400 residents of nursing homes or long-term care facilities in the Empire State have died during the pandemic, according to the New York Post. A July report by the New York Department of Health said Cuomo’s March 25 decision requiring nursing homes to accept coronavirus patients discharged from hospitals was not responsible for spreading the virus among residents, claiming instead that nursing home visitors and staffers spread the disease. For his part, Cuomo acknowledged in late July that the state made “a lot of mistakes” in its fight against the virus.
Cuomo’s nursing home order remained in effect for 46 days before it was rescinded in early May amid growing criticism. More than 32,000 New Yorkers have died from the disease, the highest death toll in the country.
Most Vulnerable at Risk
In addition to calling for Cuomo’s impeachment, Paul, a physician who tested positive for COVID-19, has blasted lockdowns and other measures imposed to stem the spread of the virus.
“Terrible public health policy decisions were made and I think in the end, none of these policies have probably been good for the economy or actually good in containing the virus,” Paul told the Fox News “Rundown” podcast, as reported by several news outlets.
Cuomo is not the only governor catching heat over nursing homes. In June, Rep. Steve Scalise (R-LA), ranking member on the House Select Committee on the Coronavirus Crisis, led a group of GOP lawmakers in sending letters to five governors, all Democrats, asking for detailed information about their COVID-19 policies in nursing homes.
“The ongoing COVID-19 pandemic has disproportionately affected the elderly, especially those living in nursing homes and other long-term care facilities,” the lawmakers wrote in their June 15 letters to the governors. “We write seeking information, on a granular level, about the science and information used to inform your decision to mandate nursing homes and long-term care facilities to admit untested and contagious COVID-19 patients from hospitals.”
Targeted governors were also requested to supply a chronological list of all hospital discharges to nursing homes and other senior living facilities; data on nursing home deaths due to COVID-19; communications among the governors’ offices, state health departments, and operators of long-term care facilities; and communications between nursing home administrators and government officials.
In addition to Cuomo, the letters were sent to Govs. Gavin Newsom (California), Gretchen Whitmer (Michigan), Phil Murphy (New Jersey), Gretchen Whitmer (Michigan), and Tom Wolf (Pennsylvania).
One co-signer, Rep. Jackie Walorski (R-IN), made a scathing assessment of the governors’ action.
“Just about the worst possible thing to do is knowingly introduce the coronavirus to the most vulnerable populations, yet that’s exactly what several states did by mandating nursing homes accept infected patients,” Walorski said in a statement. “These misguided policies deserve close scrutiny and the leaders who put them in place have a lot of tough questions to answer.”
$5,000 Nursing Home Payment
Michigan’s State Budget office issued a directive April 22, offering to pay nursing homes $5,000 for each bed they could offer a sick or recovering COVID-19 patient. The directive states Whitmer’s Department of Health and Human Services will use up to $5 million of $50 million from the general fund appropriated for increased health care to make the payments.
“Under this plan, one or more facilities within a region will be designated as a hub for receiving COVID patients discharged from hospitals,” the directive states. “This ensures hospitals can continuously discharge recovering COVID patients and maintain surge capacity within their facilities.
Robert Regan, a candidate running for the state’s 73rd legislative district, made the payments a focus of his campaign.
“There was a palpable sense of disbelief at first when I presented it to voters,” Regan said.
Regan says the directive has gotten little media attention, but a video about it that he posted to his website got 500,000 views.
“Hopefully, it will stimulate discussion and lead to a demand in accountability for the Governor’s actions,” Regan said.
Michigan recently announced it has agreed to a $600 million settlement to resolve lawsuits related to the Flint water crisis.
Elderly Risk Was Known
It was common knowledge by spring that the virus was dangerous to people in nursing homes, says Gregg Girvan, health care fellow at the Foundation for Research on Equal Opportunity (FREOPP).
“We began to learn which age groups were at greatest risk by early March,” Girvan said. “By then, we had learned that all seven people who had died under quarantine aboard the Diamond Princess cruise ship were over the age of 70, as well as received studies from China showing the same skew of severe illness and death toward the elderly, especially those with preexisting conditions.”
Girvan says the nation is still learning more, but he would not be surprised if similar payments were made in other states.
“Though my initial impression was such states were using a ‘stick’ rather than a ‘carrot’ approach—they were basically ordering nursing homes to take recovering patients,” Girvan said.
Whether hospitals were exceeding surge capacity to justify the placement of patients in nursing homes, is another question, Girvan says.
“In hindsight, it appears the policy of sending recovering patients back to nursing homes was foolish, even if you were exceedingly generous with such policies, based on a worry of exceeding hospital capacity,” Girvan said.
Bonner R. Cohen, Ph.D., (email@example.com) is a senior fellow at the National Center for Public Policy Research.