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Some of the earliest and most deadly outbreaks of COVID-19 Have been in nursing homes. But some states are ordering nursing homes to accept patients who've been hospitalized for COVID-19 because there are not hospital beds anywhere else. Here's NPR's Ina Jaffe.
INA JAFFE, BYLINE: The state directives ordering nursing homes to admit patients regardless of their COVID-19 status have been strongly condemned by the Society for Post-Acute and Long-Term Care Medicine. Dr. Sabine von Preyss is the president of the Washington state chapter. She says that a distinction must be made between nursing homes that have suffered COVID-19 outbreaks and those that are still COVID-free.
SABINE VON PREYSS: The question is, should we be forced to introduce a disease with such deadly potential into a population that has been sheltered? And my experience tells me that would be ill-advised.
JAFFE: And it won't even help overcrowded hospitals, says Dr. Michael Wasserman, the head of the California Association of Long Term Care Medicine.
MICHAEL WASSERMAN: 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.
JAFFE: New York and New Jersey have both ordered nursing homes to admit patients regardless of their COVID-19 status. California had a similar directive, and then suddenly it didn't. After a couple of days of outcry from the medical community, the state softened its instruction. It now says that a nursing home can expect to receive COVID-positive residents if it can follow CDC infection prevention guidelines. But advocates for nursing home residents aren't satisfied.
TONY CHICOTEL: You've got a recipe for disaster in nursing homes.
JAFFE: That's Tony Chicotel, a staff attorney with California Advocates for Nursing Home Reform. The problem, he says, isn't just whether California nursing homes will accept COVID-positive patients - the state has also waived regulations so that nursing homes can temporarily increase capacity and reduce staff.
CHICOTEL: We're going to have, potentially, a lot more residents crammed into nursing homes. You're going to cut the staffing minimums at the same time, and then you're going to introduce perhaps the most efficient killer of older adults into the building?
JAFFE: Neither New York nor California officials were available for interviews. There are states taking a different approach. Some are reviving closed nursing homes or empty wings just to treat COVID-positive patients. And in Louisiana, where there are COVID-19 clusters in more than 60 nursing homes, a facility is prohibited from admitting patients who are COVID-positive or were treated for respiratory problems unless it can show it has the capacity to care for them.
ALEX BILLIOUX: What we were looking at is, what makes the most sense for the patients themselves and the other residents?
JAFFE: That's Dr. Alex Billioux, assistant secretary for Louisiana's Office of Public Health. Louisiana has what he calls Tier 2 hospitals as well as new care facilities, like the one at the convention center in New Orleans.
BILLIOUX: Individuals who are still too ill to return back to a nursing home could be sent to those Tier 2 facilities, where they're still getting nursing care and attention. And we know that the majority of these individuals will recover and then be able to be moved back to a nursing facility
JAFFE: Because the facilities aren't just where patients receive medical care, they're also the places they call home.
Ina Jaffe, NPR News.
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