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MI task force endorses new model for nursing homes afflicted by COVID-19

A state nursing homes task force proposed new ways to help reduce the effects of isolation on residents in a report released Tuesday, recommending outdoor visits, small-group activities with no contact, limited communal dining and increased virtual visitations.

They are among 28 recommendations sent to Gov. Gretchen Whitmer, including others focused on resources, staffing, and placement of some of the state's most vulnerable residents.

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The recommendations targeted several aspects of life inside Michigan nursing homes during the public health crisis underway since March.

How to care for and treat nursing home residents in Michigan who test positive for the novel coronavirus has been one of the state's greatest challenges. 

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Bridge Magazine, Detroit Free Press and Michigan Radio are teaming up to report on Michigan hospitals during the coronavirus pandemic. We will be sharing accounts of the challenges doctors, nurses and other hospital personnel face as they work to treat patients and save lives. If you work in a Michigan hospital, we would love to hear from you. You can contact reporters Robin Erb rerb@bridgemi.com at Bridge, Kristen Jordan Shamus kshamus@freepress.com at the Free Press and Kate Wells katwells@umich.edu at Michigan Radio.

The report recommends the state have “Care and Recovery Centers.” Earlier this year, regional nursing home hubs were established to accept some positive patients from hospitals or other nursing facilities.

“Under the new model, the State will identify criteria and procedures to approve facilities as Care and Recovery Centers,” the report said. “Facilities that were previously designated as hubs may, at their discretion, reapply to be designated as a Care and Recovery Center, subject to the new criteria.”

The task force also called for pressing hospitals to keep certain COVID-19-positive patients, rather than sending them back to their nursing homes. It would apply to those residents who had less than 72 hours left in an isolation period.

The report says hospital and recovery center options should be prioritized for COVID-19-positive people. When those options aren’t best for a person’s needs, the task force recommends using experienced nursing facilities that meet certain criteria.

“COVID-19-positive residents who are discharged from hospitals should not be sent to ‘COVID-19 naïve facilities’ (facilities that have not had COVID-19-positive residents) except in exceptional circumstances,” the report said.

During the pandemic, nursing homes in Michigan and throughout the country have been heavily impacted by COVID-19.

State data shows about 1 in 3 coronavirus-related deaths in Michigan are nursing home residents. So far, there have been more than 8,200 confirmed cases of COVID-19 among nursing home residents and more than 2,000 resident deaths related to the virus.

The task force was created in June to help the state’s response to a potential future wave of COVID-19. Whitmer said in a statement that she'll review the recommendations.

Whitmer has faced criticism from state Republicans and others over the decision to house residents who tested positive for the coronavirus in the same nursing homes as non-infected residents. Critics argued the move creates an unsafe situation for seniors.  

Whitmer has said officials wanted to make sure patients discharged from hospitals had a place to go and officials had to strike a balance.

Members of the task force did not reach a consensus on whether to recommend the admission of nursing home residents with COVID-19 into facilities that are not specifically designated Care and Recovery Centers. It included the majority position. 

The task force is made up of 20 people, including doctors, Michigan Department of Health and Human Services Director Robert Gordon and Michigan Department of Licensing and Regulatory Affairs Director Orlene Hawks.

Also on the task force is Melissa Samuel, president and CEO of the Health Care Association of Michigan, which represents more than 350 nursing homes. She called the recommendations good.

“If there’s anything that we’ve learned about this virus ... it’s constantly evolving and our response to it should as well,” she said.   

The state is in a much different spot now than at the start of the pandemic and has a strong testing strategy in place now, she said.

Other task force recommendations include improving the allocation of personal protection equipment and improving support for nursing home staff. 

It also urged efforts to decrease the public health reporting burden on nursing homes, though it didn’t recommend how individual nursing homes might reduce reporting requirements to state and federal regulators while maintaining safety accountability. 

“Protecting the health, safety and wellbeing of seniors and the most vulnerable residents remains a top priority,” the report said.

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