AARP Hearing Center
| Some of the states hardest hit by the coronavirus are mandating that hospital patients recovering from COVID-19 be transferred to nursing homes, in some cases forcing uninfected residents to move elsewhere.
The result: Some of the country's frailest patients in need of long-term care are being moved around like dominos. And some nursing home residents are facing yet more risk of COVID exposure.
- New York led the way in late March, with a sweeping directive intended to free up much-needed hospital beds by ordering nursing homes to take COVID-19-positive patients.
- Massachusetts followed with its own order but has apparently dialed it back after criticism.
- New Jersey instructed nursing homes that they could not reject medically stable patients diagnosed with COVID.
- California issued its own stern order only to soften it a couple of days later, after an outcry from advocates for patients.
The decrees follow a federal ban on almost all nursing home visits, leaving residents isolated from family support and protection. The rulings have applied ever more pressure on the more than 15,000 nursing homes across the country, many reeling from COVID-19 as resident deaths mount and stressed staff members search for elusive masks, gloves and gowns.
At least 7,000 COVID-19 deaths have occurred among people living in or associated with nursing homes, according to a New York Times investigation, meaning 1 in 5 coronavirus deaths in the U.S. are tied to a nursing home.
Transferring COVID patients from hospitals to nursing homes threatens to make the problem worse. In addition to housing the most vulnerable Americans, many nursing homes already have poor infection control records. Personal protective equipment is hard to come by, and testing kits are often scarce.
As the number of transfers increases, AARP is asking Congress to prohibit long-term care facilities from discharging patients due to inability to pay for services during the pandemic. It also wants Congress to require the facilities to report data on discharges and transfers, which can be physically and emotionally difficult for patients leaving hospitals and for nursing residents displaced to make room for COVID patients.
"This notion of transferring people was something we expressed a lot of concern about,” said Elaine Ryan, AARP vice president of state advocacy and strategy integration, citing a lack of transparency around the process.
"People didn't know where they would go,” she said. “How disturbing is it not to have one of their family members tell them?”
'Not possible to fully comply with directives'
New York issued an order late last month that “No resident shall be denied re-admission or admission to [a nursing home] based on a confirmed or suspected diagnosis of COVID-19.” The advisory prohibited nursing homes to require that a hospitalized resident deemed medically stable be tested before admission.
