Government forcing nursing homes to accept covid patients

[slash2k]

@Fotheringay-Phipps

I would think that people who are definitely known to be infected are higher risk than people who might be infected.

With people definitely known to be infected, everybody involved knows the stakes are higher, and staff are more likely to be cautious and wear PPE. Staff who don’t know they are infected are more likely to ignore masks, etc. This is just human nature.

@Fotheringay-Phipps

At any rate, my specific point in response to your post was that the transmission risk via introducing infected patients to a facility is not (only?) via ventilation systems and the like as you seemed to imply but rather via the very person-to-person caregiver contact that you pointed to as the primary source of transmission.

I refer you to my previous posts in this very thread, specifically #28 and 35, where I talked about how ventilation systems do not appear to be a primary vector. It is person-to-person contact that is the primary source, and staff who blithely assume neither they nor the patient in their charge are infectious are more likely to spread it than staff who know what they’re dealing with.

[DSeid]

@Fotheringay-Phipps

After 5,000 deaths, state changes nursing home policy

Cuomo is backing off this in a weird, face-saving way. The original regulation remains in place, and nursing homes are still barred from refusing Covid patients. But he’s adding a new regulation on the hospitals, which bars them from releasing Covid patients to nursing homes. …

I don’t see it as “backing off” so much as responding to current facts on the ground, as made sense in my hypotheticals given previously:

@DSeid

So let’s play some different hypothetical circumstances.

Hospital capacity not near capacity. For sure keep until considered as no significant risk of contagion. Open debate if one asks for negative PCRs or 10 days from onset 3 days no fever and consistent improvement of symptoms. When back still good PPE use etc.

No room at the inn to accept patients getting sick in nursing homes. Patient from nursing home who was admitted sick now afebrile and improving to no longer needing hospital care but not completely resolved. No place to send if nursing home won’t take back. No room for new sicker patients if they don’t leave. Much less likely contagious than the newly sick person in the nursing home. What to do?
BTW, best hopes for your being negative!

NYC hospitals are now not near capacity. For sure keep until considered as no significant risk of contagion, or send to a COVID-19 specific step down facility, and determining that lack of significant contagion risk with a negative PCR.

Past diagnosis of COVID-19 is still NOT an acceptable reason to refuse admission by a nursing home.

FlikTheBlue, you were negative I hope?

[FlikTheBlue]

@DSeid

I don’t see it as “backing off” so much as responding to current facts on the ground, as made sense in my hypotheticals given previously:

NYC hospitals are now not near capacity. For sure keep until considered as no significant risk of contagion, or send to a COVID-19 specific step down facility, and determining that lack of significant contagion risk with a negative PCR.

Past diagnosis of COVID-19 is still NOT an acceptable reason to refuse admission by a nursing home.

FlikTheBlue, you were negative I hope?

Negative 3 separate times. It’s been crazy around here. Governor Abbott has orders all nursing home patients and staff tested. For me that meant once at each of the facilities I visit with different owners. So far we’ve had 5 different facilities with one or two patients test positive and only one with a larger outbreak.

ETA. I agree that past diagnosis with Covid-19 is not an acceptable reason to deny admission. The issue for me is those with currently active infections.

[russian_heel]

At what point do we ask nursing homes to do their job, which is to take care of sick elderly patients, rather than just pointing fingers at the governors who asked them to do so? I have little sympathy for an industry with a history of mentally and physically abusing patients, underpaying and overworking their staff, and gouging families out of every last penny by using guilt. Now they have been trying to hide infection and deaths from C19 that took place in their overcrowded and inadequate buildings.

Yeah yeah yeah I know there are a lot of good facilities but overall there’s too many disgraceful stories and I feel a certain group out there is using this situation for political gain when maybe we need to take a closer look at this industry.