New York Mandates Nursing Homes Take Covid-19 Patients Discharged From Hospitals

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By Anna Wilde Mathews Wall Street Journal March 26, 2020

State cites urgent need to expand hospital capacity; doctors group says decision ‘represents a clear and present danger to all of the residents of a nursing home.’

NEW YORK, NY – MARCH 24: Doctors test hospital staff with flu-like symptoms for coronavirus (COVID-19) in set-up tents to triage possible COVID-19 patients outside before they enter the main Emergency department area at St. Barnabas hospital in the Bronx on March 24, 2020 in New York City. New York City has about a third of the nations confirmed coronavirus cases, making it the center of the outbreak in the United States. Misha Friedman/Getty Images/AFP

New York told nursing-home operators that they will be required to accept patients infected with the new coronavirus who are discharged from hospitals but may be still convalescing, amid more cases in the state that are straining the health-care system.

The decision will draw pushback from some nursing-home officials, who have warned that such moves endanger residents who aren’t infected by the virus, because discharged patients may still be contagious. A group representing doctors who work in nursing homes, known as AMDA, the Society for Post-Acute and Long-Term Care Medicine, said in a recent resolution that “admitting patients with suspected or documented Covid-19 infection represents a clear and present danger to all of the residents of a nursing home.”

“We’ve got an extraordinarily vulnerable population on our hands,” said Christopher Laxton, executive director of the group. Nursing homes’ older, often frail residents are particularly susceptible to the virus. Many nursing homes have also long struggled with infection control, according to federal inspection records and researchers.

Covid-19, the respiratory illness caused by the new coronavirus, has been spreading rapidly in nursing homes, resulting in large outbreaks and more deaths across the U.S. The federal government has said there are cases in at least 147 nursing homes, with clusters and deaths reported in elder-living facilities from Louisiana to Vermont to Florida.

At least 37 deaths have been tied to an outbreak in one Seattle-area nursing home, Life Care Center of Kirkland.

Vice President Mike Pence on Tuesday called the New York metropolitan area “high-risk” and urged anyone who recently traveled out of the region to self-isolate for 14 days to avoid the spread of the novel coronavirus. Photo: Eduardo Munoz Alvarez/Getty Images

In the directive sent Wednesday to nursing homes, which was viewed by The Wall Street Journal, the New York State Department of Health said, “No resident shall be denied readmission or admission to the [nursing home] solely based on a confirmed or suspected diagnosis of Covid-19.” In addition, the document said, nursing homes “are prohibited from requiring a hospitalized resident who is determined medically stable to be tested for Covid-19 prior to admission or readmission.”

The document noted that there is an “urgent need to expand hospital capacity in New York State to be able to meet the demand for patients with Covid-19 requiring acute care.”

A spokesman for the state’s Department of Health said that “protecting New York’s most vulnerable nursing-home population is a priority for addressing the current Covid-19 outbreak and containing the virus.” The department continues to issue guidance to nursing homes regarding testing, visitation and other matters during the outbreak, he said.

Like other health-care sectors, nursing homes have said they are struggling with a lack of personal protective equipment for their workers, and that in some cases they aren’t able to get prompt coronavirus tests for all of their residents and employees who might need them.

Write to Anna Wilde Mathews at