Coronavirus in one state (45)

Today is a big day in this series and perhaps in the coverage of COVID-19 in Minnesota. The Star Tribune is featuring a story on what I have been calling the nursing home crisis roughly since I began this series. Chris Serres reports “Minnesota nursing homes, already the site of 81% of COVID-19 deaths, continue taking in infected patients.” Subhead: “Nursing homes accepting infected patients, even as death toll mounts.” The story opens:

Despite the devastating death toll, Minnesota nursing homes are still being allowed by state regulators to admit coronavirus patients who have been discharged from hospitals.

Early in the pandemic, the Minnesota Department of Health turned to nursing homes and other long-term care facilities to relieve the burden on hospitals that were at risk of being overwhelmed by COVID-19 patients. Minnesota hospitals have since discharged dozens of infected patients to nursing homes, including facilities that have undergone large and deadly outbreaks of the disease, state records show.

Now that practice is drawing strong opposition from some lawmakers, residents’ families and health watchdogs, who warn that such transfers endanger residents of senior homes that are understaffed and ill-equipped to contain the spread of the coronavirus. They are calling for more state scrutiny over transfers, including stricter standards over which nursing homes should be allowed to accept COVID-19 patients from hospitals.

Currently, even poorly rated nursing homes with large and deadly clusters of coronavirus cases have been allowed to admit COVID-19 patients from hospitals. One such facility, North Ridge Health and Rehab in New Hope, has accepted 42 patients from hospitals and other long-term care facilities since mid-April even as the coronavirus has raged through its 320-bed nursing home, killing 48 of its patients and infecting scores more.

And then we have this:

State health officials and long-term care industry representatives have defended the practice of discharging some COVID-19 patients to nursing homes, saying it is part of a broader strategy to conserve critical hospital beds during the pandemic. Long-term care facilities can provide treatment for coronavirus patients who still need care, but have stabilized enough that they no longer require hospitalization, officials said.

So far, 11 facilities statewide have been designated as “COVID support sites,” with separate units or wings to handle coronavirus patients. These specialty sites have gone through a vetting process by the state to ensure they have adequate staffing, supplies and infection-control standards.

However, other nursing homes have been allowed to admit COVID-19 patients under private arrangements with hospitals. The practice is widespread. The state Department of Health has reviewed the cases of about half the patients hospitalized for COVID-19 statewide. The agency found that 27%, or about 268 patients, were discharged to long-term care facilities since the pandemic began.

“Hospital beds are a key resource during this pandemic, and they must be preserved for those who are in need of acute care,” the Minnesota Department of Health said in a statement. “For COVID-19-positive patients whose care requirements are below that level, the goal is to get them out of the hospital and into an appropriate setting for their next stage of care — one that can provide the services they do need while minimizing the risk of transmission.”

But the fear that moving coronavirus patients to nursing homes might trigger more infections has been compounded by the alarming death toll in such facilities.

You don’t say.

“Statewide, the respiratory disease caused by the coronavirus has killed more than 600 Minnesotans at nursing homes and assisted-living facilities. That is a staggering 81% of the deaths from the pandemic statewide….”

Well, that’s what I’ve been saying for the past six weeks or so. The Star Tribune is a little slow on the uptake.

Where’s Walz? The Star Tribune omits any mention of the governor or his “5-Point Battle Plan” of May 7 to mitigate the spread of the disease in nursing homes. Based on the daily press briefings from which I have been excluded, I believe the Walz administration is still in the process of implementing the “battle plan.”

Oh, well.

The authorities announced 17 new deaths that they attributed to COVID-19 yesterday, bringing the total to 748. Thirteen of the 17 decedents were residents of long-term care facilities, leaving the share of LTC deaths to all deaths attributed to COVID-19 just over 81 percent.

The age breakdown of the new decedents followed the pattern we have observed. One was in his 100’s, three were in their 90’s, four were in their 80’s, three were in their 70’s, and six were in their 60’s.

Reminder: Decedents with significant underlying medical conditions account for 98.46 percent of all those whose deaths have been attributed to COVID-19.

Below is the audio of yesterday’s daily press briefing. You’d never know we are in the middle of a scandal.

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