Gov. Andrew Cuomo of New York was not the only state leader to have directed nursing homes to admit patients who had been hospitalized for COVID-19. Governors from Michigan, California, New Jersey, and Pennsylvania, all Democrats, enacted similar policies last year as fears grew that hospitals would be overwhelmed with new patients and too few healthcare providers.
New York: Gov. Cuomo issued a directive on March 25 to nursing homes and long-term care facilities that prohibited them from discriminating against residents who had tested positive for the coronavirus. Though it was not an order, nursing homes in New York interpreted it that way and took in COVID-19-positive residents until the directive was invalidated in May.
Cuomo’s office has been accused of manipulating data reflecting deaths among nursing home residents by excluding the numbers of those who died after being transferred to hospitals. A leaked call with Cuomo’s aide Melissa DeRosa and state Democrats confirmed that the administration had undercounted fatalities to preserve its reputation.
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Michigan: Gov. Gretchen Whitmer issued a similar order on April 15. The Whitmer administration ordered that a long-term care facility “must not prohibit admission or readmission of a resident based on COVID-19 testing requirements or results.” The policy was renewed three times until it was rescinded in July 2020.
California: Gov. Gavin Newsom’s administration ordered on April 10 that “patients hospitalized, or receiving treatment at an alternate care site, with COVID-19 can be discharged to a [skilled nursing facility] when clinically indicated.”
The policy mandated testing for patients who are discharged from a hospital to a skilled nursing facility so that a coronavirus-positive patient could be isolated from other residents.
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New Jersey: Gov. Phil Murphy approved a directive from state Health Commissioner Judith Persichilli that said no patient can be denied admission or readmission to a nursing home “solely based on a confirmed diagnosis of COVID-19.” A patient should not be discharged until diagnostic test results have confirmed whether he or she should be discharged. However, nursing homes cannot require a discharged patient to undergo a COVID-19 test in order to be admitted to the nursing home as long as doctors conclude that the patient is “medically stable.”
“We did advise long-term care facilities to readmit their residents … if they had appropriate PPE and appropriate staffing and the ability … to separate COVID-19 patients from non-COVID-19 patients,” Persichilli said. “If the long-term care facility was not able to do that, they should not have readmitted.”
Pennsylvania: Gov. Tom Wolf enacted a mandatory admission policy in March, saying that “nursing care facilities must continue to accept new admissions and receive readmissions for current residents who have been discharged from the hospital who are stable.” The policy was enacted to protect hospitals from being overwhelmed by the volume of COVID-19 patients.
The order added that nursing home admissions “may include stable patients who have had the COVID-19 virus.”