Detroit nursing homes have 100+ COVID-19 deaths, state taking new actions

Detroit Mayor Mike Duggan said Tuesday there have been 124 COVID-19 deaths recorded among residents and staff in city nursing homes — and added it’s likely the final number will be dramatically higher.

The city also is two-thirds of the way through testing residents at each of the city’s 26 nursing homes, Duggan said during a news conference, and 26% of the 1,282 residents and staff tested have positive for the virus.

“The infection rate among the homeless in the homeless shelters is lower than it is in nursing homes,” said Duggan.

He said the testing process should be wrapped up by this Thursday.

Multiple positive COVID-19 test results and deaths at long-term care facilities such as nursing homes, homes for the aged, adult foster care facilities and assisted living facilities have been reported in Southeast Michigan.

Earlier this month, the Advance first reported the deaths of a staff member and two residents at Ambassador Nursing and Rehabilitation Center in Detroit.

The Michigan Department of Health and Human Services (DHHS) notes that long-term care facilities are places where multiple positive COVID-19 test results threaten the safety of the entire facility due to the nature of the care provided in them and the vulnerable statuses of their residents. 

Multiple positive COVID-19 test results and deaths at long-term care facilities are also being reported in other parts of the state, including the multiple active cases and deaths reported at Maple Woods Manor nursing home in Genesee County, and a death at a nursing home in Lapeer County.

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However, unlike other states, Michigan has not reported overall COVID-19 numbers in nursing homes. DHHS spokesperson Lynn Sutfin said the department will begin sharing numbers from nursing homes later this week.

In order to get a handle on COVID-19 in long-term facilities all over the state, DHHS has rolled out a new three-part strategy to combat the impacts of COVID-19. 

The first is mandating enhanced reporting requirements for all long-term care settings. Beginning Tuesday, all long-term-care facilities will be required to submit daily reports to DHHS, including information about current capacity/bed availability, personal protective equipment inventory and the current number of COVID-19 cases and deaths within their facility.

The second main action is activation of the COVID-19 Infection Prevention Resource and Assessment Team (COVID iPRAT), which was designed to help prevent and contain the spread of COVID-19 in long-term facilities.

The COVID iPRAT is comprised of staff members from across the Public Health Administration Division of Communicable Diseases, and it will work closely with the Medical Services Administration, Michigan Long-Term Care Ombudsman, Michigan Licensing and Regulatory Affairs (LARA) and local health department partners. 

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Through the iPRAT, local health departments and long-term care facilities in their jurisdiction will have access to training on the latest DHHS, Centers for Disease Control and Prevention (CDC), and the Centers for Medicare & Medicaid Services guidance.

Additionally, long-facilities will be reviewed on their infection control policies and procedures, standardized training and protocols, remote contact tracing assistance and remote facilitation of an infection prevention and control assessment using the CDC’s Tele- Infection Control Assessment and Response Program (ICAR) tool. 

The third action is establishing DHHS-designated COVID-19 regional hubs, which will provide higher levels of care and services to treat patients with increased needs.

All other nursing facilities will continue providing care in a traditional manner which may include the care of patients who have been diagnosed with COVID-19, but do not require specialized care and services.

The creation of DHHS’ strategy comes after Gov. Gretchen Whitmer signed Executive Order 2020-50 last Wednesday, which she said aims to keep thousands of employees and residents who work and live in long-term care facilities across Michigan healthy and safe.

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The order called for several new procedures to be put in place, which includes requiring a long-term care facility to inform employees and residents if another resident shows symptoms of COVID-19.

Nursing homes are required to have separate units for residents who test positive for COVID-19 or are experiencing symptoms, supplied with appropriate personal protective equipment.

Finally, the order aims to ensure that residents of long-term care facilities get the medical care they need if they test positive with COVID-19.

The order says that if a facility has a dedicated unit of space for residents with COVID-19, they can only be moved there if they are medically stable, meaning that they don’t have a change in mental status or a significant change or abnormality in blood pressure, heart rate, oxygenation status, or laboratory results that warrants emergent medical evaluation.

If the facility doesn’t have a designated space to take care of a COVID-19 positive resident, or if the resident becomes medically unstable, they will need to be transferred to one of the regional hubs until they are medically stable.

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If there is no space available at a regional hub, the resident will be taken to the hospital until they become stable again. Once they’re medically stable, they would be allowed to return to the nursing home. 

DHHS chief medical executive Dr. Joneigh Khaldun said the order will help ensure long-term care facilities are using best practices to keep their residents and employees safe.

Service Employees International Union (SEIU) Healthcare Michigan supports the state’s strategies and Whitmer’s order.

“Transparency has been a huge challenge in nursing homes. We commend the Governor for taking this step for more accountability for our workers and residents,” said SEIU President Andrea Acevedo.