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LI hospitals sent hundreds of COVID-19 patients to nursing homes, rehabs at peak of pandemic

Members of the medical staff at Nassau University

Members of the medical staff at Nassau University Medical Center stand by the admission tent outside the hospital on April 15. Credit: Newsday/Alejandra Villa Loarca

Long Island hospitals sent hundreds of COVID-19 patients to nursing homes and rehabs during the peak of the health crisis in March and April, according to figures from area hospitals.

The wave of patients was largely facilitated by a state order on March 25, which said nursing homes could not refuse a person simply because they were COVID-19 positive. Nursing homes, however, did not have to accept the patients if they could not care for them safely, the order said.

The state’s mandate came under withering criticism from nursing home officials and families of residents, who say the move introduced sick people into settings ill-prepared to protect the most vulnerable people.

Nassau and Suffolk counties have more than 1,200 confirmed and presumed COVID-19 deaths reported at nursing homes and adult facilities. 

A scramble in mid-March

The surge of patients into nursing homes is slowing as the numbers of new COVID-19 cases and hospitalizations decrease over time, hospital officials said. And on May 10, Gov. Andrew M. Cuomo announced that COVID-19 patients must test negative for the virus before entering a nursing home.

But by the middle of March, coronavirus was sickening thousands of New Yorkers, sometimes in a single day. Long Island hospitals were scrambling to expand bed capacity, building field hospitals, and transforming operating rooms, conference centers and recovery units into COVID-19 areas for patients.

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There was pressure to “help an unprecedented hospital bed capacity issue,” said Dr. Maria Carney, medical director of post-acute medicine at Northwell Health.

In addition, the hospitals found that many COVID-19 patients, especially the elderly, required significant care even after they were discharged from the hospital, Carney said.

Northwell, which has 12 of its 19 hospitals on the Island, said it released a total of 1,006 of its 9,498 COVID-19 discharges, or 10.6%, to nursing homes and rehabs from March 1 to May 3, officials said.

Catholic Health System, composed of six hospitals on Long Island, sent 530 of its 2,291 discharges, or 23%, to nursing homes or rehabs in March and April, officials said. CHS went so far as to create a Post-Hospital COVID-19 Discharge Unit to smooth the transition.

CHS executive vice president Dennis Verzi praised Cuomo’s latest order as positive step toward protecting a fragile population.

“Although there might be a slight increase in the length of hospital stays as a result of this order, we don’t anticipate a significant negative impact on the number of hospital beds available,” Verzi said.

Stony Brook University Hospital released 167 of its 1,085 COVID-19 discharges, or 15%, to nursing homes or rehabs in March and April, officials said. Mount Sinai South Nassau hospital said it released 256 of its 737 discharges, or 35%, to nursing homes and rehab during that period. Nassau University Medical Center said it released 56 of its 537 discharges, or 10%, to nursing homes and rehab for the same time frame.

Carney, of Northwell Health, said it’s too early to anticipate the full impact of Cuomo’s latest order. She said she expects some patients will end up staying in the hospital longer.

Carney said the hospitals are finding that some elderly patients are still testing positive for as long as six weeks. Some are testing positive even though they are no longer contagious, she said. She believes these people are a small percentage of the COVID-19 patients.

“We’re trying to quantify this population and determine the safest plan,” Carney said. “Whether we should keep them where they are, transfer to an alternative care site, or try to identify skilled nursing facilities that can be COVID-safe.”

A nursing home strained

Hospitals sent a total of 58 COVID-19 patients to Gurwin Jewish Nursing and Rehabilitation Center in Commack in March and April, said facility president Stuart Almer.

Almer said Gurwin is suffering financially because of the added expenses of treating these residents, such as creating an isolated unit for them and paying for some ventilators as well as overtime and hazard pay for staff. Moreover, the nursing home is not seeing people come in for rehabilitation after elective surgeries such as knee and hip replacements, because hospitals have largely stopped doing these operations amid the crisis, he said.

He said the 460-bed facility is customarily full but is currently down 104 beds. A total of 49 residents there died due to COVID-19, he said.

Beyond that, Almer said he worries about the new state mandate that calls for testing staff twice a week, which he said could cost the facility $300,000 a week.

“This is an impact in the millions,” he said. 

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