Elderly stranded in hospitals across US as nursing homes turn them away over coronavirus
LOS ANGELES — Carl Schoen’s 99-year-old mother has lived in a nursing home for five years. On March 13, she was taken to the emergency room at Huntington Memorial Hospital with pneumonia.
She got better quickly, within a few days, but now the nursing home won’t take her back because she can’t prove she doesn’t have the coronavirus. She got tested 12 days ago but the results aren’t back yet.
“They are being very steadfast in saying that until she gets the test result back she can’t return,” said Schoen, who asked that his mother’s name and the name of the care facility in northeast L.A. not be published for fear of alienating her caregivers.
Across the country, hospitals and nursing homes are stuck in similar high-stakes battles over the fate of elderly patients amid the coronavirus pandemic.
Hospitals are desperately trying to discharge patients to clear space for an expected wave of COVID-19 victims. But nursing homes are reluctant to accept any new patients — or even returning residents — until it is proven that they are free of the virus.
Dr. Michael Wasserman, medical director at the Eisenberg Village nursing home in Reseda, said he won’t accept any patient returning from a hospital until they have two negative coronavirus tests performed 24 hours apart.
The extreme vulnerability of elderly residents to the novel virus makes taking a patient who might have the highly contagious pathogen “akin to premeditated murder,” he said.
Wasserman pointed to the devastation at the Life Care Center nursing home in Kirkland, Wash., site of one of the first COVID-19 outbreaks in the United States. Two-thirds of the residents and 47 workers fell ill, and 35 people died.
“I’m afraid there will be a minimum of 50 more Kirklands in California before this is done,” Wasserman said.
Wasserman, a geriatrician for more than 30 years and president of the California Association of Long Term Medicine, has been in touch with state public health officials regarding advice to nursing homes. Their message, he said, has been unclear and shifting.
“First, they were telling nursing homes to take patients from hospitals, then they were telling us not to take patients, now there’s conflicting guidance saying be prepared to take them,” Wasserman said.
But Wasserman agrees with doctors who say nursing homes should not send residents to hospitals, even if they have COVID-19 symptoms, unless they are in dire need of care.
“We’ve got a whole strategy on how to deal with this in the skilled nursing facilities,” he said. “If you think someone has it, you have to contain it there. We don’t want to send someone to the hospital unless they really need the ICU.”
Once a patient has gone to the hospital, he said, nursing homes have a moral duty to be sure they are not carrying the virus when they return, especially to a facility with no sign of contamination.
“If I knew someone was trying to send a COVID patient into my nursing home,” Wasserman said, “I would stand in front of the door and say, ‘Hell no, I’m not going to let you do this.’”
The nationwide shortage of tests, and long waits for results, are exacerbating the problem because it can be difficult to prove that a patient who has been in a hospital is completely free of the virus.
Officials at the Los Angeles County Department of Health Services, the second-largest municipal health system in the country, confirmed they are running into this problem.