As hospitals brace for a surge in coronavirus patients in the coming weeks, two Boston-area health care facilities are racing to repurpose their operations to admit recovering COVID-19 patients too sick to go home or return to senior care residences.
Spaulding Hospital in Cambridge and the AdviniaCare nursing home in Wilmington are moving more than 130 nursing home residents and rehab patients to other sites. The goal is to create dedicated space for COVID-19 patients who are discharged from Boston area hospitals, yet who may still be contagious and in need of oxygen, physical therapy, and other support.
But the relocations are already prompting protests from advocates and the families of residents of these facilities, who say the plans may traumatize and endanger fragile seniors.
Four groups that advocate for nursing home residents are calling for a halt to the transfers, which are among the first of an expected wave of such consolidations of patients and nursing home residents statewide. In a letter Tuesday night to Massachusetts Health and Human Services Secretary Marylou Sudders they objected to the plans and demanded a meeting with state officials.
“It’s a nightmare,” said Arlene Germain, policy director of the Massachusetts Advocates for Nursing Home Reform. “It’s like an eviction. I don’t see the need. There are so many options in Massachusetts with dormitories, athletic fields and empty nursing homes. It’s a recipe for disaster.”
But nursing homes are under pressure to help hospitals and segregate healthy residents from recovering COVID-19 patients.
AdviniaCare in Wilmington is the first nursing home in the Boston area to agree to become a recovery center and will begin moving its residents out of the 142-bed facility to other sites in the next few days. Chris Hannon, chief operating officer of the Wilmington nursing home’s parent company, Norwood-based Pointe Group Care, said the decision was not easy to make, but it seemed necessary.
“We understand the challenges it presents to residents and families," he said. "But we felt it was the best and only decision we could make given the insurmountable health crisis.”
AdviniaCare disclosed the move late Tuesday night, only hours after the operator of the state’s first planned recovery center, Beaumont Rehabilitation and Skilled Nursing Center in Worcester, acknowledged that a resident it was preparing to move had tested positive for the virus.
Plans to complete Beaumont’s relocation of 147 residents have been delayed as the patient remains isolated there while others on the same floor are tested for the novel coronavirus.
Pointe Group Care said its decision to designate AdviniaCare as a dedicated site for recovering patients was made at the request of the Massachusetts Executive Office of Health and Human Services. State officials didn’t respond to a request to discuss the fast-evolving program.
Hannon said AdviniaCare began informing families of its plan last night. It said AdviniaCare residents would be moved after they received a negative test for COVID-19. He said management will work with Partners HealthCare to determine how to test residents and get results quickly.
If a resident tests positive, Hannon said, he or she will remain isolated in their rooms at AdviniaCare. But the home may still begin taking in recovering coronavirus patients from hospitals.
Spaulding has already moved 20 patients from the fourth floor of its Cambridge hospital, mostly to other Spaulding sites in Boston, and is preparing to move another dozen from the second floor.
David Storto, president of Spaulding Rehabilitation Network, acknowledged that only those residents showing coronavirus symptoms have been tested before going home or moving to other facilities. State officials, working with the National Guard and Broad Institute, are now trying to accelerate testing at skilled nursing facilities but haven’t given details on how that will be done.
“It’s a significant challenge,” Storto said. “The infection control measures needed to deal with this is above and beyond what the garden-variety skilled nursing facility has ever had to deal with before.”
The two open floors at Spaulding will give its Partners HealthCare affiliates, Massachusetts General Hospital and Brigham and Women’s Hospital, space to send discharged patients. Patients on the third floor, many of whom would be difficult to move, will remain there, isolated from the COVID-19 patients.
In the worst-case scenario, Storto said, the two floors won’t be enough to handle the Partners overflow, let alone the needs of other area hospitals treating patients. So state health officials are scouting for about a dozen skilled nursing homes, from Cape Cod to Western Massachusetts, that can quickly be converted into larger virus recovery centers.
Hannon said about 100 residents of AdviniaCare will be moved to sister Pointe Group facilities and other skilled nursing facilities in the area. He said most of those sites will be within a 15-minute drive of Wilmington. The staff at AdviniaCare will remain there and care for recovering coronavirus patients, who are scheduled to begin arriving early next week.
“The timeline is based on the public health crisis,” Hannon said. “The expectation is that during the next week-and-a-half, we’ll be seeing an increased surge of [virus] patients.”
Hannon said state and federal officials have agreed to compensate nursing home owners for the cost of moving residents and setting up the new recovery centers, possibly by modifying the terms of Medicaid reimbursements. But he said the parties are still working out the details.