Bowing to concerns about moving old and frail residents, Baker administration officials Monday backpedaled on a controversial plan to empty select nursing homes across the state to treat COVID-19 patients discharged from hospitals.
Instead, they said, they’ll add nearly 1,000 beds by temporarily reopening former nursing homes for COVID-19 recovery.
The about-face comes after an uproar from families, resident advocates, and social workers citing the trauma of relocating older residents amid a pandemic — and after the first three facilities volunteering to become recovery centers reported residents testing positive for coronavirus, raising fears they could infect residents at their new facilities.
“We needed to pivot and try to find some other strategies,” Marylou Sudders, the state secretary of health and human services, said at a press briefing Monday afternoon.
State officials did not identify the new sites, but operators and town officials have said at least two will be in New Bedford, one in East Longmeadow, and one in Falmouth.
Underscoring the virus’s danger to seniors, the number of COVID-19 cases at nursing homes and other senior care facilities continues to climb. On Monday, state public health officials reported 378 deaths attributed to COVID-19 in long-term care, an increase of 38 from a day earlier. The officials reported that 3,446 people have tested positive at 201 long-term care facilities in Massachusetts as of Monday morning.
The toll at senior care facilities — which is thought to undercount the actual tally because only a minority of residents have been tested — represents nearly 45 percent of all coronavirus-related deaths in Massachusetts.
Yet public health officials are only beginning to glean the prevalence of the virus in long-term care facilities because testing has been limited. Cambridge last week became the state’s first municipality to unveil a program to test everyone at long-term care residences, regardless of whether they have symptoms.
As of Monday evening, city officials said 203 people who reside or work in Cambridge’s seven skilled nursing and assisted living facilities have tested positive for COVID-19, including six who have died. But city officials couldn’t say what percentage of those tested were infected because results for only 950 of the 1,500 people tested had come back. City officials said 256 other Cambridge residents have tested positive for the virus over the past six weeks, including one who died.
The extreme vulnerability of long-term care residents ultimately made it infeasible for state officials to turn nursing homes into recovery centers; by the time the plan was conceived, the virus had already crept into too many sites. The final straw came earlier this month when more than 75 residents at the AdviniaCare in Wilmington, most of whom were asymptomatic, tested positive just as they were preparing to be relocated. Seven have died.
Governor Charlie Baker said the plan to establish the “step-down” recovery centers was intended to avoid the need for the kind of mandates seen in other states that have required nursing homes with no infections to admit recovering COVID-19 patients, potentially exposing healthy residents.
Long-term care homes are “by far the most difficult kind of facility — because of the nature of the population, the nature of the work, and the nature of the way they’re organized and the way they support and serve their residents — to manage against a contagion like COVID-19,” the governor said.
State officials have said the first operator to volunteer, Beaumont Rehabilitation and Skilled Nursing Center in Worcester, which had already transferred 120 residents to new sites before it discovered infections, has begun moving in recovering patients. They didn’t say whether Fairview Commons in Great Barrington, which also found infected residents, will go forward with plans to convert their sites to recovery centers. A spokesman for AdviniaCare said Monday that the nursing home still plans to become a recovery center, though the timetable is unclear.
Massachusetts officials said they’re moving to assist nursing homes that are having trouble with staffing, infection control, or obtaining protective gear for nurses.
They said they’re working with facility administrators and the Massachusetts Medical Society to recruit volunteers and temporary workers to staff long-term care facilities struggling with staff shortages as nurses and other employees fall sick. They’re also trying to find staff to work at the new COVID-19 recovery centers.
“This is a very aggressive interaction,” Sudders said.
She said part of the $30 million Massachusetts officials set aside last week for nursing home operators who converted their facilities to recovery centers will be used to set up “COVID-positive” wings in existing nursing facilities.
Nursing homes and assisted living centers continued to report new or expanded COVID-19 outbreaks Monday. The Falls at Cordingly Dam, an assisted living facility in Newton, said that 14 residents have died of complications linked to the novel coronavirus; an additional 32 residents and 24 workers have tested positive.
“Our heartfelt thoughts and deepest sympathies go out to each resident’s family, and we remain committed to helping all our residents, families and associates through this very difficult time. We are working around the clock to provide the best care possible for those residents that have COVID-19 and to protect those who do not," said Amanda Cillo, a spokeswoman for Benchmark Senior Living, which operates the facility.
The Falls, which has about 90 residents and 100 workers, began testing all of them two weeks ago. It has been providing regular updates to residents and their families.
A man whose mother lives at The Falls said his mother needs to be at a facility that can provide around-the-clock care, but he worries about the risk of keeping her there.
“I don’t want to take her out, and I don’t want her to die,” said the man, who spoke on the condition that he not be identified to protect his mother’s privacy. “You hope for the best, and you cling to all the statements about the things they are doing to try to make things better.”
Life Care Center of Nashoba Valley, the site of one of the largest outbreaks in eastern Massachusetts, on Monday reported the deaths of four more residents from the virus, bringing the total at the Littleton facility to 14. A nurse also died there recently after quitting over concerns about how the operator had handled the coronavirus pandemic.
The testing program in Cambridge, which could become a model for other municipalities struggling to control the virus at long-term care facilities, was conducted by the Broad Institute, a genomics research institution affiliated with Harvard and the Massachusetts Institute of Technology.
Under the pilot program, all residents and staff are being tested twice in three-day periods, officials said.
In a statement, city officials said they are working with the nursing facilities to provide guidance on separating those who tested positive from people who tested negative.
(Laura Krantz of the Globe staff contributed.)
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