For the second week in a row, a comprehensive report has been released recommending how Michigan’s health department could better manage COVID-19 in nursing homes.
The 30-page report, from the Center for Health and Research Transformation at the University of Michigan, is separate from last week’s report, which came from Governor Gretchen Whitmer’s nursing home task force.
But the two are quite similar. Both recommend allowing outdoor (and in special cases, indoor) visits at nursing homes, and supporting staff by providing extra pay and training resources. Both say hospitals and nursing homes need to be better integrated as steps in a “continuum of care” for elderly patients.
The CHRT researchers compared Michigan’s nursing home response to those around the country, and found nursing homes that had strong relationships with local hospitals did a better job of controlling infection.
“But not all nursing homes have that,” said CHRT’s executive director Marianne Udow-Phillips during a press call on Tuesday. “So we are recommending strengthening and formalizing those relationships.”
The CHRT report dedicates special attention to the state’s regional hub policy, which selected nursing facilities that could isolate recovering COVID-19 patients in separate units. It found the policy to be "an appropriate response" to the first surge of COVID-19 cases in Michigan.
This summer, that policy weathered sustained criticism from Republicans in Lansing.
They claimed, without presenting evidence, that the policy was largely responsible for Michigan’s more than 2,000 COVID-19 deaths among nursing home residents. They wanted to replace it with their own policy, one that would have required the Michigan Department of Health and Human Services to establish entirely separate facilities (not just isolation wings) for recovering COVID-19 patients.
Senator Peter Lucido (R-Shelby Township) sponsored that bill. In late July, Governor Whitmer vetoed it.
MDHHS director Robert Gordon was also on the CHRT press call, where he emphasized that the report refuted political opponents.
“For months now there have been political criticisms about Michigan’s performance in protecting nursing home residents,” he said. “Today’s analysis brings some facts to bear.”
He highlighted the report’s finding that nursing home residents make up 38.6% of COVID-19 deaths nationally, compared to 33.2% in Michigan. (Counting probable deaths, that figure is slightly lower, at 31.2% as of Monday).
But some of the report’s findings are still considered “preliminary.” For example, the researchers found "no evidence of transmission of COVID-19 between patients admitted from hospitals to nursing home residents in hubs." But that's based on aggregate data, not facility-level data.
In an interview with Michigan Radio last week, Udow-Phillips said the CHRT was working with MDHHS to get as much of the latter data as possible.
But reporting difficulties early in the pandemic mean the information may not be totally accurate.
“There may be a point where we need to go back and survey the nursing homes, and MDHHS may do that on our behalf, but right now we’re mostly working with the datasets that MDHHS has,” said Udow-Phillips.
Gordon also said during Tuesday's press call that MDHHS would be announcing adjustments to its visitation policies for long-term care facilities this week.