Recommended by Ricochet Members Created with Sketch. Democratic Nursing Home Policy?

 

Having failed to bury news of his March 25 order prohibiting nursing homes from rejecting patients with COVID-19, Governor Cuomo tried blame-shifting. He was “following federal guidelines,” he claimed, citing a March 13 order from the Center for Medicare and Medicaid Services. The head of CMS rejects the claim.

“Under no circumstances should a hospital discharge a patient to a nursing home that’s not prepared to take care of those patients’ needs,” Verma said on Fox News Radio. “The federal guidelines are absolutely clear about this.”

We can read the fine print and decide for ourselves who is right here. Or we can think about this:

Though reports seem oddly cryptic on the point (typically saying “some states,” without saying which states), as far as I’ve been able to gather, every governor who had a policy of sending COVID-19-positive into nursing homes is a Democrat. We’re talking about at least NY, NJ, PA, MI, CA, MN.

I’ve been looking around, but have yet to find one Republican governor with a similar policy. (Correct me if I’m wrong, and I’ll gladly amend the post.)

What could account for this discrepancy? And why isn’t it in the news everywhere?

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  1. Instugator Thatcher
    Instugator Joined in the first year of Ricochet Ricochet Charter Member

    • #1
    • May 29, 2020, at 6:48 AM PDT
    • 14 likes
    • This comment has been edited.
  2. JoelB Member

    I think the Dems are so fixated on forced nondiscrimination that they missed the whole problem of contagion.

    • #2
    • May 29, 2020, at 6:49 AM PDT
    • 9 likes
  3. Instugator Thatcher
    Instugator Joined in the first year of Ricochet Ricochet Charter Member

    • #3
    • May 29, 2020, at 6:51 AM PDT
    • 17 likes
  4. MarciN Member

    JoelB (View Comment):

    I think the Dems are so fixated on forced nondiscrimination that they missed the whole problem of contagion.

    That’s what I think happened too. For them, it’s a knee-jerk reaction. “You can’t deny admittance to that person.” 

    I think the nursing home administrators are as much to blame here as anyone else. They are faithful bureaucrats rather than true executives. 

    Each and every single one of them should simply have said, “No.”

    • #4
    • May 29, 2020, at 6:55 AM PDT
    • 4 likes
  5. Nerina Bellinger Member

    I think those states were also the ones anticipating a high demand for acute-care bed space and so took the aggressive action of clearing out patients – even elderly ones infected with the virus – to free up beds. It was a stupendously stupid decision given the fact (perhaps the only fact that has remained true throughout this crisis) that old people die in large numbers from this disease.

    • #5
    • May 29, 2020, at 6:55 AM PDT
    • 13 likes
  6. katievs Member
    katievs Joined in the first year of Ricochet Ricochet Charter Member

    JoelB (View Comment):

    I think the Dems are so fixated on forced nondiscrimination that they missed the whole problem of contagion.

    Personally, I incline more in the “reckless disregard for life” direction. 

    • #6
    • May 29, 2020, at 6:58 AM PDT
    • 10 likes
  7. katievs Member
    katievs Joined in the first year of Ricochet Ricochet Charter Member

    Nerina Bellinger (View Comment):

    I think those states were also the ones anticipating a high demand for acute-care bed space and so took the aggressive action of clearing out patients – even elderly ones infected with the virus – to free up beds. It was a stupendously stupid decision given the fact (perhaps the only fact that has remained true throughout this crisis) that old people die in large numbers from this disease.

    How to explain, then that there were so many empty beds in NY? The USS Comfort and the Javits Center, for instance, were hardly used.

    • #7
    • May 29, 2020, at 6:59 AM PDT
    • 6 likes
  8. katievs Member
    katievs Joined in the first year of Ricochet Ricochet Charter Member

    I honestly think there was more to it than “non-discrimination.” And I can’t help noticing that Democrats have a political interest in increasing the number of COVID-related deaths. In my darkest moments, I note that they have a financial interest in reducing the number of sick elderly people. This is the party that sends millions to Planned Parenthood. This is the party that favors healthcare-rationing. Remember Obama telling Grandma she can “take a pill” to ease pain, rather than get that life-saving surgery?

    This is the same party that is demanding that healthy people wear masks and businesses stay shutdown. They are all but openly rooting for economic catastrophe.

    Ramesh Ponuru was right to call them the Party of Death, imo.

    • #8
    • May 29, 2020, at 7:07 AM PDT
    • 11 likes
    • This comment has been edited.
  9. Aaron Miller Member
    Aaron Miller Joined in the first year of Ricochet Ricochet Charter Member

    Nerina Bellinger (View Comment):

    I think those states were also the ones anticipating a high demand for acute-care bed space and so took the aggressive action of clearing out patients – even elderly ones infected with the virus – to free up beds. It was a stupendously stupid decision given the fact (perhaps the only fact that has remained true throughout this crisis) that old people die in large numbers from this disease.

    And because temporary overflow hospitals had already been established. They had resources for recovering COVID patients but chose instead to send them back among the most vulnerable.

    As I recall, this was after Cuomo and other New York Democrats complained that a Christian organization hosted the overflow hospital in Central Park, as if such an organization had ever refused non-Christian patients. 

    • #9
    • May 29, 2020, at 7:08 AM PDT
    • 6 likes
  10. MarciN Member

    I often found this sort of thinking in the schools I volunteered at. Many teachers and principals, when parents or others informed them that things were not going well or that some aspect of the education experience their school was providing was in some way failing or endangering the students would respond, “It’s the law. We have to do it this way.” 

    To me, that is not an excuse. If my job is to keep nursing home patients or students in my school safe from harm, there’s no state or federal law that is stronger than that purpose. Go ahead and fire me because I cannot do the job you hired me to do anyway. I don’t want to take money I’m not earning honestly.

    I grew up hearing the adage, “An honest day’s work for an honest day’s pay.” To me, taking money to do a job I can’t do is pretty much the same thing as stealing. 

    I think this is a government problem. I’m in the private sector, and if someone approaches me to do work I can’t do, I smile and say so. It’s not a big deal to me. 

    • #10
    • May 29, 2020, at 7:08 AM PDT
    • 6 likes
  11. Percival Thatcher
    Percival Joined in the first year of Ricochet Ricochet Charter Member

    Maybe we’ve been calling the wrong brother Fredo.

    • #11
    • May 29, 2020, at 7:09 AM PDT
    • 6 likes
  12. Instugator Thatcher
    Instugator Joined in the first year of Ricochet Ricochet Charter Member

    Percival (View Comment):

    Maybe we’ve been calling the wrong brother Fredo.

    Embrace the power of “and”.

     

    • #12
    • May 29, 2020, at 7:16 AM PDT
    • 5 likes
  13. katievs Member
    katievs Joined in the first year of Ricochet Ricochet Charter Member

    MarciN (View Comment):

    I often found this sort of thinking in the schools I volunteered at…. “It’s the law. We have to do it this way.”

    Marci, you are too generous here, imo. If it were the law, wouldn’t we expect to find Republican governors doing the same thing? Aren’t Republicans known for being law-abiding?

    Contrast these Dem governors’ policies with Ron DeSantis in FL, who from the beginning set out to protect seniors in care facilities. Note the different in nursing-home-death-rates between FL and NY.

    • #13
    • May 29, 2020, at 7:17 AM PDT
    • 10 likes
    • This comment has been edited.
  14. MarciN Member

    katievs (View Comment):

    Nerina Bellinger (View Comment):

    I think those states were also the ones anticipating a high demand for acute-care bed space and so took the aggressive action of clearing out patients – even elderly ones infected with the virus – to free up beds. It was a stupendously stupid decision given the fact (perhaps the only fact that has remained true throughout this crisis) that old people die in large numbers from this disease.

    How to explain, then that there were so many empty beds in NY? The USS Comfort and the Javits Center, for instance, were hardly used.

    I don’t think they knew they would stay empty. Or for how long. The treatment time is long for this virus.

    And frankly, they didn’t know how high the death toll would be. The more people died, the more beds they had. Horrible but true.

    As the situation unfolded, it got worse and worse because they didn’t know what was going on and they didn’t have special infectious disease hospitals. The hospitals had nowhere else to send the patients, from what I’ve read.

    Truthfully, Massachusetts had the same thing happen in our long-term-care and rehab facilities. We have a Republican governor. As far as I know, he did not issue the same order. But I don’t know that for sure. He has instigated the opening of separate facilities in our state for covid-19 patients for the future. But those facilities, capable of treating people with one or two health issues as well as covid-19, were not available in February and March. That said, Baker has hired a special prosecutor to look into the deaths of 70 veterans in one VA hospital in Massachusetts. I don’t know what he expects to find.

    I think the disaster planners need a new textbook to work from. This was a crisis simply because they never anticipated these circumstances, and for the life of me, I’m not sure why. That’s been bugging me since it started. I read a great book a few years ago called Five Days at Memorial which chronicles the events at a New Orleans hospital during the Hurricane Katrina disaster. It should be required reading for all town administrators across the country.

    • #14
    • May 29, 2020, at 7:18 AM PDT
    • 3 likes
    • This comment has been edited.
  15. katievs Member
    katievs Joined in the first year of Ricochet Ricochet Charter Member

    MarciN (View Comment):

    I think the disaster planners need a new textbook to work from. This was a crisis simply because they never anticipated these circumstances, and for the life of me, I’m not sure why. That’s been bugging me since it started. I read a great book a few years ago called Five Days at Memorial which chronicles the events at a New Orleans hospital during the Hurricane Katrina disaster. It should be required reading for all town administrators across the country.

    New Orleans was also run by Democrats. Democrats across the nation back then were blatantly using the natural disaster to tarnish President Bush.

    • #15
    • May 29, 2020, at 7:24 AM PDT
    • 7 likes
  16. MarciN Member

    katievs (View Comment):

    MarciN (View Comment):

    I often found this sort of thinking in the schools I volunteered at…. “It’s the law. We have to do it this way.”

    Marci, you are too generous here, imo. If it were the law, wouldn’t we expect to find Republican governors doing the same thing? Aren’t Republicans known for being law-abiding?

    Contrast these Dem governors’ policies with Ron DeSantis in FL, who from the beginning set out to protect seniors in care facilities. Note the different in nursing-home-death-rates between FL and NY.

    I would have been on top of this I think much earlier in terms of testing staff and patients and visitors. That said, the tests were not available that I would have needed. 

    I don’t know how I would have kept it out of the facility. 

    This has been the mystery to me all winter and spring. I hear doctors criticizing their own hospitals for closing up shop for other medical problems, and I don’t understand why they are upset. Do these doctors believe that they could have conducted surgeries and tests safely without transmitting the virus to their patients? I ask that most sincerely. I have not understood some of this from the beginning. I do know that hospital-acquired infections are a huge problem everywhere and all the time. This virus is especially bad in healthcare settings. And in fact, in Lombardy, Italy, it was the healthcare system that became the vector for the disease, just as the nursing home in Seattle did. 

    From where I’m sitting, that’s really what was going on across this country during these months of shutdown. The hospitals and labs and rehab facilities had to redesign their infectious disease protocols because this virus blew through all of their existing defenses. All the other reasons the press listed for the shutdown I don’t think were the real causes for it. To me, it looked like the healthcare systems could not handle this virus and keep it from spreading to patients. They can now, but they couldn’t a month ago. 

    This does not let the governors off the hook in my mind. What they did was not the right answer. That said, I’m not sure it would have mattered if they had not done that, looking at what happened in Massachusetts long-term-care facilities. 

    • #16
    • May 29, 2020, at 7:30 AM PDT
    • 2 likes
  17. katievs Member
    katievs Joined in the first year of Ricochet Ricochet Charter Member

    MarciN (View Comment):

    This does not let the governors off the hook in my mind. What they did was not the right answer. That said, I’m not sure it would have mattered if they had not done that, looking at what happened in Massachusetts long-term-care facilities.

    It’s Democratic governors, not all governors. Ron DeSantis has shown what they could have done. 

    Massachusetts is likewise run by Democrats.

    • #17
    • May 29, 2020, at 7:33 AM PDT
    • 4 likes
  18. Seawriter Contributor

    MarciN (View Comment):
    Many teachers and principals, when parents or others informed them that things were not going well or that some aspect of the education experience their school was providing was in some way failing or endangering the students would respond, “It’s the law. We have to do it this way.” 

    Gee, a lot of German officers used that excuse after WWII. They were only following orders.

    It ended badly for them. It is a shame that attitude will not end badly for those educators.

    • #18
    • May 29, 2020, at 7:34 AM PDT
    • 5 likes
  19. MarciN Member

    katievs (View Comment):

    MarciN (View Comment):

    This does not let the governors off the hook in my mind. What they did was not the right answer. That said, I’m not sure it would have mattered if they had not done that, looking at what happened in Massachusetts long-term-care facilities.

    It’s Democratic governors, not all governors. Ron DeSantis has shown what they could have done.

    Massachusetts is likewise run by Democrats.

    Yes. It is. But we do have a Republican governor who faced many of the same problems, which was, where to send these infected patients.

    I don’t know how I would have kept the virus out of a nursing home last winter. People were carrying the virus and having zero symptoms. All it would take is a nurse’s aid with the virus to infect the patients who were extremely vulnerable.

    This is what caused the nationwide panic among hospitals in our country to begin with. How were they to keep this virus out of their facilities that were treating people who would not be able to shake off this virus? 

    This is the story I will be following for years to come because I don’t know what I would have done if I had been running a hospital or lab or clinic or PT facility or even a visiting nurses’ operation. I am really interested in this aspect of the story of this winter’s virus outbreak. Have we just been lucky up to now? I don’t know. 

    • #19
    • May 29, 2020, at 7:46 AM PDT
    • 2 likes
  20. MarciN Member

    katievs (View Comment):

    MarciN (View Comment):

    I often found this sort of thinking in the schools I volunteered at…. “It’s the law. We have to do it this way.”

    Marci, you are too generous here, imo. If it were the law, wouldn’t we expect to find Republican governors doing the same thing? Aren’t Republicans known for being law-abiding?

    Contrast these Dem governors’ policies with Ron DeSantis in FL, who from the beginning set out to protect seniors in care facilities. Note the different in nursing-home-death-rates between FL and NY.

    I’ll have to look into the situation in Florida. I don’t know what DeSantis did differently from what Charlie Baker did. I am interested to know too. 

    • #20
    • May 29, 2020, at 7:48 AM PDT
    • Like
  21. katievs Member
    katievs Joined in the first year of Ricochet Ricochet Charter Member

    MarciN (View Comment):

     

    I don’t know how I would have kept the virus out of a nursing home last winter. People were carrying the virus and having zero symptoms. All it would take is a nurse’s aid with the virus to infect the patients who were extremely vulnerable.

    Again, check out Ron DeSantis’ policies. From the beginning, he left FL generally far more open and free than other states, while he issued orders to protect and safeguard Nursing homes. It worked.

    …Have we just been lucky up to now? I don’t know.

    It’s not luck. If it were, we would expect to find the bad results roughly evenly distributed between Dem.-run and Rep.-run states. They’re not.

     

    • #21
    • May 29, 2020, at 7:51 AM PDT
    • 7 likes
  22. MarciN Member

    katievs (View Comment):

    MarciN (View Comment):

     

    I don’t know how I would have kept the virus out of a nursing home last winter. People were carrying the virus and having zero symptoms. All it would take is a nurse’s aid with the virus to infect the patients who were extremely vulnerable.

    Again, check out Ron DeSantis’ policies. From the beginning, he left FL generally far more open and free than other states, while he issued orders to protect and safeguard Nursing homes. It worked.

    …Have we just been lucky up to now? I don’t know.

    It’s not luck. If it were, we would expect to find the bad results roughly evenly distributed between Dem.-run and Rep.-run states. They’re not.

     

    I just don’t know. It could have been a different, less virulent strain in Florida and California than in the Northeast. 

    Florida’s winter weather is vastly different from weather in the Northeast. That’s why there are the snowbirds down there. :-)

    I don’t think politics explains all of the good and bad outcomes. Perhaps it does, but I’m not there yet. :-) 

    I’m not arguing with you, truly. I’m just throwing out some other factors that I think affected the situation. :-) And as I said, I’m not sure there would have been a different outcome up here in the Northeast even if the governors had not issued those stupid orders. We did not have the tests we needed nor the PPE up here. 

     

    • #22
    • May 29, 2020, at 8:01 AM PDT
    • 2 likes
  23. katievs Member
    katievs Joined in the first year of Ricochet Ricochet Charter Member

    Marci, here’s a good column by Michael Goodwin laying out the contrast.

    …The 5,500 nursing-home deaths in New York are more than the total deaths in all other states except New Jersey.

    Many if not most could have been avoided. The earlier outbreaks in Asia and Europe demonstrated that the elderly were easy prey for the virus, doubly so when they have underlying health conditions. Everybody knew that.

    Florida got the message and implemented a model response. Despite its vast enclaves of long-term care homes, it reported ­under 750 deaths in them, or slightly more than one for each of its 615 facilities.

     

    • #23
    • May 29, 2020, at 8:04 AM PDT
    • 5 likes
  24. katievs Member
    katievs Joined in the first year of Ricochet Ricochet Charter Member

    MarciN (View Comment):

    I’m not arguing with you, truly. I’m just throwing out some other factors that I think affected the situation. :-) And as I said, I’m not sure there would have been a different outcome up here in the Northeast even if the governors had not issued those stupid orders. We did not have the tests we needed nor the PPE up here.

    It sounds like you’re searching for ways to avoid the obvious. It sounds like you want it to be the case that nobody could have done anything differently; that there is no significant policy difference between Republican and Democratic governors. 

     

    • #24
    • May 29, 2020, at 8:09 AM PDT
    • 7 likes
  25. MarciN Member

    katievs (View Comment):

    MarciN (View Comment):

    I’m not arguing with you, truly. I’m just throwing out some other factors that I think affected the situation. :-) . . .

    It sounds like you’re searching for ways to avoid the obvious. It sounds like you want it to be the case that nobody could have done anything differently; that there is no significant policy difference between Republican and Democratic governors.

    I am sorry what I’ve written comes across that way.

    I’m sure things could have been done differently. I am thrilled that one state did so much right that the results were wildly better than those achieved anywhere else. (Sounds like Eisenhower and the Spanish flu. :-) )

    I’m also sure that Massachusetts is taking steps to prevent a second wave that I hope will pay off next fall. So that will also be a Republican victory.

    So yes, I want Republicans to take some victory laps, but I do stop short of condemning the governors in the Democratic Northeast states for malice toward nursing home patients. Given the options at their disposal in terms of testing, other places for the covid-19 patients to go, and their not knowing how widespread the virus was in their communities and thus not being sure that it wouldn’t have mattered who they kept out because so many people had the virus without symptoms–I can’t fault them for making the wrong guess.

    It was a really bad situation for nursing homes in the Northeast, and as I saw this train wreck occurring, I don’t know how it could have been avoided up here.

    There’s just way more vitamin D in California and Florida in February and March. :-) And humidity is a factor too. The big question in Asia was why Wuhan had the virus in such numbers when its neighbor Vietnam at the same time had almost none. Weather is the only difference.

    All it would have taken would have been a single asymptomatic carrier working or visiting a nursing home during those months to put the infection inside those settings in the Northeast. Even testing as it existed back then would not have helped. The virus was so prevalent in the Northeast metropolitan areas that a person tested yesterday may come in tomorrow morning carrying it.

    The rapid test will prevent all of this next winter. But it did not exist this past winter.

    On the other hand, it has now been determined that in three of the hardest hit cities in Massachusetts, only 10 to 13 percent of the population appears to have the virus. So perhaps stopping people at the door of the nursing homes until they could be tested might have slowed the spread to the nursing homes. I don’t know either way. I know the Northeast governors did not have this information at the time they made their decisions.

    • #25
    • May 29, 2020, at 8:29 AM PDT
    • 1 like
    • This comment has been edited.
  26. MarciN Member

    katievs (View Comment):

    MarciN (View Comment):

    I’m not arguing with you, truly. I’m just throwing out some other factors that I think affected the situation. :-) And as I said, I’m not sure there would have been a different outcome up here in the Northeast even if the governors had not issued those stupid orders. We did not have the tests we needed nor the PPE up here.

    It sounds like you’re searching for ways to avoid the obvious. It sounds like you want it to be the case that nobody could have done anything differently; that there is no significant policy difference between Republican and Democratic governors.

    You’re not entirely wrong about my feelings here. When I am absolutely certain that Governor Baker did not issue the same order, and I have been unable to find out, then I will happily blame the Democrats. Until I know for sure that he didn’t, I’m reserving judgment of Cuomo. :-) :-)

    I just don’t want to lose Baker in our desire to get rid of Cuomo. :-) :-)

    • #26
    • May 29, 2020, at 8:37 AM PDT
    • 1 like
    • This comment has been edited.
  27. EODmom Coolidge

    katievs (View Comment):

    MarciN (View Comment):

    This does not let the governors off the hook in my mind. What they did was not the right answer. That said, I’m not sure it would have mattered if they had not done that, looking at what happened in Massachusetts long-term-care facilities.

    It’s Democratic governors, not all governors. Ron DeSantis has shown what they could have done.

    Massachusetts is likewise run by Democrats.

    And they had new information about the virus and its impact very early on. And did NOT – and in MI and MN have not yet – modified their policies. I’d bet my mortgage that it comes down to who pays how much for which disease and/ or cause of death. Medicare patients or state plan patients are on very tight payment schedules. People living long term in “the nursing home” are likely in Medicare eligible homes and they are very ill when they get there. Low income people and people with few options. The state/city gets nothing for their care. Follow d money. As they say. 

    • #27
    • May 29, 2020, at 9:09 AM PDT
    • 2 likes
  28. EODmom Coolidge

    MarciN (View Comment):

    katievs (View Comment):

    MarciN (View Comment):

    I often found this sort of thinking in the schools I volunteered at…. “It’s the law. We have to do it this way.”

    Marci, you are too generous here, imo. If it were the law, wouldn’t we expect to find Republican governors doing the same thing? Aren’t Republicans known for being law-abiding?

    Contrast these Dem governors’ policies with Ron DeSantis in FL, who from the beginning set out to protect seniors in care facilities. Note the different in nursing-home-death-rates between FL and NY.

    I’ll have to look into the situation in Florida. I don’t know what DeSantis did differently from what Charlie Baker did. I am interested to know too.

    He acted tactically and immediately on receiving new information about the distribution of the virus. He acknowledged reality and acted accordingly. 

    • #28
    • May 29, 2020, at 9:10 AM PDT
    • 3 likes
  29. MarciN Member

    EODmom (View Comment):

    MarciN (View Comment):

    katievs (View Comment):

    MarciN (View Comment):

    I often found this sort of thinking in the schools I volunteered at…. “It’s the law. We have to do it this way.”

    Marci, you are too generous here, imo. If it were the law, wouldn’t we expect to find Republican governors doing the same thing? Aren’t Republicans known for being law-abiding?

    Contrast these Dem governors’ policies with Ron DeSantis in FL, who from the beginning set out to protect seniors in care facilities. Note the different in nursing-home-death-rates between FL and NY.

    I’ll have to look into the situation in Florida. I don’t know what DeSantis did differently from what Charlie Baker did. I am interested to know too.

    He acted tactically and immediately on receiving new information about the distribution of the virus. He acknowledged reality and acted accordingly.

    I think Baker did too. But I know you don’t like him and probably wouldn’t see it that way. That’s okay. We’ll just have to agree to disagree. :-) 

    • #29
    • May 29, 2020, at 9:14 AM PDT
    • Like
  30. EODmom Coolidge

    MarciN (View Comment):

    EODmom (View Comment):

    MarciN (View Comment):

    katievs (View Comment):

    MarciN (View Comment):

    I often found this sort of thinking in the schools I volunteered at…. “It’s the law. We have to do it this way.”

    Marci, you are too generous here, imo. If it were the law, wouldn’t we expect to find Republican governors doing the same thing? Aren’t Republicans known for being law-abiding?

    Contrast these Dem governors’ policies with Ron DeSantis in FL, who from the beginning set out to protect seniors in care facilities. Note the different in nursing-home-death-rates between FL and NY.

    I’ll have to look into the situation in Florida. I don’t know what DeSantis did differently from what Charlie Baker did. I am interested to know too.

    He acted tactically and immediately on receiving new information about the distribution of the virus. He acknowledged reality and acted accordingly.

    I think Baker did too. But I know you don’t like him and probably wouldn’t see it that way. That’s okay. We’ll just have to agree to disagree. :-)

    You’re asking what they did differently. Because they did act differently and there have been different outcomes. 

    • #30
    • May 29, 2020, at 9:24 AM PDT
    • 1 like