Why Some Nursing Homes Are Taking In More COVID-19 Patients

Across the Midwest and the nation, many COVID-19 cases have been concentrated in nursing homes. It’s often the result of an outbreak. But sometimes, it’s actually by design. 

More than 9 percent of Ohio’s COVID-19 cases, and 70% of deaths, are in long-term care facilities like nursing homes and assisted living centers.

The facility with the highest number of cases is McNaughten Pointe, on Columbus’ East Side. They’ve reported more than 120 cases.

But a McNaughten Pointe spokeswoman says that's not due to an outbreak. Rather, they are actively taking in COVID-positive patients from hospitals or other facilities, and housing them in two dedicated units to "serve their community." 

They declined a request for an interview, but in an emailed statement a spokeswoman says the COVID units are separated from other residents. Employees who work in those units do not work in the rest of the facility.  

"The facility has recovered many of these residents and they returned home or to their previous nursing facility," the statement reads. 

Other facilities across the state also are reaching out for COVID patients, and Ohio Medicaid director Maureen Corcoran says some of them are being incentivized. “Because of COVID, we created a special designation that nursing homes could apply for, that has higher reimbursement rates."

These designated facilities are called Health Care Isolation Centers, and they have the bed capacity and specialized staff to take care of COVID-19 patients. The higher Medicaid reimbursement helps ensure that people who does not live in a nursing home can still get into one if they contract COVID-19.

“Maybe they were at home, broke their hip, went to the hospital, but then found out they had COVID,” Corcoran says. “We knew we would have a really difficult time finding somebody who would be willing to take them, to admit them.”

There are only 13 Health Care Isolation Centers in Ohio. McNaughten Pointe is not one of them.

Corcoran says another motivation for taking in COVID-positive seniors is keeping occupancy high. Many long-term care facilities in Ohio have seen at least a 10% reduction in occupancy.

“When we stopped doing a lot of surgery, it meant that nursing homes who were doing more of this kind of rehabilitative care, they experienced a bigger drop,” she says.

Pete Van Runkle of the Ohio Health Care Association says if facilities voluntarily take on COVID-19 patients, they should be transparent so families aren’t alarmed at the rising number of cases inside.

“The more you communicate and explain what is going on to anyone, the better that they understand and the less likely they are to think there is something bad afoot," he says.

He says the communication issue is only exacerbated by the lack of visitation at some facilities. After months of closed doors, Ohio began allowing visitations again at nursing homes and long-term care facilities in July, but only outdoors. And not everyone is even doing that yet.

“No one was allowed in,” says Vickey Kidd, whose mother, Norma Ann Carter, was a resident at McNaughten Pointe. “They could have done anything. That’s what makes me so upset.”

A spokeswoman for McNaughten Pointe says they kept families informed. But Kidd says it was difficult to get answers about her mom's condition.  

“They told me that she had tested positive,” Kidd says. “So the next day I tried to get a hold of them to find out what they were doing. Well, I called and no one answered.”

Eventually, Kidd got in touch with a nurse. “I said, ‘Is she having a hard time breathing? ... How is she doing today?’ And they’re like, ‘No, she’s holding her own.’

"And the very next day she passed away.”

Kidd doesn’t know if her mom was ever put on a ventilator, or transferred to a hospital for further care. McNaughten Pointe declined to comment. 

A spokeswoman for McNaughten Pointe says at least 75% of their cases were people admitted with COVID-19. But the latest self-reported numbers from the CDC show about 50% of the facility's case numbers are from admissions, which would mean the rest originated inside the facility. They declined to comment on the discrepancy. 

"We are doing everything we can to ensure we reduce the spread of COVID-19, including staying in very close communication with local and state health officials to ensure we are taking all the appropriate steps," the statement reads. 

The spokeswoman says they are taking those steps while also trying to ensure that COVID-positive seniors have a place to go. 

This story was produced by Side Effects Public Media, a news collaborative covering public health.