Over the last few weeks, all eyes have been on New York Gov. Andrew Cuomo (D) for his nursing home scandal. Cuomo instructed nursing homes to take in COVID-positive patients that were being discharged from the hospital, a move that resulted in more than 10,000 deaths.
As it turns out, Cuomo wasn't the only governor to make that kind of call. Reporters in Michigan are suing Gov. Gretchen Whitmer (D) to obtain data about the Great Lakes State's deaths in nursing homes, something prosecutors say could end in criminal charges. Washington State Gov. Jay Inslee (D) can now be added to that very list.
Washington State's Aging and Long-Term Support Administration, which falls under the Department of Social and Health Services, directed nursing homes to accept COVID-positive patients that were no longer needing "acute care" in a hospital. The goal was to "transition" those patients to "alternative settings"
"Our primary strategy to create capacity in acute care hospitals is working with participating patients and families to transition to nursing homes," a March 20, 2020 memo stated. "Once in the nursing home, Home and Community Services staff will work the eligible individual and their family to transition to a permanent home and community-based setting of their choice."
In exchange for taking in those patients, nursing home facilities would receive an additional $100 Medicare add-on for up to six months, The Post Millennial. That funding was part of two Medicaid waivers the state filed.
The state will be requesting enhanced Medicaid match through an 1115 Waiver and eligibility and procedural flexibility through an 1135 Waiver. The 1115 waiver would provide enhanced federal funding for local health jurisdictions and services and to create capacity by expanding patient discharge from hospitals. Additionally, it would be used to pay outside vendor rates and/or cover overtime wages for health care personnel. The 1135 waiver would provide flexibility by allowing individuals to self-attest eligibility, waive CMS face-to-face requirements, increase eligibility levels for specific categories within geographic regions, extend redetermination timelines for current enrollees, suspend CHIP premium payment requirements, and other procedural requirements. We ask that both waivers be approved.
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Here's the kicker: that directive was made roughly one month after the Life Care Center in Kirkland, Washington saw a massive coronavirus outbreak. The Life Care outbreak was dubbed America's "epicenter" for the Wuhan coronavirus, which officially began on Feb. 19, 2020.
The Life Care Center had two outbreaks, with a total of 156 confirmed COVID cases in its facility, with 101 being residents and the other 55 being staff members, KING-TV reported. The nursing home facility amassed "46 deaths between residents, staff, and visitors."
On March 24, 2020, a little more than a month after the Life Care outbreak, the Department of Health issued guidelines for how nursing home patients should be accepted into nursing homes.
"Long-term care facilities should admit residents with COVID-19 who are no longer acutely ill back to their long-care residence," the guidelines stated. "The decision to admit should be based on clinical care needs rather than the need for transmission-based precautions."
Since testing was scarce at the time, nursing homes were told to accept patients who were seven days after the onset of their symptoms "AND 72 hours since resolution of fever without antipyretics and symptoms proving."
On March 30, 2020, Inslee issued a proclamation deeming it "necessary to immediately waive and suspend portions of licensing statutes and rules relating to health care facilities" throughout the state. He also moved to "immediately waive and suspend portions of the licensing and administrative statutes relating to health care facilities to remove barriers to adding health care facilities and beds to meet the demands of the COVID-19 response."
What's amazing is Inslee and his team at DOH saw the outbreak at Life Care and still asked nursing homes to take in COVID-positive patients. The Seattle Times says these decisions contributed to roughly half of the state's 5,000 coronavirus-related deaths to the nursing home policy because "nearly 200 nursing homes" had "at least one outbreak." Some had multiple outbreaks. Very few long-term care facilities in the state have gone without any COVID infections. But in King County, where Seattle is located, "455 people connected to nursing homes have died, account for a third of the county's total deaths."
While New York Gov. Andrew Cuomo (D) deserves scrutiny, especially because he oversees the largest metropolitan city in America – NYC – scrutiny also needs to be given to Gov. Jay Inslee. Washingtonians deserve to know just how deep this runs. Americans deserve to know how this outbreak impacted the rest of the nation, especially since Life Care was where this all started for the United States. And Inslee needs to be held personally accountable for every single one of these deaths.
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