Patients Beware! LA County is Discharging COVID-19 Patients to Dangerous Nursing Homes with Deadly Outbreaks

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In the name of keeping people safe from COVID-19, the Los Angeles County Department of Public Health is yet again exposing those living in nursing homes or needing nursing home care to grave danger. With remarkably little public attention, the Department has signed up dangerous and worrisome nursing homes in the County to serve as dedicated COVID-19 facilities for hospitals to use as discharge sites for COVID patients.

The County’s outrageous practice first came to light on May 3 when the Los Angeles Times published a story – Coronavirus patients could be cash cows for nursing homes – about a single nursing home, Country Villa South, that the Department had designated for this purpose. The Times’ article raised concerns about a deadly outbreak that had taken place at the facility, its poor track record, and allegations that it was dumping long term residents on Medi-Cal to make room for short-term COVID-19 patients who qualified for lucrative Medicare payments.

Since then the County has signed up 19 additional nursing homes to take hospitalized patients who have COVID-19. In a preamble to its list, the Department bizarrely claims that strict rules for transfer of patients with COVID-19 from acute care hospitals to skilled nursing facilities (SNFs) “have protected patients in SNFs” while causing a bottleneck in hospital discharges.  Further, it states that “designating SNFs with specific units, floors or buildings dedicated to COVID-19 patients fills this valuable niche to both keep SNFs safer and at the same time open needed hospital capacity.”

Indisputably, LA County has not kept nursing home residents safe. More than a thousand nursing home residents have died in LA County from the coronavirus and many times that number have been infected and suffered serious illness. Some of the worst outbreaks occurred at the 20 skilled nursing facilities before they were designated, with more than 220 residents dying at them from COVID-19 causes according to County and State data. For example, the County reports that 26 residents at Grand Park Convalescent Hospital died of COVID-19 related causes and nearly 100 residents and staff were infected. At Hollywood Premier Healthcare Center, another of the dedicated COVID-19 SNFs, 19 residents have reportedly died from COVID-19 causes and over 90 residents and staff were infected.

By all appearances, the LA County Department of Public Health is awarding this designation to skilled nursing facilities that it knows have miserably failed to keep their residents safe from the coronavirus. 

Most of the 20 designated nursing homes also have long histories of poor care. Nine of them currently have 1-or 2-star ratings from the Centers for Medicare and Medicaid Services (CMS). 

Alarmingly, the Department has deleted data on outbreaks at these nursing facilities from its online listing of congregate care settings with outbreaks, which will keep the public in the dark about the deadly outbreaks that have occurred in these facilities.

The LA Department of Public Health’s guidance on designation is exceptionally weak. It does not even consider how many residents have gotten sick and died from the coronavirus.

It is not known how many patients with COVID-19 that hospitals have discharged to these County designated facilities and what patients are being told, if anything, about their track records and the deadly outbreaks they have experienced. The designation process seems designed to deceive patients by giving what might appear to be the County’s seal of approval to nursing homes that most certainly do not deserve it. 

Nor is it known if the County is monitoring and tracking what has become of the non-infected residents who lived at these facilities at the time they were designated to admit COVID-19 patients. Their lives and rights are being put at risk by these troubling designations.

At the state level, the California Department of Public Health is aware that the Los Angeles County Department of Public Health is designating dangerous nursing homes for this purpose, but it has given no indication that it is concerned about this practice. 

There is a glimmer of hope that public officials are beginning to recognize their responsibility to respond to the nightmarish conditions in nursing homes. On May 26th, the Los Angeles County Board of Supervisors approved a motion to appoint an Inspector General to oversee skilled nursing facilities. It remains to be seen if that action will be helpful or not in dealing with the ongoing crisis, however, it is encouraging nonetheless that some elected officials are finally seeing their duty to engage and respond.