Rehab Units For Recovering COVID Patients In Nursing Homes Causing Concern 

There are plans to open new isolation centers for COVID-19 patients who are well enough to leave the hospital, but need more rehabilitation, said Maureen Corcoran, director of the Ohio Department of Medicaid.

Many of these COVID patients, some possibly still infectious, are currently being transferred to special units inside Ohio nursing homes. 

This practice of using nursing homes for COVID patient rehab concerns Bruce Sundman, whose 97-year-old mother is a long-time resident in the Fairmount Health nursing home. Part of the Ohio Living Breckenridge Village in Willoughby, Fairmont recently admitted six patients recovering from COVID into a special unit on the second floor.

Fairmount’s only confirmed cases of COVID-19 are the new patients who were transferred in from local hospitals.

 “My concern was that why if they've spent so much time keeping it out of the building, why were they letting it into the building? It doesn't take a lot for some kind of an incident or accident to occur where it might end up in the rest of the building,” Sundman said.
The decision to do this does not make sense because the elderly are the most vulnerable population in the community, he said.

Breckenridge opened a six-bed unit inside Fairmount a few weeks ago specifically for these COVID patients, said Dean Palombaro, executive director for Ohio Living Breckenridge. 

 “When they are in the hospital most of the time they are in the ICU. Sometimes they’re coming off vents. And when they come here they are compromised more than just with the virus,” Palombaro said.

“They are compromised more physically, so they come here for rehab, that way they are not tying up a (hospital) bed for patients that are much sicker,” he said.

Ohio Living has taken every precaution possible. The COVID recovery unit is in a different area of the building than Sundman’s mother and the other residents, Palombaro said. The staff uses a separate entrance and there is no cross mixing of staff from that unit and others in the building, he said.

 “I would be 100 percent OK with them being here if it were my mom or dad,” Palombaro said.

Not all nursing homes in Ohio were happy, however, when the state’s Medicaid department strongly suggested they take in recovering COVID patients back in March, said Peter Van Runkle, executive director of the Ohio Healthcare Association. The group represents hundreds of long-term care facilities across the state, including many in Northeast Ohio.

 “A lot of our members took the position we're not admitting anybody unless they've been tested. And there weren't enough tests. And so the state got very angry with us,” Van Runkle said.

As the weeks went by it became clear there would not be the predicted surge of sick patients into Ohio hospitals. This relieved the pressure on hospitals so they can keep COVID patients longer as they recover, Van Runkle said.
The recovery from a long stay in an ICU unit can be very long so many patients still need a place to rehab and Medicaid is still asking nursing homes to fill that role, he said.

“There is still their (Medicaid’s) position that if you have the ability to appropriately isolate the person, you should admit them. And we would not disagree with that,” Van Runkle said.

It would give families of elderly nursing home residents more peace of mind if the state had separate facilities for discharged COVID patients, Sundman said.

Medicaid Director Corcoran said there are plans in the works to do just that.  The department is reviewing proposals from several companies who want to set up separate facilities for recovering COVID patients, Corcoran said.
 “We've had a couple applications, just in the last couple of days, and we're working to get those up and running,” she said.

“There may be a larger nursing home, for example, and maybe they have a separate building that we're requiring a few extra things (requirements). We're not requiring a lot of extra things. If you're already regulated, you're already licensed by the state,” Corcoran said.
The state is also open to allowing these COVID rehab facilities in other spaces – they don’t have to be operated by nursing homes, she said.

For example, MetroHealth recently announced the opening of a new 11-bed rehab unit inside the main campus hospital for recovering COVID patients. 

MetroHealth officials said one of the reasons they opened this new unit is they wanted these COVID patients separate from other rehab patients in their Old Brooklyn campus facility.

Even though hospitals and nursing homes have years of experience with controlling infectious diseases, it’s the unknown about COVID that worries Sundman.

 “We've come upon a virus here that reacts with people in a severe manner that we really haven't experienced in the past. All the doctors and the facilities they're learning the best way to even treat this at this point. They're going to be learning for a long time,” he said.

His mother is not really bothered by all of this, Sundman said. She knows that things have changed in her nursing home, but he has not told her there are recovering COVID patients upstairs in her building.