Are hospitals shipping untested COVID19 patients to nursing homes? DHEC wants answers
State health department board members are questioning whether all hospitals are testing patients for the coronavirus before transferring them to nursing homes, where scores of people have died since early March.
The S.C. Department of Health and Environmental Control does not require hospitals to test patients for COVID-19 prior to sending them to nursing homes and long-term care facilities -- and agency board members want to know why.
DHEC board member Sonny Kinney says that, in one case, a person who was not checked at a hospital tested positive within three hours of being transferred to a nursing home.
“The reports I’ve been getting is that patients have been admitted to the nursing facilities from the hospital, tested upon admission and found to be positive,’’ Kinney said during the DHEC board’s monthly meeting Thursday.. “‘’What is the plan to test patients prior to leaving the hospital? Some of the hospital systems are doing it very effectively and others are not.”
He also said “Some of the hospitals are saying ‘We are not required to test and therefore will not’ .’’
Kinney, a former nursing home industry executive and past president of the SC. Health Care Association, said after Thursday’s teleconference board meeting he has been told about the situation by a nursing home industry source. He declined to name the source, but said he believes the questions are legitimate.
Kinney told The State he’s concerned that the number of cases in nursing homes might be misrepresented and that patients not tested in hospitals could spread the coronavirus upon arrival at a nursing home.
Board chairman Mark Elam and board member Rick Lee said they also want to know more about testing by hospitals.
“I’m just curious to know why we don’t stipulate that they can’t move until they get a clearance on whether or not they had the Covid virus or not,’’ Lee said.
Nursing homes are being targeted by DHEC for a dramatic increase in testing because many have become hot spots for coronavirus infections, statistics show.
Roughly one third of the deaths associated with the coronavirus in South Carolina since March have involved patients in nursing homes and care facilities or their caregivers, according to data released Friday. All told, more than 300 people across the state have died from COVID 19. The coronavirus was first confirmed in South Carolina March 6.
Nursing homes are a particular concern because residents are kept in proximity to each other with less opportunity to maintain their distance, a practice advised as a way to lower the spread of coronavirus. Staff members who come into nursing homes daily also have been infected and are suspected of spreading the disease.
In an email to The State, DHEC spokeswoman Laura Renwick said hospitals have extensive infection control procedures they follow and the department has “no evidence’’ of COVID 19 transmission in hospitals. She said the state does not require COVID 19 testing by hospitals for patients transferred to nursing homes.
Still, DHEC health division chief Joan Duwve said she has had conversations about the issue Kinney raised and is working with federal experts on infection prevention. She said DHEC would try to determine how often people have been transferred from hospitals to nursing homes without being tested.
‘There have been several of us engaged in conversations around this particular issue trying to understand the risk to the hospitals, to the nursing homes and the risks to the patients and staff,’’ she said. “We are discussing your concerns.’’
Randy Lee, the current president of the state Health Care Association, a nursing home industry group, said some people in nursing homes have tested positive for COVID 19 who had previously been in the hospital. But Lee said he didn’t know if they got the infection in the hospital.
“Where they contracted that, I do not know,’’ Lee said.
If patients are being transferred to nursing homes from hospitals without being tested for the coronavirus, it probably is not widespread, said Schipp Ames, a spokesman for the S.C. Hospital Association.
The hospital and health care associations have developed a protocol for identifying the status of patients being transferred from hospitals to nursing homes, the hospital association said.
A hospital association form obtained by The State says all hospitalized patients should be assessed for COVID 19 before they are transferred to a “post acute care facility.’’ But the form also has a part for hospitals to note when tests are not needed, in accordance with Centers for Disease Control and Prevention criteria.
Prisma Health spokeswoman Tammie Epps said the Midlands and Upstate hospital system follows CDC rules on testing patients for COVID 19 before they are discharged. A spokeswoman for Lexington Medical Center was unavailable.
The coronavirus is a highly contagious disease that attacks people’s lungs. Older people and those with underlying health conditions are most likely to die from the disease. Statewide, South Carolina has had more than 7,000 cases since early March.
This story was updated May 8 to reflect new nursing home statistics.
This story was originally published May 7, 2020 at 7:52 PM.
