Michigan’s nursing home strategy during pandemic ‘perfectly appropriate,’ report says

Michigan’s response to coronavirus as it relates to nursing homes was a “perfectly appropriate strategy…

Michigan’s nursing home strategy during pandemic ‘perfectly appropriate,’ report says

Michigan’s response to coronavirus as it relates to nursing homes was a “perfectly appropriate strategy to be taken,” according to an independent analysis conducted by the Center for Health and Research Transformation.

The nonprofit health policy center at the University of Michigan evaluated the state’s decision to establish 21 nursing home “hubs” to help care for COVID-19 patients transferred from other nursing homes or discharged from hospitals, and came up with recommendations to improve the system moving forward.

Upon reviewing the state’s handling of the pandemic, and national best practices, the group recommended continued use of the hub strategy, according to its report released Tuesday, Sept. 8.

“We collectively believe that the state’s strategy was an appropriate strategy that was taken in the peak of the surge,” said Marianne Udow-Phillips, CHRT’s founding executive director. “The strategy followed the guidance that was known at the time and it was a perfectly appropriate strategy to be taken.”

Michigan’s use of the nursing home “hubs” has been heavily criticized by many Republic lawmakers, who said actions by Gov. Gretchen Whitmer and her administration exacerbated the situation. But Michigan has fared better than other states.

Through Aug. 19, 271 of Michigan’s 442 nursing homes (61%) had at least one COVID-19 resident case, and 209 (47%) had at least one COVID-19 resident death. Nursing homes reported 8,456 resident cases, 4,226 staff cases, 2,100 resident deaths, and 21 staff deaths.

Michigan has reported a smaller percentage of COVID-19 deaths coming from nursing homes (33.2%) than the U.S. average (38.6%), according to CHRT’s data. The percentage of deaths among nursing home residents with COVID-19 was also considerably lower in the hubs (17.4%) than compared to non-hub nursing homes (26%).

Related: State’s handling of COVID in nursing homes worthy of critique, but GOP lawmakers miss mark, experts say

Among Republicans’ biggest complaints has been that the administration hasn’t created separate facilities to house nursing-home patients with COVID-19. Instead, those patients are quarantined in facilities that also have non-COVID-19 residents.

But CHRT opposes those calls.

“We don’t think a COVID-only facility will answer the problem that is trying to be addressed, and we know now that patients indeed can be maintained safely with the right safety protocols,” Udow-Phillips said. “We don’t think a separate facility is appropriate. In fact, we think it’s probably counterproductive. It’s very expensive, very inflexible, and certainly not needed.”

The independent review provided the Michigan Department of Health and Human Services with more than 50 recommendations that aim to improve criteria for selecting nursing homes as hubs, increase training and monitoring of hubs, and to provide nursing home staff with more access to mental health resources.

There are also recommendations for more flexible and broader visitation policies, which Udow-Phillips said is important for the mental health of residents who are struggling with social isolation and depression. She noted room for more outdoor visitation, where feasible, and other unique ways to setup in-person communication in areas where there’s low community spread.

Robert Gordon, MDHHS director, said the state is looking at best practices for nursing home visitation policies, and MDHHS will provide new guidance “this week.”

Gordon said MDHHS remains committed to protecting nursing home residents and their family members. He thanked CHRT for its analysis and said the department takes the recommendations with the utmost seriousness and will continue to strive for improvement.”

“Do we think our performance has been perfect or is perfect now — the answer is no,” Gordon said. “We have been and remain deeply committed to doing everything in our power to improve our performance and there’s always room for improvement.”

In evaluating the state’s nursing home strategy during the pandemic, CHRT’s team spoke to more than 25 “key informants” around the country, including researchers, policy-makers, nursing home and association representatives, patient advocates, and representatives of Doctors Without Borders. They also reviewed “all peer-reviewed literature done to date,” and conducted a “detailed analysis” of what’s happened in Michigan and nationally, according to Udow-Phillips.

“Since the April surge, we have more knowledge and experience with managing COVID-19 patients safely in nursing homes and long-term care facilities,” Udow-Phillips said. “That information will allow states all across the country to improve their strategies.”

To view the full 30-page report, visit CHRT’s website, here.


In addition to washing hands regularly and not touching your face, officials recommend practicing social distancing, assuming anyone may be carrying the virus.

Health officials say you should be staying at least 6 feet away from others and working from home, if possible.

Use disinfecting wipes or disinfecting spray cleaners on frequently-touched surfaces in your home (door handles, faucets, countertops) and carry hand sanitizer with you when you go into places like stores.

Michigan Gov. Gretchen Whitmer has also issued executive orders requiring people to wear face coverings over their mouth and nosewhile in public indoor and crowded outdoor spaces. See an explanation of what that means here.

Additional information is available at Michigan.gov/Coronavirus and CDC.gov/Coronavirus.

For more data on COVID-19 in Michigan, visit https://www.mlive.com/coronavirus/data/.

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