Nursing home debate gets heated with Michigan health director testifying at COVID-19 oversight hearing

LANSING, MI – Michigan Department of Health and Human Services Director Robert Gordon defended the state’s handling of coronavirus precautions in nursing homes during a COVID-19 oversight committee hearing at the Capitol on Wednesday.

His presentation touting the state’s successes led to heated debate and criticism from some Republican members of the Joint Select Committee on the COVID-19 Pandemic in the Sep. 16 hearing.

In his four-part testimony, Gordon countered allegations of forced placement of COVID-19-positive patients in nursing homes and lauded the state’s strategy of establishing hubs for isolation rather than exclusive treatment facilities. He also pointed to to that state beefing up PPE stockpile.

Community spread will reflect risk in nursing homes, Gordon said, and considering how hard Michigan was hit by coronavirus in March, the response, he argued, was successful.

“As we responded statewide – and as Governor Whitmer took decisive action using her emergency powers to protect the lives of Michiganders – the loss of life in Michigan abated. And so too the loss of life in nursing homes abated,” he said. “Outcomes in our nursing homes improved dramatically even as other states’ experience worsened. In fact, our nursing homes outperformed given the challenges we faced statewide.”

Michigan is ranked among the top 10 states in coronavirus deaths per 1,000 residents, but is No. 18 nationally in nursing home deaths per capita, according to Center of Disease Control and Prevention data cited by Gordon. In addition, 33.2% of COVID-19 deaths in Michigan occurred in nursing homes, versus the national average of 38.6%, according to a Center of Health and Research Transformation study cited by Gordon.

The definition of nursing homes is different from state to state, so the numbers could be skewed to make Michigan appear to be performing better, countered Committee Vice Chair Sen. Aric Nesbitt, R-Lawton.

“Does the definition include assisted living facilities, memory care units, retirement homes,” Nesbitt asked.

“It’s nursing homes,” Gordon said. “As regulated entities, there are 442 of them that don’t include assisted living facilities.”

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

Allegations that the state forced nursing homes to accept COVID-19 patients are unfounded, Gordon said. Republican lawmakers point to Gov. Gretchen Whitmer’s Executive Order 2020-50, which required nursing homes to create “dedicated hubs” for coronavirus patients to prepare for a lack of hospital bed capacity.

Since MDHHS didn’t recommend the action, that provision in the order was “not operable,” Gordon said. After receiving the order, he said, the department addressed concerns from nursing homes about a lack of PPE to create dedicated hubs, which stalled the implementation of the order.

“Our Medicaid program sent an email to the professional associations instructing them to ‘postpone movement of COVID-19-affected residents, except as required for medical reasons.’ The nursing homes correctly understood that they were not being forced to separate patients and create dedicated units,” he said. “And since they were not being forced to create dedicated units, they also were not being forced to accept transfers.”

The guidance did lead to long-term care facilities creating isolated COVID-19 containment wings, such as a Hillsdale County facility that at one point accounted for more than half of the county’s cases and deaths.

Related: 51 coronavirus cases attributed to same Hillsdale nursing facility, more than half of county total

Gordon also cited testimony from Rich Farran and Melissa Samuel of the Health Care Association of Michigan, as well as Senate Oversight Committee Chair Sen. Ed McBroom, R-Vulcan, who said no forced transfers of patients were completed.

Samuel sent a request to Gordon in March, days after the first coronavirus case in Michigan, that asked for the creation of isolated facilities specialized just for COVID-19 patients. MDHHS instead recommended the hub strategy that would set up isolated wings for COVID-19 patients in clinics, nursing homes and long-term care facilities to deal with capacity issues.

Nesbitt pushed Gordon on why that request was ignored. Gordon responded that given time constraints, there was not enough time to staff coronavirus-specific buildings and provide enough PPE.

Committee Chair Rep. Matt Hall, R-Marshall, blasted Gordon for ignoring Samuel’s request before criticizing him for not cooperating with email and data requests made by the oversight committee.

“We have asked for many months that you and your department turn over emails and communications related to nursing homes,” Hall said, “so I’m interested in when are you going to turn them over? Or do we have to issue a subpoena?”

“We’ve provided many, many emails to you,” Gordon said.

“That’s not true. That’s completely false,” Hall said.

Rep. Vanessa Guerra, D-Bridgeport Township, accused Hall of badgering Gordon, and Sen. Curtis Hertel, D-Lansing, said the committee’s focus has been on partisan finger-pointing.

Related: One-sided nature of Michigan’s COVID-19 oversight committee could compromise findings, critics warn

The data requests have nothing to do with the state’s response to COVID-19, Gordon argued.

“They have to do with our timing to the response to this committee’s many, many requests,” he said. “We have been extremely busy on protecting people and saving lives… You will forgive me if in our focus on actually protecting the well-being of people, we are not able to meet your requests with the haste you would like.”

Gordon and his department was too busy to take expert recommendations from the Health Care Association of Michigan and the Michigan Nursing Homes COVID-19 Preparedness Task Force, Hall responded. Task Force Chair Dr. Betty Chu’s on Sep. 9 recommended Whitmer’s administration continue to explore COVID-19-specific facilities, but warned that there might not be enough time to build the facilities and implement safety protocols.

Related: ‘Mistakes made in good faith’: GOP legislators question future nursing home recommendations

The data points to Michigan’s ability to save lives, Gordon said.

“My own focus is did we do enough to save lives,” he told Hall. “I have provided considerable evidence that our performance is solid. I have not actually heard any evidence from members of this committee that challenges or undercuts what I have shared.”

Since the start of the pandemic, Michigan has confirmed 115,183 confirmed coronavirus cases and 6,612 deaths. There also are another 11,675 probable cases and 320 probable deaths.

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.

COVID-19 PREVENTION TIPS

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 nose while 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, click here.