The Minnesota Department of Health (MDH) yesterday released updated data on the status of COVID-19 in long term care settings during a Senate Family Care and Aging Committee hearing.  

MDH Commissioner Jan Malcolm opened the hearing by highlighting a preliminary data analysis of positive cases and deaths in nursing homes based on the CMS nursing home reporting requirements:

• Positive Cases: Average number of nursing home cases per 1000 – National average is 62%. Minnesota average is 39.9%.
• Deaths: Average number of nursing home deaths per 1000 – National average for is 27.5%. Minnesota average is 12.7%.

The Commissioner noted that there is not a standardized process for how all nursing homes are reporting data, so it still varies state-by-state, and that many states do not track or report positive cases or deaths in assisted living like we do in Minnesota.

That status of long-term care settings in Minnesota that have a determinable outbreak:

• 855 facilities with determinable outbreak status (439 or 51% have active infections/cases).
• 472 facilities with 1 or 2 cases (144 or 30% have active infections/cases).
• 377 facilities with 3 or more cases (295 or 78% have active infections/cases).

Download the Presentation. Watch the Hearing (1 hour, 23 minutes)

Testing

On testing, the National Guard has swabbed more than 40 long-term care settings across the state, including over 8,000 residents and staff. More than 40 settings are scheduled for initial or follow-up National Guard swabbing over the next week.

MDH noted that may other long-term care providers have completed full-house testing on their own using their own staff or an existing provider partnership. Leading Minnesota members are reminded of the process MDH recommends for point prevalence surveys (testing):  

• You should first work with your regular health system and laboratory to provide needed testing materials and support.
• If you do not have this capability or are unable to access these resources, the State can support facility efforts through its Mobile Testing Team.

Members are encouraged to complete the RedCap survey to request support from the Mobile Testing Team. MDH note that more than 400 providers have responded to the survey, with 127 providers saying they plan to test on their own. If you have not already done so, please complete the RedCap survey.  

MDH said the state continues its work to identify a mechanism for payment so that providers do not accrue the costs related to testing.

Admitting COVID-19 Positive Patients in Long-Term Care Settings

Senators who serve on the committee asked several questions regarding the data and testing, but also raised a concern that we are also seeing reported in the media: whether COVID-19 positive patients from hospitals should be discharged to long-term care settings.

MDH Commissioner Malcolm said that a skilled nursing setting can be the right setting as they provide the right level of care from staff who have the experience and capability to serve those patients. She also noted that in some instances people may be returning to their home from a hospital stay. MDH also referenced that there are criteria for settings that admit COVID-19 positive patients, including an isolated unit or wing and a dedicated staff team with the appropriate ppe.

As we have previously reported, the Long-Term Care Imperative requested a meeting with key stakeholders to discuss admission of COVID-19 positive patients in long-term care settings. As Minnesota is still anticipating a surge and potentially greater pressure from hospital discharges, this discussion is a timely one.

A meeting was held this week with MDH, the Minnesota Hospital Association, Long Term Care Ombudsman, LeadingAge Minnesota and Care Providers of Minnesota top discuss admission of COVID-19 positive patients into long-term care settings and clearer guidance and communication on the step-down procedures for providing care for COVID-19 positive patients.

We will keep you posted as this discussion progresses.