Michigan=E2=80=99s New COVID-19 = Requirements for Long-Term=20 Care Facilities
DOWNLOAD PDF =- Domas,=20 Peter Bela= nger,=20 Jeremy =20 =20
-
Industry Alerts =
=20
On April 15, 2020, Michigan Governor Gretchen Whitmer issued a new=20
Executive Order, No. 2020-50 (the =E2=80=9CE.O.=E2=80=9D), to protect =
residents and staff of=20
long-term care facilities and to ensure continued access of care. This =
E.O.=20
applies to nursing homes, homes for the aged, adult foster care =
facilities, or=20
assisted living facilities. The requirements of the E.O. shall remain in =
effect=20
until at least May 13, 2020 (the =E2=80=9CEmergency =
Period=E2=80=9D).
ADMISSION/READMISSION REQUIREMENTS
Long-term care facilities are not permitted to prohibit the =
admission or=20
readmission of a resident based on COVID-19 testing requirements, unless =
doing=20
so is consistent with guidance issued by the Michigan Department of =
Health and=20
Human Services (=E2=80=9CMDHHS=E2=80=9D).1
When a resident, who had temporary housing outside of the long-term =
care=20
facility, seeks readmission, the long-term care facility must comply =
with the=20
following:
- The long-term care facility must not condition readmission on = forfeiture=20 of any right the resident had before the Emergency Period when a = resident was=20 hospitalized or on therapeutic leave.
- If the long-term care facility can meet the medical needs of the =
resident,=20
has the capacity, and has no other statutory grounds to refuse =
admission, the=20
long-term care facility must readmit the resident. The Statutory =
grounds=20
are:
a. Medical reasons;b. The patient=E2=80=99s = welfare; andc. The welfare of other = patients or=20 employees; - The long-term care facility must comply with guidance issued by = MDHHS on=20 returning residents, which include without limitation screening = patients for=20 COVID-19 symptoms (e.g., fever, atypical cough, atypical shortness of = breath),=20 checking the residents=E2=80=99 temperature, and, if necessary, = isolating those=20 patients that are symptomatic.
Long-term care facilities with a census below 80% are required to = create a=20 dedicated unit, either within the facility or, for long-term care = facilities=20 with multiple facilities, designating a dedicated facility, for the care = of=20 COVID-19 positive residents. The dedicated unit must have sufficient PPE = for=20 staff to care for the patients.
When a COVID-19 positive patient is being discharged from a =
hospital to a=20
long-term care facility, the hospital must first attempt to discharge =
the=20
patient to a long-term care facility with a dedicated unit, if there is=20
availability. If there is capacity, the long-term care facility with the =
dedicated unit must accept the patient. When that is not possible, the =
patient=20
should be discharged to a regional hub, which is a nursing home =
designated by=20
MDHHS as dedicated to the temporary and exclusive treatment of COVID-19 =
infected=20
patients.
If a regional hub is not available, the hospital will transfer the =
resident=20
to an =E2=80=9Calternate care facility," which is a facility designated =
to provide=20
relief to hospitals exceeding their patient capacity. These alternate =
facilities=20
are required to accept the resident if capacity allows. These alternate=20
facilities should transfer the resident to an appropriate long-term care =
facility as soon as capacity exists.
PROTECTIONS FOR RESIDENTS AND EMPLOYEES
While a resident is admitted to a long-term care facility, the =
facility=20
must adhere to the following guidelines to protect employees and=20
residents:
-
Employees who test positive, or are symptomatic for COVID-19, are = not=20 permitted to work, and long-term care facilities are not permitted to=20 discharge, discipline, or otherwise retaliate against those employees = for=20 staying home.
-
Cancel all communal dining and internal and external activities = during=20 the Emergency Period.
- Ensure all CDC guidelines for cleaning and disinfecting the = facility are=20 complied with.2
- To the extent possible, provide employees interacting with = residents with=20 PPE and hand sanitizer.
- Inform employees when an affected resident is in the facility no = later=20 than 12 hours after identification.
- Keep accurate and current information about the PPE available, = including=20 quantity and type, which must be reported upon MDHHS=E2=80=99s = request.
- Report all positive or presumed positive cases of COVID-19 to = MDHHS as=20 soon as possible, but no later than 24 hours.3 =
DISCHARGES AND TRANSFERS OF COVID-19 PATIENTS FROM =
LONG-TERM CARE=20
FACILITIES
Long-term care facilities are prohibited from evicting or =
involuntarily=20
discharging residents for non-payment or to otherwise deny access to a =
resident,=20
except as described in the E.O. Once a resident has been identified as =
having=20
COVID-19, the long-term care facility must first determine whether the =
patient=20
is stable or requires hospitalization. Some of the factors to asses for=20
hospitalization include without limitation:
- Trouble breathing;
- Persistent pain or pressure in the chest;
- New confusion or inability to arouse; or
- Bluish lips or face.
If a patient does not require hospitalization, long-term care =
facilities=20
must determine whether to transfer a patient. If there is a dedicated =
unit, the=20
long-term care facility must transfer the resident to that unit. If the=20
long-term care facility does not have a dedicated unit, the resident =
should be=20
transferred to a regional hub, if one is available and has capacity. If =
not, the=20
long-term care facility should attempt to transfer the patient to a =
hospital, or=20
as a last resort to an alternate facility. All transfers should include =
the=20
patient=E2=80=99s advance directives and notifications to the =
resident=E2=80=99s representative.=20
Transfers made under these guidelines are considered to be for the =
safety of the=20
residents and facility employees.
Dickinson Wright health care attorneys can assist long-term care =
facilities=20
with ensuring they comply with the requirements of the Executive Order =
while=20
providing care and treatment to their residents.
Related Services
Contacts
Jere=
my=20
Belanger =20
Associate =
=20
Troy =
=20
=
=20
T:248-433-7542 =20
=
=20
E:JBelanger@dickinsonwright.c=
om =20
Peter=20
Domas =20
Member=20
Ann Arbor =
=20
=
=20
T:248-433-7595 =20
=
=20
E:PDomas@dickinsonwright.com=
=20
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