Nursing homes can relocate patients to contain COVID-19, state orders

Nursing homes are now permitted to relocate or discharge residents to reduce the risk of COVID-19, even if families or local officials object.

Indiana State Health Commissioner Kristina Box on Tuesday issued an order allowing the moves, saying it would help keep elderly residents safer during the pandemic.

“I know the thought of moving residents in an already difficult time is incredibly stressful for families,” Box said. “We have made it clear that families need to be notified of these plans.”

The goal of the order is to protect residents who have tested negative from getting the infection, while allowing residents who have tested positive for COVID-19 to get treated together in designated units or buildings, the state health department said.

The new order comes eight days after the Daviess County Health Department ordered a Fishers-based company, Chosen Healthcare, to stop relocating residents of a 140-bed facility. The company had loaded up several busloads of residents for other sites before the county ordered it to stop.

The company had planned to use the facility as a designated COVID-19 treatment center. None of the residents in the Daviess County nursing home had tested positive for COVID-19, and several families had said the relocation came with little warning and was upsetting their elderly relatives.

Box said her order supersedes orders from local health departments and will remain in effect for the duration of the public health emergency.

She said relocating residents from long-term care facilities to keep the infection from spreading is scientifically sound. She added it could also improve the quality of life of some elderly patients who have tested positive. If COVID-19-positive residents are kept together in a single unit or facility, they can eat meals together and socialize.

“This is not a decision that I made very lightly,” Box said. “It has been incredibly important to me that I have been supportive of local health officers and local communities across our state and have interacted very closely with them. But we fully believe this is a necessary step to further protect the vulnerable residents in our 92 counties.”

The order covers all transfers, discharges, transports and relocations of residents made to reduce the risk of the disease spreading, including moves across city or county boundaries.

Box added that setting up designated COVID-19 units or facilities can allow nursing homes to protect health care workers while helping to conserve personal protective equipment, such as masks and gowns.

A trade association representing long-term-care facilities said it supported Box’s order. The Indiana Health Care Association said decisions about resident transfers should be based on guidance from federal and state governments, and “not based on fear or averting treatment for COVID-19 positive citizens in a given community.”

“Unfortunately, some long-term-care facilities that desire to do the right thing, according to the guidance from government, have been directly confronted with fear and misunderstanding,” said Zach Cattell, association president, in written remarks. “It is our job to help create better understanding and acceptance of the difficult choices that are being made in our health care system during the pandemic. These difficult choices may mean that residents have to be moved from one long-term-care facility to another, even if they are not symptomatic or a positive for COVID-19.”