Florida Approach to Nursing Homes

Discussion in 'Free Board: General Discussion Forum' started by BoilerBF, May 20, 2020.

  1. BoilerBF

    BoilerBF All-American
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  2. New Pal Boiler

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    I thought all the smart folks were in the blue states?
     
  3. chiefboiler23

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    This is one of those instances that shows that sometimes you really don't need to overthink it. The response, as outlined in the article, is one of common sense and should have been what Cuomo was doing as well. While I do think the response around the beaches initially was lax (spring breakers contracting and spreading virus back across country), nursing homes and elderly population centers were obviously the key target.

    My parents are snowbirds and still in FL near St. Pete's, and have been giving us updates that most people are finding a balance between living their lives but still wearing masks at the grocery store and not congregating when unnecessary.
     
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  4. BoilerBiker

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    4 BoilerBiker, May 20, 2020
    Last edited: May 20, 2020
  5. chiefboiler23

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  6. atlboiler2156

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    Apologies if you've already seen this but it's hard to blame him for getting fired up after what they've said about him.
    Tweet!
     
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  7. BSIT

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    But it’s only a matter of time before Florida cases explode. At least that is what I’ve heard. Tic
     
  8. Bethboilerfan

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    I think that virus will diminish in summer, especially with camps, etc closed, and return in the fall. Just read another article on mutation of this virus. It seems to me that it is mutating more than other viruses. But not my area of expertise so it’s an observation.
     
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  9. indy35

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    Didn't Florida just fire a Department of Health data manager because she refused to manipulate the data in such a way to support the state's wish to reopen?
     
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  10. BSIT

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    Possibly but my comment was based on current situation. I hope there’s something to herd immunity and hope a lot more of us have the antibodies than originally thought and we get a safe vaccine by year end
     
  11. BoilerBF

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    Had not seen that. Good stuff from the Governor.

    Any word if CNN has apologized yet to Florida? CNN blasted Florida, Georgia, South Dakota for weeks.
     
  12. BoilerBF

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    "Just wait two more weeks".

    MSM warning/rallying cry on Florida since middle of March.
     
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  13. BSIT

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    Sad instead of celebrating success, many in the MSM are rooting for a spike. That’s all you need to know
     
  14. atlboiler2156

    atlboiler2156 All-American
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    Have you thought about getting into stand up comedy?
     
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  15. TheCainer

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  16. indy35

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    Wonder if Trump said "I would like you to do us a favor though"
     
  17. TopSecretBoiler

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    nah he didn't send planes full of cash. that's how real men ask for favors.
     
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  18. MJ-79Boiler

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    I give Florida Kudos for what they they have done with their nursing homes. They were smart. They researched the demographic impact of the virus, locked them done quickly from visitors and . . more importantly, got the positives out of general population - A major lesson learned from the Chinese.

    While they benefited a "bit" by the quick fulfillment of their PPE supply needs (ie within 3 days), I do not see any significant skewing of the "amount" of supplies sent versus those sent to other states. It appears some of those early shipments were allocated based on population size, versus qtys requested. I personally have no problem with this.

    Again, kudos for the early action with respect to the nursing homes. Other states should have done the same thing and at the very least, follow their lead once it was clear that they were having much better success in their numbers (ie Use the lessons learned across the country.)

    I hope they stay vigilant. As we have seen before, time bought by early decisions can be erased quickly.
     
  19. BuilderBob6

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    Apologize to a state?
     
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  20. BoilerBF

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    Yes CNN should apologize to Desantis and for their hit pieces on him and Florida in general. CNN got it wrong.

    Today CNN is live from Georgia beaches & beaches across the country. They still don't understand this virus is primarily spreading indoors (Nursing homes, public transportation, homes, hospitals etc). Why aren't they investigating where the virus is spreading and killing people (i.e Nursing homes)?
     
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  21. BSIT

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    And couldn’t you imagine what a hit piece they would run if he was Governor of NY instead of Fl? The irony of one of CNN’s anchors yucking it up with his NY Governor brother about test swab sizes is all you need to know
     
  22. BuilderBob6

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    I've looked for these hit pieces you're referring to. I haven't found where they called him pathetic or crazy or a loser or liar or scumbag or cheater. They didn't call for his resignation or protests or an investigation. Have they said he's in over his head or doesnt have a clue?

    What are they supposed to apologize for? They and most everyone else, experts included, criticized his decision to leave the beaches open for spring break.........and given what we knew about the virus at the time, the criticism was warranted. DeSantis didn't know something nobody else in the country did. He was under pressure from the business community and made a decision. We don't know the extent of the spread from the spring breakers but it did happen.

    I give him credit for his moves on nursing homes and his attempts to quarantine travelers from the more infected states. But local and county officials shut down areas all over Florida weeks before his stay at home order. He supported them in their decisions but they certainly deserve some credit for containing the spread at that crucial time.

    https://www.wsj.com/articles/smart-or-lucky-how-florida-dodged-the-worst-of-coronavirus-11588531865

    Are Florida's numbers even correct? We need to see how that plays out.

    Seems strange the party who labels people snowflakes is now demanding apologies from everyone. Where does that come from?
     
  23. Bruce1

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    Link Please. How much was data supposedly modified?
     
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  24. cosmickid

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    Plenty of links available. This is from the Tampa Bay Times. Btw, this is pretty similar to the situation that happened in Ga, where they cooked the numbers for 3 straight weeks...

    "One day before a top Florida Department of Health data manager lost her role maintaining the state’s COVID-19 data, she objected to the removal of records showing people had symptoms or positive tests before the cases were announced, according to internal emails obtained by the Tampa Bay Times.

    On Tuesday, a spokeswoman for Gov. Ron DeSantis said she had been fired.

    According to the emails, department staff gave the order shortly after reporters requested the same data from the agency on May 5. The data manager, Rebekah Jones, complied with the order, but not before she told her supervisors it was the “wrong call.”


    By the next morning, control over the data was given to other employees, according to an email Jones posted Friday on a public listserv. Jones, the department’s geographic information systems manager, wrote that she was no longer handling questions about the department’s “Florida’s COVID-19 Data and Surveillance Dashboard.” She implied her removal was an act of retribution.

    Jones said Tuesday that she was offered a settlement and the option to resign in lieu of being fired, effective May 26.

    The dashboard that Jones managed is the best official source for in-depth data on how the deadly pandemic is moving through the state. Studying it is the surest way to know where outbreaks are growing and where testing is being done. Without access to the data, Floridians would have to rely on the word of officials and politicians without being able to verify for themselves."

    https://www.tampabay.com/news/healt...irus-data-before-reassigning-her-emails-show/
     
  25. tsmatthias

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  26. BoilerBF

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    https://tallahasseereports.com/2020...ickbait-the-media-dreams-of-but-its-all-fake/

    Chris Cuomo "investigating" a non story in Florida (see link above).....but ignores the New York Nursing home scandal????

    New York Nursing home and adult facility deaths : 5,800 (# does not include Nursing home residents that died in hospitals)

    Florida deaths from ALL SOURCES 2,300

    Florida has a larger population than New York...and more elderly people as well.

    Desantis identified Nursing homes as highest risk area from the start. Cuomo finally followed that strategy on May 10th (but only after defending his failed Nursing home policy for 2 weeks).
     
  27. tsmatthias

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    What is up with the Cuomo obsession? Every, single post, and nobody cares.
    The drumbeat isn't getting any louder.

    [​IMG]

    BF, can you help us out here?
    Could you compile your top 10 grievances about Cuomo's SNF policy and put them in one, concise post? We'll pin it at the top of the board and we all save time.

    mb
     
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  28. BoilerBF

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    I'll post what I what I want to post. Simple solution for you....if you aren't interested in reading my posts....don't read them.

    With 28,000 deaths in New York, and estimates of 60-65% of Covid 19 spread around U.S. coming from New York....I happen to think Cuomo's decisions are very relevant.
     
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  29. BSIT

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    Michigan Governor's also been terrible
     
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  30. tsmatthias

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    You keep choosing to play Monday Morning QB on an outcome that was already decided by lack of available testing, a misguided Trump Administration CMS policy/waivers, and an industry that has been forced to survive on awful private equity deals amid declining Medicare/Medicaid reimbursements. Your ignorance on SNF facilities and how they operate, particularly in the NY/NJ/PA area, clearly shows. This was explained to you over a month ago, but you still will not let it rest. You keep trying to apply the situation in NY/NJ to anywhere else to make your point and it just doesn't hold water.
    This is truly a case of don't hate the player, hate the game.

    The media has raised the same question you keep asking multiple times in the past weeks and there's really no story there unless they also want to drag Trump under too once you match up timelines, etc.

    I wouldn't consider myself a Cuomo fan at all. There's a reason why I moved out of the East Coast almost a year ago. There's also a reason some SNF systems do not conduct business in NY. But, he's going to come out of this relatively unscathed. He was dealt a near impossible hand.

    What does need to happen in the future is reform/bailout for the SNF industry or it will fail. Some of the larger systems have 40k census currently so what do we do there? The 'Silver Tsunami' that is supposed to take place in the next few years as large numbers of Boomers transition to SNFs is no longer going to happen. Does anyone want to go in an SNF now? These systems were absolutely relying on this for their long term viability.

    For those thinking about retirement, please consider getting some long-term care insurance. The industry is not getting any better if you choose to rely on Medicare/Medicaid to see you through till the end. Also, the best SNF systems choose which states to operate in that are best for business and their patients. So, do your research.

    I apologize for my tone last night. I'm tired of misinformation, especially when it's about something that is directly tied to my livelihood.
     
  31. BoilerBF

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    Not sure if you heard but on May 10th, Cuomo reversed his failed Nursing home policy. You were wrong over a month ago....just like Cuomo was wrong.

    When first asked asked about idiotic Nursing home policy Cuomo acted like he didn't know anything about it....and turned to his medical advisor to answer question. Then a few days later he said he was going to "investigate Nursing homes". Then after a week or two of getting criticism from New York Post and Fox....Cuomo reversed his failed policy.

    When the criticism continued from Fox and New York Post.....Cuomo came up with the "blame Trump/CDC" defense.

    You are definitely right about one thing....Cuomo will come out unscathed from ABC/NBC/CBS/CNN/MSNBC. They don't care about 5,800 New York Nursing home deaths......because they love Cuomo's politics.
     
  32. tsmatthias

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    I showed this to my colleagues and we had a big laugh. You sound like an Indiana cornball right now. You literally have no clue about the situation, especially as it relates to SNF facilites on the East Coast.

    Please go back to the original thread and show me where the info I provided was wrong.

    Once again, nothing is really going to come of this. A tragic situation, but many reasons for the high number of deaths.
    Sorry to rain on your parade. He will get some criticism, but not much. Especially, when you dig deeper...

    These are the CMS Waivers put out by the Trump Administration on March 13th (retroactive to March 1st). These are the new waivers and guidelines for how Hospitals and SNF facilities should proceed during COVID-19.

    https://www.cms.gov/files/document/...laration-health-care-providers-fact-sheet.pdf

    To simplify, let's ask CMS Administrator Seema Verna what this means.
    “Our actions allow hospitals to reserve beds for the most severely ill patients by discharging those who are less severely ill to skilled nursing facilities," Verma said Friday.
    In case you are unaware of who Seema is.
    Seema Verma is an American health policy consultant and since March 2017 (not Obama appointed) administrator of the Centers for Medicare & Medicaid Services, serving in the Trump Administration.
    https://skillednursingnews.com/2020...g-homes-as-failsafe-for-overloaded-hospitals/

    This allowed COVID-19 patients to be allowed back in facilities that were able to handle them, whether right or wrong. Some facilities do have the capabilities to handle the patients with no problem. Based on the dire projections and situation in some New York hospitals, no surprise that the state followed the Trump Administration's guidelines.

    Am I surprised that Cuomo couldn't answer questions about the SNF policies when asked initially? No. Nor, would I expect Trump too either. That's why he hires Seema Verma to be able to answer those questions.
    I wasn't surprised by the change in course on May 10th. Now that the infections are more controlled in the hospitals, this makes much more sense.

    SNFs, as I explained a month ago, are also held to "Bed Hold" laws. These could be waived depending on a states' COVID plan.
    Patients at SNFs have states rights that are reinforced by federal law. That changed September 28, 2016. Bed Hold laws explained:
    https://theconsumervoice.org/upload..._Return_to_Facility_After_Hospitalization.pdf

    You seem to imply that there were no outside infections coming into these facilities.
    Staffing is a huge issue in SNFs. CNAs in the NY/NJ are making just above minimum wage and they typically work at 2-3 different facilities, sometimes more. Combine this with the fact that most of these CNAs have to take public transportation. Not to be mean, but you're not getting the best candidates in these situations.
    There was a good MSN article from a couple weeks ago on this but I can't seem to find it. Will post if I do.

    The lack of necessary testing in these facilities was/is a very significant issue.
    I think that we can all agree that there was not sufficient testing available on March 14th (day of CMS waiver) to test all 100,000 SNF patients as well as the 10,000+ SNF employees in New York.
    In fact, there wasn't even enough testing available last week to do all this!

    As of May 21st:
    https://skillednursingnews.com/2020...offers-free-covid-19-tests-for-nursing-homes/
    The new requirements by Cuomo require 370,000 tests to be performed weekly now.

    Any hate for Governor Murphy of NJ too? 5,368 dead and counting in New Jersey. This is a good article about the problems that we have seen all up and down the Mid-Atlantic in SNFs. This also explains how most infections came in from outside the facility.
    https://www.nj.com/coronavirus/2020...crisis-rampaged-through-nj-nursing-homes.html

    Your argument against Cuomo only looks at the policy while ignoring the reality of the situation. I suggest you take a less myopic approach in the future.
     
    32 tsmatthias, May 26, 2020 at 4:55 PM
    Last edited: May 26, 2020 at 5:28 PM
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  33. BoilerBF

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    The reality was there were empty beds in Javitz center, empty beds on Navy Ship, and beds available in most New York hospitals. Cuomo finally reversed his Nursing home policy on May 10th (but only after getting questions about it for a week or two).

    Desantis identified the Nursing homes as highest risk environment early on....and put policies in place to try and save the most vulnerable lives. For whatever reason Deblasio and Cuomo spent more time worrying about parks and beaches....than Nursing homes.
     
  34. tsmatthias

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    All were possibilities for housing SNF patients except for a few things. Believe me, these were thought of.

    Transporting weak and elderly patients would be a nightmare. Probably do more harm than good in some cases. It is 6 hours in some parts of the state to drive across New York to these facilities (Javits/Comfort). Vans? Buses? Who is driving them? Who does the liability of the patient fall on then? The state or the SNF? You'd have to find family members to sign off on this stuff. The scope of this would be unreal especially given the timeframe.
    There would be issues getting the right medications, records, and then of course, the testing. Testing just wasn't available to get a clear picture of the magnitude of this or which employees have it.

    Javits and the Comfort were just initially earmarked as just non-Covid trauma centers to take pressure off the hospitals, correct? Hindsight is what it is. They were barely used, if at all.


    Actually, in the first article I posted, Cuomo had a relatively good idea of converting centers that closed but he needed help from the Army Corps of Engineers. Not sure what happened to that idea, but some regional centers could've helped. The article points out that staffing would be an issue too. Nurses aren't just appearing from the hills in the Adirondacks.

    "New York Gov. Andrew Cuomo floated one such solution that could bridge the gap: taking the unprecedented step of using federal manpower to retrofit unused buildings as health care facilities.

    “Start now, bring in that Army Corps of Engineers. This is what they do. They build,” Cuomo said on CNN Monday. “I’ll give them dormitories. Build temporary medical facilities, but they have to do it. I’m not shy, but a state doesn’t have the capacity to build that quickly to that level.”

    That idea could dovetail nicely with the other overarching trend that the industry has seen in recent years: nursing home closures. Between 2015 and 2019 alone, 550 nursing homes were forced to shutter across the country, according to a recent analysis from long-term care trade group LeadingAge."

    https://skillednursingnews.com/2020...g-homes-as-failsafe-for-overloaded-hospitals/

    If there was more time to execute these plans, more staffing and testing available, they could've made a difference. None of which we had the pleasure of.

    The industry has been suffering for years for several reasons but I hope this tragedy keeps the spotlight on some key issues.
     
  35. BoilerBF

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    The Army Corps of Engineers did go to New York and convert the Javitz Center to a hospital, the Comfort came to New York. Franklin Grahams doctors and temporary hospital tents came to New York to treat Covid 19 patients. Cuomo asked if both the Javitz and Comfort could be used for Covid patients....Trump said "yes". There was a lot of excess capacity. Even most hospitals in New York City had excess capacity.

    6 hours away from New York City there was a lot of excess capacity in hospitals, because Cuomo cut off elective procedures. So not sure why you are talking about transporting a Nursing home Covid 19 patient 6 hours???

    As for dangers of transporting a Nursing home patient to a hospital.....its a lot more risk to leave an infectious Covid 19 resident in Nursing home....a breeding ground for spreading the disease.

    On May 10th, Cuomo finally decided to stop forcing Nursing Homes to admit/readmit infectious Covid 19 resident. I applaud that decision. Just unfortunate that Cuomo didn't realize Nursing Homes were the biggest risk out there...like Desantis did early on.
     
  36. tsmatthias

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    You keep playing Monday Morning QB. Anyone can do that.

    Javits, not Javitz. Thought you made a typo the first time. Nope, turns out you're just completely uneducated on this whole thing.
     
  37. BoilerBF

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    Cuomo was asked about the Nursing home policy on April 20th....he defended that policy until May 10th. That isn't "Monday Morning qb" its defending a dumb policy for 20 days after being asked about it. Even Cuomo figured out it was a bad policy. No idea why you are still defending the policy.

    Great catch on me spelling the Convention center name wrong. When you are behind in a debate you have 2 choices:

    1) Quit
    2) find a spelling error
     
  38. tsmatthias

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    This is a debate? What?

    Just pointing out your continued hayseed ignorance with Javits.

    Since I feel you are making claims on things I haven't said. Once again, where did I defend the policy? I am well aware of the policies but that these decisions are not as simple as they seem. I pointed out the likely inspiration for it (CMS waivers), as well as other contributing factors (bed hold laws).
    I have said the whole thing is tragic. Hindsight is 20/20. That's why he's not being raked over the coals for your pleasure.
    There is a reason this hasn't gained more steam. Don't know what to tell you, man.
    You are completely grasping at straws here.

    Sorry, that you want a debate or something?
    lol
     
  39. boiler800

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    Governor DeSantis is a decorated Veteran, Harvard and Yale grad, and has top flight people around him. He is nobody's fool and he was so right. I am damned glad he is my Governor. The plan for the Nursing homes was quite brilliant and look at the results. Especially in comparison to New York.
     

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