The surge hasn’t hit, so Miami’s public hospital is building a makeshift nursing home
In mid-March, as COVID-19 cases began to spike in Miami-Dade, the county’s public health system decided to delay demolishing its old rehabilitation hospital, preparing to use it instead for a grim possibility: a wave of patients that could overwhelm its beds.
That surge hasn’t come, so Jackson Health System officials have found a new use for the building — a place to discharge people who are still testing positive for the virus and can’t yet go back to their nursing home. They’ll start moving patients there this week, a Jackson official said.
The change reflects the persistent number of COVID patients entering the public hospital, and provides another way for the hospital to be reimbursed by the federal government for treating the patients.
Nursing homes and other facilities require residents to test negative for the novel coronavirus twice before returning from the hospital, Jackson CEO Carlos Migoya said, meaning they often must stay in the hospital for several days longer than they need to. The rehab building will offer more than 40 beds, still staffed by Jackson healthcare workers.
“Thank God, we didn’t get that surge,” Migoya said, adding that there are 20 to 30 hospitalized patients from nursing homes who could be moved right now.
Migoya said the lingering nursing home patients mean the system’s total number of coronavirus patients was kept artificially higher. The number has generally hovered between 150 and 165 for nearly a month, including the nursing home patients that could be moved.
There’s money at stake, too. The system is reimbursed by Centers for Medicare & Medicaid Services for COVID-19 patients under the managed care model, which gives hospitals a fixed amount per case.
“The idea behind that is to try and motivate you to improve the way you do things and get them out as soon as you can, but obviously, with COVID patients, they’re here for a longer period of time, and you’re not getting any additional compensation,” Migoya said.
Jackson Health, which is already licensed to operate long-term care facilities, was able to quickly move through regulations to open the new building as a nursing home with the assistance of the state-run Agency for Healthcare Administration, Migoya added. Officials from the public health system met with the state agency on Friday, arranged for inspectors to look at the building and plan to move patients as soon as Wednesday, he said.
“This was out-of-the-box thinking on behalf of AHCA and they came through in a very fast mode,” he said. “Unusually fast for a regulatory agency.”
Migoya said he expects moving the nursing home residents to the other building will slightly reduce the number of patients hospitalized.
“We think as soon as we do this, it’s not going to happen overnight, but we’re going to have 15-20 patient number drop within the next week or so,” he said. “This will then give you a more accurate number of COVID-positive patients who truly need hospitalization at Jackson.”
