Nursing homes: Protecting the most vulnerable

By MARY BETH SALLEE
Jobe Publishing Reporter
marybeth@jpinews.com

Nationwide, nursing homes have become the breeding ground for the novel coronavirus. The disease caused by the virus, COVID-19, strikes elderly the hardest and causes severe illness among those in the senior community.

The first positive case of COVID-19 in a nursing home facility occurred at Life Care Center in Washington state. By March 21, 35 deaths were linked to the facility.

According to the Center for Disease Control (CDC) as based upon current information and clinical studies, older adults and people of any age who have underlying medical conditions are at higher risk for severe illness from COVID-19.

During a press conference on April 3, Kentucky Governor Andy Beshear provided an update regarding nursing homes in the state. According to the Office of Inspector General, six nursing homes in the commonwealth had reported confirmed positive COVID-19 cases among residents. Three nursing homes in the state had reported cases among staff members.

To limit contacts, a majority of non-emergency inspections throughout the state are being postponed to limit contacts. Governor Beshear also stated that officials are attempting to establish more COVID-19 isolated units at all nursing home facilities.

“We want to prevent the coronavirus from reaching our nursing homes and, when it does, from spreading through them,” Governor Beshear said. “This is an area where people are very susceptible, and we want to make sure we protect them the best that we can.”

As of April 5, no cases of COVID-19 had been reported at Barren County Nursing and Rehabilitation (BCNR) or Signature HealthCARE (SHC) in Horse Cave, Glasgow, Morgantown, or Tompkinsville.

Representatives at both facilities have stated that the safety and well-being of all residents are of the utmost concern during the pandemic.

“We are following the guidance from the state Department of Public Health, the Office of Inspector General, and the CDC to maintain a safe environment for our residents,” said BCNR Administrator Jason Gumm. “I think the Governor acted very quickly, and it will benefit our state in the long run for his quick actions. We are screening everyone who comes into the facility and are still limiting visitors to those at end-of-life, which is what was recommended by the governmental agencies.”

Ann Bowdan Wilder, Media/PR/Communications Manager for SHC, said its facilities are also implementing the suggested measures.

“Signature HealthCARE has been aggressively proactive in implementing active measures against the novel coronavirus and its corresponding illness, COVID-19,” Wilder said. “The safety and well-being of our residents and stakeholders is always our top priority. We have been closely monitoring all CDC and other government agency updates and following their directives, as well as employing appropriate standard precautions and preventative measures against infection, including, but not limited to, restricting in person access to our facilities, except under very specific and essential resident circumstances.”

BCNR has approximately 100 team members and averages about 90 residents and patients. The facility typically has 15% of their residents as short-term rehab patients.

Gumm said that BCNR has an emergency operation procedure that is updated annually as needed, further explaining that the facility has previously planned for a pandemic a few years ago when the threat of the bird flu was at hand.

“We are in a constant training mode right now, as things change so quickly,” Gumm said. “We will be ready to respond, and our staff has done a fabulous job with this endeavor. A big part of our days has been spent keeping up with the current recommendations, the changes and updates, and the necessary planning for the next steps that we will be taking in the coming days, weeks, and months. We have spent a great deal of time preparing just in case this should occur to ensure that staff and residents are safe.”

“We had a resident council meeting the other day, with social distancing, and I asked if any of the residents had any questions or concerns,” Gumm added. “And one of them said to me, ‘Jason, I don’t feel there’s any better place for me to be then right here. I feel safer here really than anywhere I could be.’ Obviously, that was a huge compliment to our staff and our team.”

Wilder also stated that SHC is well-prepared for the coronavirus pandemic and any issues that may arise.

“In the event a resident would exhibit symptoms, the resident will be evaluated immediately and, if recommended by the physician and local health department, sent out for further evaluation, testing, and treatment to a partner hospital,” Wilder explained. “If positive, and in accordance with the latest CDC guidance, it will be determined on a case by case basis as to whether the resident can return to our facility for further treatment. Like most long-term care centers, our facilities are not equipped with special air pressure isolation rooms mandated by the CDC to appropriately care for certain or more serious cases of residents with this condition.”

“We will follow a similar protocol should a stakeholder exhibit symptoms of the virus. The stakeholder will be sent to the local health agency immediately for testing and will not be permitted to return to a facility until medically cleared,” Wilder added. “…We also will notify all required local health agencies of any suspected exposures we encounter and follow the local health agency’s protocol in notifying other potentially exposed residents, families, and stakeholders.”

According to its website, SHC is a family-based health care company with over 17,000 employees among its many facilities located across10 states. There are 32 SHC facilities in Kentucky. Wilder said that SHC is working to keep all of its residents connected with their loved ones.

“Although in person visitation is not permitted right now, Signature HealthCARE is offering and using many innovative alternatives to keep our residents connected with family, friends, and the outside community,” Wilder said. “Signature HealthCARE has launched several new platforms to help improve communication, while upholding mandated safety standards.”

Communication improvements for residents at SHC have included expanding the telehealth service platform YourDoc2U to allow families to set-up a virtual conference with their loved one, Internet/WiFi availability for residents, virtual chaplain visits, and cell phone, FaceTime, and Skype capabilities for connecting residents with family members. Wilder also stated that letters and cards to residents from friends, family, and the community are encouraged.

“We continue to be vigilant about safety precautions and ask that if you do send our residents letters, please remember good hand washing hygiene when handling the letters your loved ones will receive,” Wilder said. “We at Signature HealthCARE know these are difficult times for all involved. Our residents are our family, and we will continue every day to strive for excellence in their safety, health, quality of life, and keeping them connected.”

Gumm said that BCNR is also providing ways for residents to connect with their loved ones during this time, as well as providing various fun activities in which residents can participate.

“Our residents have been so resilient during this time,” Gumm said. “But they are really enjoying the different ways of communicating that we’ve used in the last week or so. We have setup Skype, Duo and Zoom accounts, along with FaceTime for those with iPhones. Our staff has really come together to help keep our residents active and connected with their families and friends during this time. We are using social distancing, but we have not decreased activities at all. We’ve just been changing the way we deliver the activities.”

Overall, both Wilder and Gumm are thankful to the communities of their facilities for continued support.

“We sincerely appreciate our families, visitors, vendors, residents, and communities’ understanding in abiding by the visitation limitations mandated by the government,” Wilder said. “These restrictions will remain in place until the government instructs us otherwise, and the facility deems it safe for our residents and staff. And we cannot say thank you loudly enough to our stakeholders who are working tirelessly to help keep our residents, their families, and each other safe and healthy.”

“We are so appreciative of all the community support, the donations, and all the notes and posts of support for our health care workers,” Gumm said. “Also, a big thanks to the families and friends of the residents and patients at our facility. They have been so supportive as well. It’s a very scary time for a lot of people, but we have some of the most dedicated people who are performing heroic acts every day at our facility to make sure that we keep our people safe. ”

NOTE: When the information for this story was received from Wilder and SHC on March 28, it had yet to be announced that SHC had any confirmed COVID-19 cases at any of its facilities. SHC has since confirmed cases in its facilities at other locations, including one confirmed case in a resident on April 3 at its facility in Newburgh, Ind., 44 cases at its facility in Cookeville, Tenn., and a confirmed case at its facility in Marietta, Ga. However, there have still been no confirmed cases of the virus at SHC’s Horse Cave, Glasgow, Morgantown, or Tompkinsville locations as of press time on Monday, April 6.