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LTC Residents and Workers Face Tragedy

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J.Adderton has 27 years experience as a BSN, MSN .

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What do you think about the high rates of COVID-19 in nursing homes?

Residents and long-term care employees have been largely overlooked as the coronavirus pandemic rages on.  Read on to learn more about the virus’s impact among our most vulnerable population.

LTC Residents and Workers Face Tragedy
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The earliest U.S. coronavirus deaths occurred in late February when residents at a Seattle nursing home began falling ill. Since then, the virus has spread like wildfire through the nation’s nursing homes. On Sunday, April 19th, ABC News reported at least 7,300 long-term care residents, in 19 states, have died during the COVID-19 outbreak. Because only 19 states have reported this data, the number of deaths is likely much higher.

Too Little Too Late

On April 2, 2020, the Center for Disease Control (CDC) issued new recommendations to help slow the spread of the virus among some of our most vulnerable patients and healthcare workers in long term care (LTC). But, COVID-19 continued to surge in LTC facilities across the nation, suggesting the CDC recommendations were not stringent enough or came too late. Here are just a few examples:

  • Canterbury Rehabilitation & Health Care Center in Richmond, Virginia, reported on April 17th, at least 46 residents died of COVID-19, which is one-fourth of the facilities population. Testing was not available to the facility until March 30th and the state only had an estimated supply of 300 kits.
  • On April 17th, officials in New York released information showing at least 14 nursing homes in New York City and surrounding suburbs have recorded more than 25 coronavirus deaths. At least 55 deaths are reported at the Cobble Hill Health Center in Brooklyn.
  • In New Jersey, almost two-thirds of the state’s LTC facilities have reported coronavirus outbreaks and more than 1,500 deaths tied to nursing homes. One of the homes was overwhelmed by the number of resident deaths and an anonymous tip led to 17 bodies being found in the facility’s morgue, which was designed for only 4 bodies.

Both Residents and Workers High Risk

Residents in long term care often require assistance with bathing, feeding, turning and other daily living activities that require close contact with the workers caring for them. The level of personal care needed puts both residents and workers at increased risk for infection. In early April, a McKnight’s Long-Term Care News Flash Survey showed 48% of respondents had workers missing work due to either having COVID-19 or experiencing symptoms. Workers and residents in LTC also face challenges that are both unique and common among all of healthcare.

  • Chronically understaffed, poor staffing ratios and ill-prepared for staff to be off work after acquiring COVID-19 or coming in close contact with someone who has tested positive.
  • Many already had a history of safety violations prior to the coronavirus outbreak.
  • Provide services to residents who are older adults who are immunocompromised due to age or chronic illness/disease.
  • Late in requiring workers and residents to wear masks.
  • Some facilities initially required a worker or resident to test positive for COVID-19 before requiring masks.
  • Poor staff to resident ratios.
  • LTC facilities designated as lower priority for COVID-19 testing than hospitals.
  • Difficult to isolate residents with symptoms due to common eating/recreation areas and semi-private rooms with double and triple occupancy.

A combination of these factors, among others, have allowed the spread of COVID-19 despite efforts to slow the spread.

Overlooked Workers

Workers in long-term care have been largely overlooked as COVID-19 plays out. Like other healthcare settings, virus tests and protective gear have been limited in many facilities. Staff in nursing homes are also less likely to receive the same level of training as those working in a hospital. In addition, many employees are poorly paid and work several jobs to make ends meet. As a result, the virus may be spread from one facility to another and even to the worker’s home.

Creative Solution

Park Springs Life Plan Community in Stone Mountain, Georgia, has found a creative way to slow the spread. The facility’s leaders asked staff members to volunteer to live on campus to avoid carrying the virus into the facility from home. Sixty workers took the bold step and volunteered. Only four staff members and one resident at the facility have tested positive for the virus and all have fully recovered.

Let Us Hear from You

Do you work in a long-term care facility or have a loved one that is a resident?

If so, what insight would you like to share on the high rates of COVID-19 in nursing homes?

Resources

‘They’re Death Pits’:  Virus Claims at Least 7,000 Lives in U.S. Nursing Homes

References


J. Adderton MSN has over 25 years of nursing experience in clinical leadership, staff development, project management and nursing education.

7 Followers; 123 Articles; 34,683 Profile Views; 396 Posts

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CharleeFoxtrot has 7 years experience as a ADN, RN.

654 Posts; 8,555 Profile Views

10 hours ago, J.Adderton said:

The earliest U.S. coronavirus deaths occurred in late February when residents at a Seattle nursing home began falling ill. Since then, the virus has spread like wildfire through the nation’s nursing homes. ...

What do I think? I want to curl up in a ball and weep, that's what I think.

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Texasharvest has 13 years experience.

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Why is this coming as a surprise to anyone? LTC facilities are chronically understaffed and most have a slew of safety violations. No one did anything about this before Covid-19, and no one will do anything about it after this is all said and done. That's the tragedy in all of this.

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Daisy4RN has 20 years experience and specializes in Travel, Home Health, Med-Surg.

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This is so sad that this is how our elderly and disabled are treated. I worked in a LTC facility and really was shocked to find out how it was ran. There is no way that it is possible for nurses/staff to care for these patients the way the deserve. I could not stay because of it. Add covid to the mix and I can see how there were so many deaths. Of course part of that was the close proximity that just cant be helped (in most of the homes if not all). Just so sad!

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181 Posts; 673 Profile Views

This was very hard to read, but as others have indicated, no surprise to any of us familiar with LTC facilities which are understaffed, under resourced and weakly regulated (or at least the enforcement of the regulations).

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NRSKarenRN has 40 years experience as a BSN, RN and specializes in Vents, Telemetry, Home Care, Home infusion.

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With 18 deaths, Marple Township has been one of the hardest hit municipalities in Delaware County, PA from the COVID-19 virus and nursing homes have borne the brunt of that; 3 located in the township. Staffing shortages from the COVID-19 pandemic left this acute-care facility in need of assistance.   As of 4/23/20, Delaware County has the third highest # positive cases in the state: 2902 positive cases; 119 deaths,  behind #2: Montgomery County: 3395 positive cases; 204 deaths and #1: Philadelphia: 1,090 positive cases', 271 deaths.   Of the 119 deaths in Delaware County, 68 have been in nursing homes.  Karen

 

PA National Guard is dispatched to help Broomall nursing home

Delco Times,  Apr 19, 2020

By Kathleen E. Carey

Quote

MARPLE — The Pennsylvania National Guard Medical Team is being deployed for three days at the request of Delaware County to assist at the Broomall Rehabilitation and Nursing Center because of staffing shortages. 

Nursing homes have bore the brunt of the coronavirus epidemic in Delaware County as of Saturday, 397 nursing home residents and 41 staff members in 37 facilities have tested positive, according to the Pennsylvania Department of Health. Of those cases, 54 have died, representing 69 percent of the current 78 virus fatalities in Delaware County according to the Chester County Health Department, the agency handling the COVID-19 care for Delaware County residents.

On Saturday, county officials announced that they had requested support from the Pennsylvania National Guard Medical Team to provide support for staff at the Broomall Rehabilitation and Nursing Center. The team is compromised of 18 military nurses and medics who will assist the facility in providing routine care for non-acute patients....

https://www.delcotimes.com/news/coronavirus/the-national-guard-is-dispatched-to-help-broomall-nursing-home/article_9b58c4c6-81e0-11ea-b86e-a3712b3073eb.html

 

Wall Street journal --registration required

Coronavirus Deaths in U.S. Nursing, Long-Term Care Facilities Top 10,000

https://www.wsj.com/articles/coronavirus-deaths-in-u-s-nursing-long-term-care-facilities-top-10-000-11587586237

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CrunchRN has 25 years experience as a ADN, RN and specializes in Clinical Research, Outpt Women's Health.

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I am afraid it will get much worse. With nursing homes shutting down if they can't make a profit and abandoning residents and staff. I hope not.

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235 Posts; 3,146 Profile Views

LTC facilities have been shut down to visitors > two weeks.

The new cases of Covid19 in residents?  
They’ve caught it from us.

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It's disgraceful and outrageous! I live in one of the major metro areas in Texas; they have just announced that they will be covid testing all guards and inmates in this county.  Yes, I get that, BUT....shouldn't all residents and cg's in nursing homes be tested first(they've committed no crime, unless in our present society it's now a crime to become elderly)!!  I emailed the mayor's office and will be calling the county commissioner tomorrow(d/t him appearing at least somewhat sympathetic to their plight).  Imho, I believe that our society has more empathy/compassion for prison inmates than the elderly---reflected in the way we care for them. As far as insight on high rates of covid in snf:  "we did what we did to get what we got"(short staffing, lack of supplies and sometimes ignorance of appropriate use, burnout, lack of supervision, worker apathy, little to no family involvement...and our culture).

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J.Adderton has 27 years experience as a BSN, MSN.

7 Followers; 123 Articles; 396 Posts; 34,683 Profile Views

12 hours ago, chrisjk said:

As far as insight on high rates of covid in snf:  "we did what we did to get what we got"(short staffing, lack of supplies and sometimes ignorance of appropriate use, burnout, lack of supervision, worker apathy, little to no family involvement...and our culture).

Agree, and a terribly low pay scale for workers- especially CNAs.  

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On 4/23/2020 at 8:23 AM, J.Adderton said:

The earliest U.S. coronavirus deaths occurred in late February when residents at a Seattle nursing home began falling ill. Since then, the virus has spread like wildfire through the nation’s nursing homes. On Sunday, April 19th, ABC News reported at least 7,300 long-term care residents, in 19 states, have died during the COVID-19 outbreak. Because only 19 states have reported this data, the number of deaths is likely much higher.

Too Little Too Late

On April 2, 2020, the Center for Disease Control (CDC) issued new recommendations to help slow the spread of the virus among some of our most vulnerable patients and healthcare workers in long term care (LTC). But, COVID-19 continued to surge in LTC facilities across the nation, suggesting the CDC recommendations were not stringent enough or came too late. Here are just a few examples:

  • Canterbury Rehabilitation & Health Care Center in Richmond, Virginia, reported on April 17th, at least 46 residents died of COVID-19, which is one-fourth of the facilities population. Testing was not available to the facility until March 30th and the state only had an estimated supply of 300 kits.
  • On April 17th, officials in New York released information showing at least 14 nursing homes in New York City and surrounding suburbs have recorded more than 25 coronavirus deaths. At least 55 deaths are reported at the Cobble Hill Health Center in Brooklyn.
  • In New Jersey, almost two-thirds of the state’s LTC facilities have reported coronavirus outbreaks and more than 1,500 deaths tied to nursing homes. One of the homes was overwhelmed by the number of resident deaths and an anonymous tip led to 17 bodies being found in the facility’s morgue, which was designed for only 4 bodies.

Both Residents and Workers High Risk

Residents in long term care often require assistance with bathing, feeding, turning and other daily living activities that require close contact with the workers caring for them. The level of personal care needed puts both residents and workers at increased risk for infection. In early April, a McKnight’s Long-Term Care News Flash Survey showed 48% of respondents had workers missing work due to either having COVID-19 or experiencing symptoms. Workers and residents in LTC also face challenges that are both unique and common among all of healthcare.

  • Chronically understaffed, poor staffing ratios and ill-prepared for staff to be off work after acquiring COVID-19 or coming in close contact with someone who has tested positive.
  • Many already had a history of safety violations prior to the coronavirus outbreak.
  • Provide services to residents who are older adults who are immunocompromised due to age or chronic illness/disease.
  • Late in requiring workers and residents to wear masks.
  • Some facilities initially required a worker or resident to test positive for COVID-19 before requiring masks.
  • Poor staff to resident ratios.
  • LTC facilities designated as lower priority for COVID-19 testing than hospitals.
  • Difficult to isolate residents with symptoms due to common eating/recreation areas and semi-private rooms with double and triple occupancy.

A combination of these factors, among others, have allowed the spread of COVID-19 despite efforts to slow the spread.

Overlooked Workers

Workers in long-term care have been largely overlooked as COVID-19 plays out. Like other healthcare settings, virus tests and protective gear have been limited in many facilities. Staff in nursing homes are also less likely to receive the same level of training as those working in a hospital. In addition, many employees are poorly paid and work several jobs to make ends meet. As a result, the virus may be spread from one facility to another and even to the worker’s home.

Creative Solution

Park Springs Life Plan Community in Stone Mountain, Georgia, has found a creative way to slow the spread. The facility’s leaders asked staff members to volunteer to live on campus to avoid carrying the virus into the facility from home. Sixty workers took the bold step and volunteered. Only four staff members and one resident at the facility have tested positive for the virus and all have fully recovered.

Let Us Hear from You

Do you work in a long-term care facility or have a loved one that is a resident?

If so, what insight would you like to share on the high rates of COVID-19 in nursing homes?

Resources

‘They’re Death Pits’:  Virus Claims at Least 7,000 Lives in U.S. Nursing Homes

I work in LTC is really sad! its so depressing at times.

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484 Posts; 6,754 Profile Views

I work in a hospital, and this week I had a patient who works in a nursing home.  Multiple exposures, so no wonder she got sick.  I'm actually surprised we haven't seen more staff members, except hopefully they are in generally good health and are able to recover at home when they fall ill.  My patient had comorbidities that put her in a higher risk category, but it's still a little unnerving to see someone in her early 20s hospitalized.

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