Nurs­ing home deaths prove dan­ger re­mains

San Fran­cisco Chron­i­cle Late Edi­tion, United States of Amer­ica, 9 Oc­to­ber 2020, https://www.pressreade­­ti­cle/2814792788­80468

COVID-19 News - - News -

“I’ve heard the new num­bers only from the news, not from within. That’s ... scary.” Cather­ine Bobeda, 58, of Wat­sonville whose mother, 91, lives at the nurs­ing home

WAT­SONVILLE — In­for­ma­tion was scarce and ac­cess to loved ones re­stricted Thurs­day as the worst pos­si­ble sce­nario played out for fam­ily mem­bers of res­i­dents of the Wat­sonville PostA­cute Cen­ter — a coro­n­avirus out­break that has killed nine peo­ple and in­fected 61.

“I’ve heard the new num­bers only from the news, not from within. That’s the part that’s scary,” said Cather­ine Bobeda, 58, of Wat­sonville as she stood out­side. Her 91yearold mother, Mary Te­genkamp, a res­i­dent of the cen­ter for roughly two years, tested pos­i­tive for the coro­n­avirus last week and is in iso­la­tion there.

“She’s not show­ing any signs of COVID, and she hasn’t. No fever, no re­s­pi­ra­tory, how­ever she’s get­ting weaker and I think it’s just be­cause of the age and her de­men­tia ... and not re­ally know­ing what’s go­ing on,” she said.

Santa Cruz County an­nounced the five most re­cent deaths at the cen­ter on Wed­nes­day, call­ing it a “se­ri­ous out­break.” Of those who

tested pos­i­tive, 46 were res­i­dents and 15 were staff, pub­lic health of­fi­cials said. The fa­cil­ity is li­censed for 95 beds.

Fed­eral and state au­thor­i­ties last year cited the fa­cil­ity for in­suf­fi­cient in­fec­tion con­trol prac­tices and in­ad­e­quate staffing.

Even though dev­as­tat­ing early out­breaks in nurs­ing facil

ities abated in past months, the re­cent spike un­der­lines that the risk still runs high, ad­vo­cates for the el­derly say. Cal­i­for­nia has seen 4,540 Covid19re­lated deaths among skilled nurs­ing fa­cil­ity res­i­dents, out of 16,427 deaths in the state.

“It is way too soon for Cal­i­for­ni­ans to breathe a sigh of re­lief that their loved ones are safe in these fa­cil­i­ties,” said Mike Dark, staff at­tor­ney with Cal­i­for­nia Ad­vo­cates for Nurs­ing Home Re­form. “The same prob­lems that ex­isted at the be­gin­ning of the pan­demic still ex­ist there now.”

Dark said com­mon short­com­ings in skilled nurs­ing fa­cil­i­ties in­clude un­der­staffing, lack of in­fec­tion pro­to­cols and in­suf­fi­cient pro­tec­tive gear, which could set the stage for a coro­n­avirus out­break. The cause of the most re­cent out­break is still un­der in­ves­ti­ga­tion.

Visi­tors have been barred from skilled nurs­ing fa­cil­i­ties un­der a county pub­lic health or­der dur­ing the pan­demic, which is why Bobeda re­cently bought her mom a cell phone out­fit­ted with Zoom and mes­sen­ger ap­pli­ca­tions. Now Te­genkamp can chat with Bobeda and her four sib­lings. On Wed­nes­day night, Bobeda said she had the first video chat with her mom in a long time.

She said de­spite mis­giv­ings with com­mu­ni­ca­tion, she knows fa­cil­ity staff mem­bers are “do­ing the best they can and they are all work­ing very hard, and they al­ways have.”

Santa Cruz County has recorded 2,535 to­tal coro­n­avirus cases and 18 deaths, ac­cord­ing to the county’s data dash­board. This fa­cil­ity’s out­break was re­ported Sept. 17 to the county, which de­ployed a rapid re­sponse team to con­duct 15minute tests and con­tact tracing, spokes­woman Corinne Hy­land said. The deaths oc­curred be­tween Sept. 24 and Oct. 5, Hy­land said.

The Cal­i­for­nia Depart­ment of Pub­lic Health, which li­censes the fa­cil­ity, also im­me­di­ately stepped in to in­ves­ti­gate and give rec­om­men­da­tions, county of­fi­cials said. The agency was not able to re­spond to de­tailed ques­tions Thurs­day. The Cal­i­for­nia Na­tional Guard pro­vided emer­gency staffing be­cause of the high num­ber of in­fected staff. Ear­lier this year, the fa­cil­ity was ap­proved for lower staffing re­quire­ments due to the pan­demic, state records show.

Fa­cil­ity ad­min­is­tra­tor Ger­ald Hunter di­rected ques­tions to the county pub­lic health depart­ment Wed­nes­day. A state­ment on Wat­sonville Posta­cute Cen­ter’s web­site said the fa­cil­ity is tak­ing “all nec­es­sary cau­tion­ary mea­sures” and ad­her­ing to Cen­ters for Dis­ease Con­trol and Preven­tion guide­lines.

Dr. David Ghi­lar­ducci, the county’s deputy health of­fi­cer, said in a state­ment that PostA­cute of­fi­cials alerted county and state health of­fi­cials “as soon as the first res­i­dent tested pos­i­tive.”

“Our staff is fo­cused on the out­break and we will con­tinue to work closely with ( Wat­sonville Posta­cute Cen­ter),” Ghi­lar­ducci said.

Of­fi­cials said staff worked with the county’s seven skilled nurs­ing fa­cil­i­ties at the start of the pan­demic to de­velop strate­gies for test­ing staff and res­i­dents, max­i­miz­ing per­sonal pro­tec­tive gear, con­tain­ing in­fec­tions, and re­spond­ing to out­breaks. Hy­land said weekly meet­ings take place be­tween lo­cal of­fi­cials and fa­cil­i­ties to make sure state health depart­ment guide­lines are fol­lowed.

State and fed­eral in­spec­tions of Wat­sonville Posta­cute Cen­ter last year re­ported sev­eral de­fi­cien­cies, in­clud­ing in­suf­fi­cient in­fec­tion con­trol pro­to­col and in­ad­e­quate staffing. It had no state or fed­eral de­fi­cien­cies this year.

Although Medicare re­ported much above av­er­age qual­ity of res­i­dent care in the fa­cil­ity, the most re­cent in­spec­tion re­port from May 16, 2019, doc­u­mented nine health ci­ta­tions, clas­si­fied as “min­i­mal harm or po­ten­tial for ac­tual harm” to “few” or “many” pa­tients. The av­er­age for a fa­cil­ity in Cal­i­for­nia is 13.

In the most con­cern­ing for a coro­n­avirus out­break, the re­port said the fa­cil­ity “failed to as­sure proper in­fec­tion con­trol prac­tices” last year.

Medicare said the fa­cil­ity had be­low av­er­age staffing for nurse aides and phys­i­cal ther­a­pists and much be­low av­er­age staffing for reg­is­tered nurses, who spent 15 min­utes with a res­i­dent com­pared to a statewide av­er­age of 38 min­utes.

The Cal­i­for­nia Depart­ment of Pub­lic Health also re­ported in­ad­e­quate staffing at the fa­cil­ity last year.

“All res­i­dents have the po­ten­tial to be af­fected by the de­fi­cient prac­tice,” read a hand­writ­ten note in a plan of cor­rec­tions signed March 23, 2020. The plan re­quired the ad­min­is­tra­tor to meet daily with a staffing co­or­di­na­tor to re­view staffing hours and re­cruit more staff. But the note also says the fa­cil­ity was ap­proved for lower staffing and would ap­ply for a waiver for lower pa­tientstaff ra­tios through 2021.

Cer­ti­fied nurs­ing as­sis­tant Bernardo Jaime, 25, stepped up to the glass doors of the fa­cil­ity on Thurs­day morn­ing to ap­ply for a job to as­sist with COVID19 pa­tients. Jaime, of Sali­nas, told The Chron­i­cle he saw an ur­gent job open­ing on In­deed to work in the fa­cil­ity’s COVID19 unit and jumped at the op­por­tu­nity to help peo­ple im­pacted by the coro­n­avirus. He said he was not aware of the ex­tent of the coro­n­avirus out­break at the fa­cil­ity, but said that does not con­cern him.

“It’s OK, I want to help peo­ple out. I want to be a nurse, and that’s the main goal, you know?” Jaime said.

Sara Go­bets / Spe­cial to The Chron­i­cle

Cather­ine Bobeda, above, tells of her con­cern for her mother, Mary Te­genkamp, right, 91, who has been in the Wat­sonville Posta­cute Cen­ter for more than two years, tested pos­i­tive last week and is in iso­la­tion there.

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