“It can spread like wildfire. It’s like trying to stop the wind.”
Elderly people who get the novel coronavirus are at much higher risk for complications and death. And that’s not long-term care facilities’ only worry — some facility owners and industry leaders worry the industry is potentially facing financial devastation.
About one in three COVID-related deaths in Oklahoma have been connected to a long-term care facility, according to the state health department.
As of Thursday evening, there were 41 confirmed COVID-related deaths reported to be associated with care centers and a total of 131 fatalities in the state. There were 446 cases identified in almost 40 facilities.
The spread of the disease in these facilities was compounded by the state’s slow start to begin widespread testing, industry leaders have said.
Facilities are on lockdown. Visitations to centers have been suspended. Communal dining and extracurricular activities have been canceled.
Kimberly Green is the chief operating officer at the Diakonos Group, which operates several skilled nursing and rehabilitation facilities in the state.
About three weeks ago, workers tested positive for COVID-19 in Franciscan Villa, a long-term care facility in Broken Arrow the group manages, Green said. They were quick to test all staff and residents because unless the disease is quickly identified, it can spread out of control.
“It can spread like wildfire,” she said. “It’s like trying to stop the wind.”
As of Thursday, Franciscan Villa had 32 confirmed cases of COVID-19 — 13 residents and 19 staff — and three people had died.
Walk into the facility now, and you’ll see workers walking through zippered-off hallways donning full personal protective equipment, Green said. Residents are stuck in their rooms from the moment they wake to the time they go to sleep. There’s little to no staff camaraderie and several health care workers are living in the facility in an effort to stop the spread.
“Here we have people coming to work for such little money to face a deadly virus and if that virus spreads in one of our facilities, the whole public is all over us,” she said. “The biggest frustration is we need support.”
Green, who has been in the industry for more than 32 years, said similar to many industries, facilities have struggled to secure protective gear while hospitals seemingly get first priority for the equipment.
Care facilities are now facing the extra costs of markups on protective gear, and in some cases additional staffing and hazard pay, Green said. For example, for hospital gowns the group would normally pay 99 cents for, they are now paying $10, she said.
The industry is underfunded as it is, and most facilities even in normal circumstances don’t make enough to cover expenses, Green said. The pandemic has severely compounded the issue.
The underfunding of facilities can be seen across the U.S., Green said. But Oklahoma is on the low end for Medicaid payment rates to facility owners, and even though the state saw an increase in rates earlier this year, it’s still not enough to break even on costs, she said.
“We just developed the 2020 budget — those budgets don’t even exist anymore and those budgets are spent to the penny,” Green said. “Now you have a 1,000 percent markup (on PPE) and a food shortage and cleaning product shortage and staffing shortages.
“And it’s just absolute devastation.”
Gov. Kevin Stitt during a press conference on Friday announced he authorized the Oklahoma National Guard to “deep clean” care facilities across the state and that teams with the health department would start testing in centers that had yet to see a confirmed COVID-19 case.
And the Oklahoma State Department of Health this week said it was forming a task force to help long-term care facilities through “consultation, assessment and training” to help prevent the spread of COVID-19. The agency also is expected to distribute personal protective equipment to facilities over the weekend.
At the Grove Nursing Center, 46 residents and 21 workers have tested positive for COVID-19, and two people have died.
The biggest hurdle for the facility has been getting protective equipment and maintaining staffing, said Larry Cain, owner of Phoenix Healthcare, which operates six care facilities in the state.
Because many employees at the center have tested positive for the disease, staffing has been depleted, Cain said, though the facility so far has managed to maintain proper staffing levels.
Cain also has faced markups for protective gear, and has spent $12 for face masks that usually cost $1 each.
“No one in the nursing home business has planned for anything anywhere close to this,” he said. “I think the assumption was always that FEMA or some other federal agency would be there to assist and help in any way that we needed in the event some crisis like this did occur.
“But in this case it ended up being not enough.”
Preventing the spread of COVID-19 in care facilities is tricky because many people don’t show symptoms. A worker could easily enter a center unaware they have the disease, said Steven Buck, president and executive director of Care Providers Oklahoma, which represents the interests of residents and workers in long-term care facilities.
“It’s well documented we (the state) didn’t have a great deal of testing,” Buck said.
As the state’s testing capacity increases, the care community warrants more testing, he said.
To slow the spread of COVID-19 in facilities, the state is in the process of establishing intermediate care centers for nursing home residents returning from the hospital. A wing of Franciscan Villa has been outfitted for that purpose, another facility is available in Enid and spaces will soon be open in Oklahoma City, Buck said.
With the heightened use of personal protective equipment, additional staffing and overtime, financial assistance for the industry will be needed.
Care Providers Oklahoma last month in a letter requested financial relief from the state. Since then, the group has discussed the issue with the Oklahoma Health Care Authority and members of the governor’s cabinet, Buck said.
“I have been encouraged by some of the early response, but nothing definitive has been offered at this time,” Buck said on Thursday afternoon. “And I would just underscore that it needs to pick up some urgency.”
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