Dr. Gregory Poland of the Mayo Clinic and immunogenetic expert suggests nursing homes need better training and practices.
Residents at two nursing homes in Johnson County have tested positive for coronavirus, and one of the homes is experiencing a potentially devastating outbreak.
Otterbein Franklin SeniorLife confirmed Thursday that 10 people have tested positive so far. They include eight elderly residents, a nurse and a contracted therapist.
The residents have been transferred to Franciscan, Community South and Johnson County hospitals. The nurse and therapist are recovering at home.
Johnson County public health officials are also reporting positive cases at a second facility. They did not provide additional details.
The outbreak at the Franklin facility is a major concern because the virus is most lethal among elderly people with underlying medical conditions, such as those in nursing homes. An outbreak at a nursing home in Washington state has been linked to at least 37 deaths.
Otterbein in Franklin houses about 120 residents at its nursing facility, the company’s spokesman, Gary Horning, said.
The first positive cases were identified earlier this week after a therapist called in sick on March 14 and a resident began to feel ill, Horning said. They both tested positive. By March 23 a nurse had also tested positive. The nursing home then began working with an Indiana State Department of Health strike team and tested 10 additional residents. Only three tested negative.
More testing is in progress, and Horning said the nursing home anticipates additional positive cases. The pace of the testing is slower than the company would prefer, he said.
“If possible, we’d love to test everyone,” he said. “But that’s unrealistic at this point because of the availability of tests.”
Asymptomatic residents in the unit where the virus appears to be most prevalent have been moved to a separate unit with designated caregivers in an effort to prevent further spread, Horning said.
State official criticizes moving patients
During a Thursday afternoon press conference with Gov. Eric Holcomb, Indiana State Health Commissioner Kristina Box did not specifically name the Otterbein facility, but appeared to chide the home for transporting several residents who had tested positive to the hospital while some could have stayed in isolation at the nursing facility.
“This taxes our health care system and unnecessarily exposes health care workers and others to this virus,” she said. “We need every facility to have a firm plan in place about how they will handle COVID-19 cases so we can reduce the spread of infection and preserve our hospital beds and health care resources for those who need them the most.”
She said the state was working closely with Indiana’s long-term health care associations to provide education and review the facilities’ plans for infection controls and isolation of potential cases.
A statement from the Johnson County Joint Incident Management Team said emergency medical crews from the City of Franklin Fire, Bargersville Fire, and Seals Ambulance were called to Otterbein at about 11 p.m. Wednesday to assist with transferring seven residents to local hospitals.
“Patients presented with no symptoms to mild symptoms,” the statement said. “We have not received any additional reports of a positive test in the facility at this time.”
Nursing homes a major concern
Spread of the virus at nursing homes has been a major concern nationally and in Indiana. A recent IndyStar analysis of federal data released in February shows about 73% of Indiana’s nursing homes have been cited for failed infection controls in the last three years.
Otterbein has not been cited for failed infection controls in the last three years, and it received an above average overall rating from the federal Centers for Medicare and Medicaid Services.
But staffing at the facility is below average. Nationally, Otterbein ranks in the bottom third for total nursing staff. Experts and federal regulators say staffing is the best indicator of quality care at nursing facilities.
Low staffing can be a factor
Low staffing levels can complicate efforts to fight infection as nursing home workers become ill or are forced to stay home with their children, said Richard Mollot, executive director of The Long Term Care Community Coalition.
Horning, the spokesman for Otterbein, said the facility’s staffing levels played no role in the outbreak or efforts to contain it.
“Staffing has no impact on either the introduction or spread of the virus,” he said. “In fact, Otterbein Franklin initiated restrictions earlier than called for by the governmental leaders in Indiana and Ohio, have conformed or exceeded CMS, the Centers for Disease Control and Prevention, and Department of Health guidelines.”
The low staffing is common in Indiana. An IndyStar investigation published earlier this month found that the quality of care and staffing in Indiana nursing homes ranks near the bottom nationally, despite the fact that the state receives hundreds of millions of dollars a year in extra Medicaid aid to boost care.
The extra money is part of a program intended to pay for nursing home care at government-owned facilities. County hospitals across Indiana have acquired nearly every nursing home in the state, at least on paper, to gain access to the funds.
But IndyStar found that under the program’s loose rules, hospitals were diverting as much as 70% of the funds away from the nursing homes and using the money instead to prop up hospital operations and construction.
The Otterbein facility in Franklin has technically been owned by Hancock Regional Hospital since 2013. The 208-bed nursing home generated about $3 million in extra Medicaid funds last year.
Neither the hospital nor Otterbein immediately responded to questions about how much of that money was actually used at the nursing home.
Contact IndyStar reporter Tony Cook at 317-444-6081 or email@example.com. Follow him on Twitter: @IndyStarTony.
Contact Tim Evans at 317-444-6204 or firstname.lastname@example.org. Follow him on Twitter: @starwatchtim.
Contact IndyStar data reporter Emily Hopkins at 317-444-6409 or email@example.com. Follow them on Twitter: @indyemapolis.
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