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A new rule from the federal government that will require nursing homes to share news of coronavirus cases with residents and family members highlights the wide range of communicativeness residents and their families have encountered as the homes have become some of the most common sites of virus outbreaks.
That disparity in communication has been on display in the long-term care facilities in Maine with the largest COVID-19 outbreaks, according to interviews with family members and facility managers and a review of communications the facilities have distributed.
At the Augusta Center for Health and Rehabilitation, the long-term care facility facing the largest outbreak of coronavirus cases, family members have told the BDN that they’ve heard little from the facility about how it’s dealing with an outbreak that’s infected about three-quarters of its residents.
They first heard about the outbreak from media reports and have had trouble getting staff to return calls about their parents who live at the facility. Some have had to reach out to the state’s long-term care ombudsman’s office or talk to the media to get a call back from the facility.
They still don’t have a grasp on the day-to-day care their family members are receiving and the facility’s plans for keeping the virus from spreading to the few remaining residents who aren’t infected.
In addition, the facility has posted no updates on the outbreak to its website.
Andrea Donovan, whose 72-year-old mother is at the facility and tested negative, was repeatedly frustrated trying to get updates on the condition of her mother, Linda Ogren, before and after she was tested. A week later, the facility hasn’t been much more forthcoming, said Donovan, who lives in Chelsea.
“You would think, given this crisis, they would have a designated person to keep the family updated,” Donovan said. “Nobody would answer the phone, and nobody would return our call.”
The facility’s parent company, National Health Care Associates, has not responded to multiple requests for comment from the BDN.
As of Tuesday, the facility had recorded 73 cases — 47 among residents and 26 among staff members, according to Nirav Shah, director of the Maine Center for Disease Control and Prevention. Three residents of the facility have died from the virus. That’s the largest number of cases among the five long-term care facilities in Maine that have experienced coronavirus outbreaks.
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The new federal rule from the Centers for Medicare and Medicaid Services, announced Sunday, will require that nursing facilities inform residents and their designated family representatives within 12 hours of confirming a first coronavirus case.
The rule will also require that homes report subsequent COVID-19 diagnoses to residents and family members, and provide weekly updates with information on what the nursing facilities are doing to contain the outbreak.
The Maine Veterans’ Homes facility in Scarborough sent a March 31 letter notifying residents and family members of the facility’s first coronavirus case — in a staff member — the day after the case was confirmed.
The home’s administrator, Maureen Carland, also outlined measures the home was taking in response — such as asking potentially-exposed residents to remain in their rooms and closing off the unit where the infected staff member worked to other staff — and offered a phone number for family members to call for updates on their relatives.
Last week, the home issued a timeline of events leading up to its first confirmed case and actions it took afterward as more cases were identified and the home isolated all of those infected in a single unit.
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Since the last week of March, the outbreak at the 125-bed facility has grown to 30 residents and 17 staff members who are infected. Five residents have died.
In an interview, Shah said the home’s quick isolation of infected residents likely controlled the virus’ spread. Last Thursday, the CDC received test results from residents and staff members in another unit of the home, and the results were all negative, he said.
“It suggests that strict infection control practices can control the spread,” Shah said.
The Maine CDC last month started sending guidelines to long-term care facilities on handling coronavirus cases, though the CDC doesn’t have power to require that the facilities follow them.
“I think of the Maine CDC when it comes to outbreaks in facilities as a technical assistance agency. If you’ve got questions, we’ve got answers,” Shah said. “Maine CDC just doesn’t have the regulatory authority to crack the whip.”
The guidelines from the CDC include a checklist for facilities to follow that details the recommended actions administrators should take in managing staffing, visitation, the use of personal protective equipment and quarantining patients who have the coronavirus. The CDC also provides templates of letters the homes can send to inform residents and family members.
“We recommend that they provide updates for those situations as often as possible,” Shah said. “Because the worst thing for a family member is to call and not be able to get anyone on the phone.”
At Tall Pines Retirement and Health Care Community in Belfast, one family member told the BDN that staff members overall have been communicative since the outbreak. Another woman told the Portland Press Herald recently that she had questions about the circumstances surrounding the death of her father — who had not tested positive for COVID-19 — earlier this month.
As of Tuesday afternoon, the outbreak at Tall Pines had grown to 29 residents and 10 staff members. Of the long-term care facilities experiencing COVID-19 outbreaks, Tall Pines has recorded the largest number of deaths — eight, accounting for all of the coronavirus-related deaths reported in Waldo County.
Executive Director Matt Griswold told the BDN last week that facility staff are following the CDC’s recommendations to contain the virus’ spread, which include screening staff and residents for any sign of symptoms, restricting all visitors and non-essential staff from entering our facility and canceling all group activities within the building.
“Right now they are under-staffed — staff members are testing positive, too — so it’s hard to pull away the nurses for phone updates,” Debbie Murphy, whose mom is at the Belfast facility and tested positive for the coronavirus, told the BDN last week. “But they are very good about returning calls and keeping the family in the loop. And the staff there are heroes, taking special care of the residents close-up. One staff aide was feeding my mom, who has little appetite, so we are very appreciative of them and aware of how difficult and scary this simple task can be.”
Watch: Should you remove loved ones from care facilities during the outbreak?