Most COVID-19 Deaths, Cases at Long-term Care Facilities

COURT HOUSE – Despite many preventative steps taken by long-term care facilities, COVID-19 cases at them account for about half of the total number of active cases and about three-fourths of Cape May County’s deaths from the coronavirus.
Four homes operated by Genesis HealthCare, Autumn Lake at Ocean View and The Shores at Wesley Manor have seen increases in positive cases over the past few weeks, and while state-wide numbers are declining, the trend for this vulnerable population continues to rise. It’s prompted the state’s Department of Health to require that all staff and residents at these facilities be tested by May 26, with follow-up testing within the following week if they test negative.
Additionally, their outbreak prevention plans must be updated by May 19 to address how the facility will manage isolation and cohorting infected and at-risk individuals, provide staffing guidelines and procedures, and future testing. The plan must be implemented by May 26.
These six homes are the only long-term care homes in Cape May County reporting positive COVID-19 cases, as of May 13. Woodbine Developmental Center, also considered a long-term care facility by the state, is also reporting multiple positive cases and several deaths.
At The Shores at Wesley Manor, in Ocean City, Executive Director Jessica Stewart said 11 staff have tested positive thus far (May 15), but no residents. Four of the staff have already returned to work, and seven of them were asymptomatic and are not working. There were five positive cases among staff at the facility as of May 4.
The preventative actions at the facility were part of their outbreak prevention plan already, but Stewart expressed concerns about how they will continue to ensure staff remain as negative as possible going forward.
“The state is eventually going to open up, and it’s scary,” she said. “I am hoping the state provides more guidance on things, like how will we have family visits, or do we limit the number of people in the building, how do we maintain social distancing? Our residents have rights. It will be interesting to see how this plays out.”
The current outcomes of positive cases at the facility, Stewart said, is a reflection of the staff and everyone adhering to the preventative measures.
“This is not inexpensive,” she said. “I’m sure all the facilities across the state face financial struggles, and how is the state going to help with that? Where is the help going to come from?”
Stewart said they have partnered with a lab on COVID-19 testing, but noted that each test costs $100.
“I agree with the need, and we want to stay ahead of the curve, but fiscally, what is the best method to test?” she asked. “Is it a test you can do easily under your tongue, do you need a lab, or do you do antibody testing and watch for those who test negative?”
“This is a new norm,” she added.
Genesis Facilities ‘Doing Their Best’
At four Genesis HealthCare facilities, Dr. Richard Feifer, chief medical officer, said they are doing their best to limit COVID-19’s spread from residents who have it to those who don’t.
Their Victoria Manor facility, on Bayshore Road, in North Cape May, has had 49 residents and 22 staff test positive, and 15 residents have died. The North Cape Center, on Town Bank Road, has had 40 residents and 22 staff test positive, and nine residents have died. Twenty-one residents and 12 staff members were asymptomatic at the time of testing.
At their Court House Center, on Magnolia Drive, four residents who tested positive have recovered. One resident tested positive at Victoria Commons, also on Town Bank Road, in North Cape May, but that resident is no longer at the facility. The Victoria Manor facility was the first long-term care facility in the county to see positive cases. All figures are as of May 15.
“There are likely typically three ways for the virus to initially enter the facility,” Feifer said. “One is via staff, which is why staff have been wearing full personal protective equipment (PPE) since March 26, ahead of the government guidance issued on April 2. “The second was via new admissions from the hospitals before centers were locked down for their first positive cases. Third, while we have canceled all outside medical appointments, some medically necessary, time-sensitive, and life-saving treatments are still occurring, such as dialysis and chemotherapy.”
“This is a complex virus that is hard to detect, people can be asymptomatic but positive, and the virus can take weeks to present itself,” Feifer added. “By the time you have a positive test result, many may have already been exposed, no matter what precautions have been taken.”
“The recent Kirkland report, released at the end of March by the Centers for Disease Control, shows that people can be asymptomatic but carrying the virus and spreading it,” he noted. “In that instance, 57% of residents who initially tested positive were asymptomatic.”
Because it’s not exactly known how the virus is entering, Feifer said, “We stay as hyper-vigilant as we can, and as we learn more, we implement more and more safety precautions.”
Genesis HealthCare, like other long-term care facilities in the state, needs to customize outbreak response plans by May 19 and implement them by May 26. The plans need to be based on national standards, addressing isolation and cohorting infected and at-risk individuals.
“Our formal plans are due to the state by May 19, and we will have more information in the coming days as we research requirements further,” said Feifer.
Now, Feifer said they are trying to limit the spread of COVID-19 from residents who have it to those who don’t.
“The safest way to manage spread is to isolate different units,” he said. “While it might seem logical to move patients to avoid exposure, we cannot tell which people may be carriers of the virus without showing symptoms.
“Moving residents throughout the facility exposes them to more potential encounters with the virus. That is why testing someone before moving them is so important in managing the spread of this virus,” he added.
Thus far, the Genesis facilities have not had issues with adequate staffing or PPE, like many facilities across the state.
“It’s no secret that the entire nation has been experiencing staffing and PPE shortages, even before the pandemic,” Feifer said. “However, as part of a large national network of facilities, these centers have not had any issues ensuring adequate staffing, relying on support from sister centers and resources via temporary staffing agencies.”
“However, we have fortunately been able to leverage all possible avenues to obtain PPE, as the company has been able to shift supply around from location to location as needed,” he added.
Autumn Lake Cases Jump
Autumn Lake at Oceanview has seen their numbers jump from 22 positive cases April 27 to 37 positive cases and two deaths, as of May 13, according to state Department of Health reports.
Multiple calls to reach Administrator Eli Finkelstein were not returned.
To contact Karen Knight, email kknight@cmcherald.com.