8/22/2020 0 Comments
In early May, a health inspector paid a surprise visit to Annandale Healthcare Center to observe the nursing home’s infection control practices at work during the pandemic. The center was home to one of the largest coronavirus outbreaks in a nursing home in Virginia.
The inspector found the first issue even before stepping foot in the door.
Early that morning, there was no one at the front desk to oversee screening staff for COVID-19 symptoms — a process that includes taking and recording staff temperatures and asking basic screening questions. The desk remained unstaffed from roughly 6:30 a.m. to just before 8 a.m.
So some workers screened themselves with an infrared thermometer. The inspector observed a few people who skipped the line entirely, saying they needed to clock in and would come back later to be screened. Several wondered out loud where the supervisor was to oversee the arrival of the morning shift staff. One enterprising nursing aide tried to solve the bottleneck herself, and started screening people with the infrared thermometer — but she had trouble working the device.
Several other nurses and nursing aides also pitched in at various points to take temperatures, but there was no official designated staff member at the desk to perform the screenings. The night shift supervisor, according to a wound care nurse, may have been tied up setting an IV for a resident, and there was no one to take her place.
Those are some of many breaches in protocol documented by the inspector, whose findings were included in a Centers for Medicare and Medicaid survey report in May. Another report from July found similar issues of staff not obeying social distancing and hand washing rules, and a continuing bottleneck of people at the front desk. Both times, Annandale Healthcare Center failed to meet federal guidelines and did not pass inspection.
The two inspection reports are a window into the scope of the challenge facing nursing homes — whose staff, budgets and supplies have been stretched to the breaking point — in planning for every contingency during the pandemic.
What the inspection reports foundLike many nursing homes in the D.C. region, Annandale was already hit hard by the coronavirus by May: The 222-bed facility had just 127 current residents. Of those, 80 contracted the coronavirus, 25 were transferred to a hospital, and 24 people had died, according to the May inspection report.
The outbreak was detected in early April, when two residents tested positive for the virus, according to Fred Stratmann, a spokesperson for Annandale’s parent company Communicare. Stratmann said he had no way of knowing how the virus spread, but noted that as many as 30 to 50% of the COVID-19 positive residents in Communicare facilities have been asymptomatic.
“Despite all of the hygiene procedures and all of the other protective measures that we we have taken, there have been asymptomatic, COVID positive people in our buildings,” Stratmann said.