Mandatory testing at long-term care facilities to begin June 1

Gov. John Carney ordered COVID-19 testing for all nursing home staff and residents May 5, but to date, three-quarters of nursing homes have requested testing materials, and state officials say the number of staff tested is unknown.

State statistics show of the 310 total deaths in Delaware as of May 20, 199 were residents in long-term care facilities.

Division of Public Health long-term care incident commander Mary Peterson said that as of May 21, 78 percent of nursing homes had asked for staff testing supplies, but she does not know how many staff members have been tested.

Peterson said two DPH staff members are tracking facilities that have ordered testing kits. As of the Cape Gazette deadline, she declined to name any facilities actively testing staff. Some facilities are using their own labs and supplies, she said.

Division of Public Health Director Karyl Rattay said she was disappointed in the low level of staff testing for COVID-19, which had been voluntary. Rattay announced May 22 that mandatory weekly testing of all staff in long-term care facilities goes into effect June 1.

“There was some concern about staff being tested and being positive and then not being able to work,” Rattay said. “Long-term care facilities are struggling with staff shortages right now, but there are some protocols to help them work through that.”

Peterson said mandatory staff testing would be staggered; one-third of staff would be tested at a time to spread testing out within a two-week period. 

Peterson said CDC guidelines for mitigating staff shortages would allow them to return to work sooner than 10 days if they follow strict infection-control protocols. Facilities with staffing shortages are receiving help through the division’s medical reserve corps, she said.

Peterson said infection control was tough to enforce initially, but staff has now been trained on using protective equipment, infection-control policies and isolation protocols. A team of Veterans Administration nurses visits facilities to provide support, she said.

“This is one of the worst viruses we have seen in my lifetime,” Peterson said. “It’s deadly and insidious, and initially everyone was struggling, but we’re keeping an eye on it to make sure staff are educated and properly equipped.”

DPH spokesperson Jill Fredel said May 25 that families wearing PPE are only permitted to visit loved ones in nursing homes near the end of life. 

“I do not believe we are looking at allowing general visitation with PPE,” Fredel said. “The facilities and DPH cannot take the risk of family members and other loved ones coming into these facilities, especially as asymptomatic carriers, and potentially spreading the virus further to these vulnerable residents.” 

Delaware’s nursing homes hit hardest

Peterson doubled down on her earlier statement that there is more chance to be infected in the community than in a nursing home. She said nursing homes are restricted to outside visitors and the use of PPE is strictly enforced. She said not everyone in the public wears masks, so there is no control of the environment. Many Delaware nursing home residents have health issues making them more likely to become much sicker, she said.

Nursing home residents account for 64 percent of all deaths in Delaware, with residents of Sussex County nursing homes accounting for 41 percent of all Delaware nursing home deaths, according to the most recent county-specific data.

The four Sussex nursing homes reporting the highest number of deaths also had a total of 93 health violations on their most recent inspections - all before the pandemic hit.

DPH reported May 15 that Sussex deaths include 31 residents of Genesis Healthcare in Milford, with 136 licensed beds; 20 residents of Harrison House Senior Living in Georgetown, with 139 licensed beds; 11 residents of Harbor Healthcare in Lewes, with 179 licensed beds; and 10 residents of Atlantic Shores Rehabilitation in Millsboro, with 181 beds.

Brandywine Senior Living in Rehoboth also reported one death.

Assuming full residency, these statistics show about 22 percent of Genesis residents have succumbed to COVID-19; 14 percent of Harrison House residents; 6 percent of Harbor Healthcare residents; and 5.5 percent of Atlantic Shores residents.  At lower residency, percentages could be even higher.

According to Medicare.gov, which details information about every Medicare- and Medicaid-certified nursing home in the country, Genesis is a for-profit corporation. Its most recent health inspection in June 2019 found 34 health violations. 

For-profit partnership Harrison House received 24 health violations in its most recent health inspection in May 2019. Atlantic Shores, a for-profit corporation, received 20 health citations in its September 2019 inspection. It has also been cited for abuse. Harbor Healthcare, a nonprofit corporation, was most recently inspected in February 2019, when 15 health violations were found.

The average number of health citations for a Delaware nursing home is 13.1.