HENDERSON, Ky. (WEHT)- Redbanks Skilled Nursing has responded to questions amid a COVID-19 outbreak at its facility in Henderson.
On Saturday, the Kentucky long term facility dashboard showed 56 residents and 56 staff members had active COVID-19 cases at the facility, with 10 known COVID-19 fatalities among residents since the pandemic began. On Monday, family members of residents told Eyewitness News they had questions on how the facility is handling the COVID-19 situation there.
The increase in cases at the Henderson facility comes as Henderson County remains in the COVID-19 red zone, with some of the highest positivity rates in Kentucky. Henderson County Judge Executive Brad Schneider told Eyewitness News that the Green River District Health Department is working with Redbanks on the increase in cases.
What is the current state of the positive cases among residents and staff members?
The current state of positive cases- we have 28 resident active cases in house in isolation today. We are removing 27 out of isolation today due to they have passed the 14 day quarantine period and are stable at this time. We currently have 40 current staff cases. Keep in mind the numbers are ever changing as we are testing residents weekly and we test staff 2x weekly with the PCR method (the more reliable that unfortunately takes about 48 hrs to return). We have the ability to rapid test anyone as well and we do test anyone that is symptomatic. We are one of the largest facilities in KY and employ about 265 people which includes our contracted therapy and housekeeping teams.
Are there any indications as to how the recent outbreak started?
When you look at the incidence maps, you can see prior to the uptick in cases in our county. There was concern for high incidence in neighboring counties such as Union- even as high as 76.5%. As we have all heard this is a community spread virus so as community numbers rose, so did the risk to congregate settings. There are 368 congregate settings in KY alone affected by the virus. In the DPH guidance for mask use, you can see mask use reduces but does not totally eliminate risk for transmission.
We have all heard of the need to also socially distance. That is not always possible to do as staff provide ADL assistance to residents. PPE is available for staff and we have educated and reeducated on use. We also have hand sanitizers everywhere and our supply is above the recommended percentage alcohol content to properly sanitize.
Back in April, we ordered a misting sanitizer which we received in July, and our environmental team has used to aid in disinfection of surfaces. I attached the guidance for LTC from DPH. We implemented all the actions they advised well before the outbreak from staff and resident screening to universal use of facemasks.
One area that was a struggle is the bundling of care that was advised. That is not always easy to do. Staff attempt to do so but when residents use their call light for a need, we have to respond. Our environmental team is contracted and works in many healthcare settings and implemented extra cleaning of high touch surfaces months ago. They have also changed their product to one that requires only a 45 second kill time for the virus.
What is Redbanks doing for the residents who tested positive? Has a strike team of nurses been called in to help, as was the case in other outbreaks at long term care centers since the pandemic started?
We already had an emergency staffing plan in place that included the use of all clinical staff regardless of role, to assist in direct patient care. This plan was preapproved by the OIG on recent COVID19 surveys (4/8/20 and 8/3/20) We have all been working to cover the halls as we truly believe patient care comes first. (hence the delay in getting a media response out). We had already spoken to DPH for strike team assistance and they provided 4 nursing assistants to us that began working here this past weekend on the night shift. There were no nurses they could offer to us. We are following the guidance on zones for residents that test positive. They move to a red zone and we follow the guidelines attached.
We also have worked with our Regional Infection Preventionist from the DPH regarding crisis Capacity Strategies to Mitigate Staffing Shortages. Below is their guidance:
When staffing shortages are occurring, healthcare facilities and employers (in collaboration with human resources and occupational health services) may need to implement crisis capacity strategies to continue to provide patient care.
When there are no longer enough staff to provide safe patient care:
• Implement regional plans to transfer patients with COVID-19 to designated healthcare facilities, or alternate care sites with adequate staffing
• If not already done, implement plans (see contingency capacity strategies above) to allow asymptomatic HCP who have had an unprotected exposure to SARS-CoV-2 but are not known to be infected to continue to work.
o If HCP are tested and found to be infected with SARS-CoV-2, they should be excluded from work until they meet all Return to Work Criteria (unless they are allowed to work as described below).
• If shortages continue despite other mitigation strategies, consider implementing criteria to allow HCP with suspected or confirmed COVID-19 who are well enough and willing to work but have not met all Return to Work Criteria to work. If HCP are allowed to work before meeting all criteria, they should be restricted from contact with severely immunocompromised patients (e.g., transplant, hematology-oncology) and facilities should consider prioritizing their duties in the following order:
1. If not already done, allow HCP with suspected or confirmed COVID-19 to perform job duties where they do not interact with others (e.g., patients or other HCP), such as in telemedicine services.
2. Allow HCP with confirmed COVID-19 to provide direct care only for patients with confirmed COVID-19, preferably in a cohort setting.
3. Allow HCP with confirmed COVID-19 to provide direct care for patients with suspected COVID-19.
4. As a last resort, allow HCP with confirmed COVID-19 to provide direct care for patients without suspected or confirmed COVID-19.
If HCP are permitted to return to work before meeting all Return to Work Criteria, they should still adhere to all Return to Work Practices and Work Restrictions recommendations described in that guidance.
Based on this guidance, we have allowed asymptomatic HCP that have tested positive to care for positive only residents. Those employees are not allowed in any other area of the building where other employees may be present such as breakrooms.
According to the CHFS, there have been 22 deaths of residents at Redbanks. Is that correct?
No, that number is not correct. I caught that and reviewed with DPH. We have experienced 18 deaths either at our facility or at the hospital. It is up to DPH if they classify them as covid related or not as some were already receiving hospice care. This number is being corrected. Our team members mourn every loss of life. These residents are like family to us and we are to them. Our hearts go out to their loved ones.
A man told us Monday his wife tested positive one day, but then tested negative a few days afterwards, and was moved out of the COVID unit, but then passed away a few days later. He did not tell us what the exact cause of death was. What are the rules regarding moving residents out of the COVID unit?
I have attached the guidelines for removal of isolation from the DPH. That is exactly what we go by in collaboration with the residents MD. I do not know what you are speaking of but most likely could not comment anyways due to patient confidentiality issues.