By Mitchell Kirk | Daily Reporter
HANCOCK COUNTY — For months, health experts have talked about how older adults, especially those who live in congregant settings like nursing homes, are more at risk for severe illness from COVID-19. Data recently released about Hancock County’s long-term care facilities shows how true that can be.
The Hancock County Health Department has released figures regarding residents of the eight facilities in the county. As of Monday, May 11, Greenfield Healthcare Center had recorded 50 cases, 10 of which resulted in deaths — more than half of the county’s COVID-19 fatalities. Woodland Terrace of New Palestine had recorded two cases, one of which resulted in a death.
The county’s other six facilities hadn’t recorded any cases or deaths for residents. They include Greenfield-based Springhurst Health Campus, Golden LivingCenter-Brandywine, CrownPointe of Greenfield and Sugar Creek Nursing and Rehabilitation; and McCordsville-based Traditions at Brookside and Pleasant View Lodge.
Greenfield Healthcare Center
Fred Stratmann, a spokesman for Cincinnati-based CommuniCare, Greenfield Healthcare Center’s parent company, said the reason the facility’s case statistics are so high is because it’s testing all residents.
“I understand there’s going to be alarm about the high numbers, and I get that,” Stratmann said. “We are dealing with a population that have the immunocompromised; they have underlying health conditions that contribute to things. We’re still trying to understand the exact nature of transmission and the effect it has on everybody. I think it’s very early in the game, but I think that we have been proactive in trying to prevent and in trying to control it when we can.”
Compared to figures the Hancock County Health Department released on Friday, May 8, a total of 14 cases and two deaths were added to Greenfield Healthcare Center’s totals on Monday. Stratmann attributed the spike to a number of test results that came back at the end of the week.
Stratmann also confirmed 10 employees at Greenfield Healthcare Center, 200 W. Green Meadows Drive, have tested positive for COVID-19.
At the beginning of the pandemic, Greenfield Healthcare Center spot-tested residents for the novel coronavirus as signs and symptoms arose, Stratmann said. As cases started to accumulate, the facility voluntarily undertook testing of all residents in late April to get as comprehensive of a view as possible. The facility has 163 beds approved to participate in Medicare and Medicaid.
“What you find is you have a lot of residents end up testing positive but have no symptoms,” Stratmann said of whole-house testing.
All residents who initially tested negative were retested about a week or two later, he continued.
Employees continue screening residents every shift by checking temperatures and for respiratory issues and other COVID-19 symptoms, Stratmann said. If a medical professional determines a resident needs another test, one is administered.
“We already have very elaborate isolation procedures in place where people who have tested positive are quarantined or isolated in specific units,” he said, including negative-pressure environments and isolating heating, ventilation and air conditioning systems.
Dr. William Petri, a professor of medicine at the University of Virginia Medical School, told the The Associated Press that there have been examples of the clotting system being activated and causing strokes, perhaps caused by an immune system responding abnormally to COVID-19.
In light of that, CommuniCare facilities like Greenfield Healthcare Center have started clinically appropriate residents on anticoagulant medication, Stratmann said.
The Associated Press has also reported that COVID-19 can trigger fluid buildup in the lungs.
To combat this, Stratmann said CommuniCare is finalizing procedures for a treatment process called proning, which entails positioning a resident in bed in a way that prevents the pooling of fluid in lung tissue, which is located in the back of the body.
“It’s an oversimplification to say you’re resting them on their stomach,” Stratmann explained.
Employees are screened for symptoms and tested if they arise, he continued. While working, they wear personal protective equipment in accordance with Centers for Disease Control and Prevention guidelines like masks, gloves and gowns.
Employees who work with patients who have COVID-19 do not work with patients who are not believed to have the disease, Stratmann also said.
Stratmann did not know if an Indiana State Department of Health strike team had been deployed to Greenfield Healthcare Center, but said the facility keeps in regular contact with the department.
CommuniCare’s website states all of the companies’ campuses continue to restrict visitation.
Stratmann said staff at Greenfield Healthcare Center and all of CommuniCare’s locations mourn the loss of every resident lost to COVID-19.
“This is not numbers to them, they’re not statistics,” he said. “They’re faces, they’re names, they’re stories. We know their lives, we know their families, we know their habits… We feel those losses tremendously. Staff are emotionally drained and devastated when someone in their care passes. It’s a tribute to the health care workers that they work in a very intense environment at the same time that they’re grieving so much.”
Woodland Terrace of New Palestine
Angela Miller, executive vice president and chief operating officer for The Justus Family of Companies, of Indianapolis and parent company of Woodland Terrace of New Palestine, said the facility’s COVID-19 case that resulted in a death was a resident who recently came to live at the facility with serious underlying health conditions.
That resident was tested in mid-March when he was hospitalized, Miller continued. His wife, who also lives at Woodland Terrace of New Palestine, was tested at that time too.
While the man’s test results had yet to come back, he was kept in isolation at the facility upon his return from the hospital, Miller said. His positive result didn’t come back until about a week after he entered the hospital, and after he had died.
“That was all very early in the (pandemic)… when tests were taking longer,” Miller said.
Due to the man’s other serious health concerns, Woodland Terrace didn’t learn COVID-19 was listed as a cause of death until last Friday, when the Hancock County Health Department released COVID-19 data on long-term care facility residents, said Ryan Skinner, executive director of Woodland Terrace.
The resident’s wife also tested positive, Miller said, but never showed any symptoms and has since recovered. Miller said the Indiana State Department of Health came in to test staff who may have been exposed to the infected residents, and all of the employees’ results came back negative. She credited staff for quickly isolating the residents and using personal protective equipment to prevent the spread of the virus.
The Justus Family of Companies posted an extensive list of procedures on its website that its independent and assisted living facilities are taking amid the COVID-19 pandemic for residents, employees and families. Among them are closely monitoring high-risk residents, restricting visitors except in compassionate care situations like end of life, frequently sanitizing, training all staff on infection control and providing meal deliveries and essential shopping.
Entry for permitted visitors is determined on a case-by-case basis and requires screening for COVID-19 symptoms. Permitted visitors are required to wear personal protective equipment, including gloves and a surgical face mask if available.
Staff and medically necessary caregivers are screened for temperature and symptoms daily before starting shifts as well.
Releasing the data
The state reports aggregate data for COVID-19 at long-term care facilities and leaves whether facility-specific information gets publicized to facilities and local health departments. The state also requires facilities to inform residents and their designated representatives on the total number of COVID-19 cases and deaths as well as actions they’re taking to prevent the spread of the illness.
In information the Hancock County Health Department sent to its local partners on Friday, May 8, Dr. Sandra Aspy, the county’s health officer, said the local health department had received several requests for countywide information on COVID-19 at long-term care and assisted-living facilities.
“Since then, and in the last week specifically, several central Indiana counties have released the number of COVID-19 cases by the name of each long-term care and assisted-living facility,” Aspy said.
During the health department’s weekly teleconferences with fellow central Indiana health departments, she continued, representatives of those departments said they were directed by their legal counsel to provide facility-specific information in order to fully comply with requests for information. Health Insurance Portability and Accountability Act, or HIPAA, laws were considered in those decisions, Aspy said, adding the Hancock County Health Department’s legal counsel also directed the department to release the information.
“While we understand facility-specific information can place a spotlight on some long-term care and assisted living facilities, we must also comply with these requests to provide public transparency during this process,” Aspy said.
Aspy also said other specific information like COVID-19 tests administered for each facility, the total number of residents at each facility and how many residents were hospitalized due to COVID-19 was not provided because the health department doesn’t have complete data to answer those questions. No other central Indiana health departments have provided that specific information for the same reasons, she added.
Latest data for all of Hancock County
On Monday the county added two more deaths from COVID-19 since Friday, May 8, raising the total to 19. While Indiana State Department of Health data doesn’t disclose whether they were residents of long-term care facilities, both were 80 or older. One was a man who died on May 6, and the other was a woman who died on May 9, according to the data. Craig Felty, vice president, chief nursing officer and chief operating officer of Hancock Regional Hospital, said neither were patients at the hospital.
The county also added 24 COVID-19 cases over the weekend, 18 of which were added on Saturday — the county’s first double-digit increase over a 24-hour period in almost two weeks. Felty said the rise was likely due to an increase in testing and that a few of the cases are likely at an extended-care facility.
