As LNP | LancasterOnline’s Hurubie Meko and Gillian McGoldrick reported in Sunday’s edition, “Lancaster County is home to 32 nursing homes, one of which has accumulated the highest number of deaths in the state: Conestoga View, one of the county’s poorest and lowest rated facilities, which has had 78 deaths from the virus in the 446-bed building and a 1-star rating. But when analyzed by percentage of deaths per resident beds, four of Lancaster County's smaller, top-rated nursing homes have been the hardest hit by the virus. Each has lost nearly a fourth of their residents to the novel coronavirus since outbreaks began.”
Luther Acres in Lititz is a 5-star rated facility with 106 licensed resident beds. It has lost 29 people, or 27% of its residents to COVID-19 — the highest percentage in the county, Meko and McGoldrick reported.
The facility’s medical director is Dr. Leon Kraybill, the chief of Penn Medicine Lancaster General Health’s geriatric division and post-acute care.
You don’t get to be a division chief at a major hospital without experience, expertise and the respect of your peers. If even Dr. Kraybill couldn’t stem the deaths at Luther Acres, who could?
A novel coronavirus wreaking havoc with the health of those it infected. A society that didn’t fully embrace the measures — masking, social distancing — that might prevent the virus’s spread.
“We worked desperately to keep COVID-19 out of our community and our nursing facility,” Kraybill wrote in a June 7 op-ed. “That was unsuccessful.”
One could sense the despair even in the measured tone of his writing. Noting the strategies his nursing home and others implemented to try to keep their residents safe — screening staff members, restricting family visits, keeping residents in their rooms, discontinuing social activities — Kraybill wrote, “Nursing homes have taken drastic steps to limit the spread of infection, but what is in the community will inevitably come to nursing homes.”
And so it did.
And nursing homes like Luther Acres suffered greatly, not because their staff members didn’t work hard enough or didn’t care enough.
But because they were short of the essential resources they needed in their fight: personal protective equipment, adequate testing supplies and testing results delivered quickly enough to prevent spread to other people.
And, frankly, they were up against a societal indifference that suggested people were more worried about the resumption of normal life than about the well-being of senior citizens.
As Kraybill wrote, “Nursing home residents and people with chronic illness pay the life-and-death price of societal decisions that do not limit the spread of COVID-19.”
Luther Acres wasn’t the only highly rated nursing home ravaged by the highly infectious new disease. As Meko and McGoldrick reported, the 60-bed Homestead Village, 94-bed Hamilton Arms and 50-bed Mount Hope Nazarene all saw the virus-related deaths of at least an estimated 22% of their residents.
At Luther Acres, the staff “would get within a day to half a day of running out of a certain supply of gowns,” and then state and federal emergency management agencies would deliver the protective gear, Craig Shelly, executive director of Luther Acres, told LNP | LancasterOnline.
To make the supplies last, he said, staff would use the same gowns to treat patients who were already infected.
Douglas Motter, president of Homestead Village, said that his staff went to considerable lengths to limit the virus’s spread, but because of shortages, new masks only were issued weekly.
N95 masks and surgical masks are supposed to be discarded after a single use.
And at Mount Hope Nazarene in Manheim — a church-based mission serving low-income people — acquiring personal protective equipment became a full-time job for administrator Michele Tornabe, Meko and McGoldrick reported.
Tornabe told LNP | LancasterOnline that despite getting less than $100 from Centers for Medicare & Medicaid Services per day per resident, the facility was forced to pay quadruple for some supplies. At one time, a supplier was charging $18,000 for 2,000 disposable gowns.
That is beyond disgraceful.
It’s hard to fathom the motivation that drives soulless price-gougers to seek to make a buck in a national crisis. But it’s just as hard to fathom the failures of the federal and state government to provide nursing homes with what they needed in a pandemic. Preparing for an epic crisis is precisely what government is supposed to do — well before that crisis hits.
It’s also hard to fathom the grief of family members as their beloveds succumbed to COVID-19 behind the walls of locked-down nursing homes.
Reba Weit, 91, died June 2 at Luther Acres. Her daughters, Jean Slaymaker and Rebecca Ericson, told LNP | LancasterOnline they believe their mother contracted the virus when a staff member brought it into the facility.
In an email, Shelly, the facility’s executive director, agreed that scenario was likely. Even vigilant screenings could not detect asymptomatic carriers of the virus, he noted.
This is why we have implored county residents to remember that nursing home staff members are part of our community and move around in it. They need us to do our part — to wear masks and maintain social distance in public spaces. They still do.
Health policy researchers at Harvard University, University of Chicago and Brown University have identified the factors associated with high rates of COVID-19 infection and death in nursing homes. The prime factor: a facility’s location.
“No care facility, no matter how excellent, can keep (COVID-19) away if it’s widespread in the areas where staff members live and work,” according to a Washington Post column co-authored by Harvard Medical School professor David Grabowski.
So as the virus began to spread in Lancaster County, nursing home staff members got infected, too.
The situation was worsened by the grievous missteps made by the Pennsylvania Department of Health.
As Meko and McGoldrick reported, that state agency issued guidance to nursing homes on March 18 requiring them to “continue to accept new admissions and receive readmissions for current residents who have been discharged from the hospital who are stable,” including those who have had COVID-19.
“This order was issued to alleviate the ‘burden’ on hospitals, according to the order, but hospitals in Lancaster County and across Pennsylvania were never overwhelmed,” Meko and McGoldrick wrote.
The state did mandate universal testing of nursing home residents. And it offered guidance on cohorting — or grouping — residents to more safely manage an outbreak.
But when even highly rated nursing homes were overwhelmed by COVID-19, it is clear that the government response — state and federal — failed.
This must not happen again. And we all need to do our part to keep the novel coronavirus from spreading in our wider community so it doesn’t overwhelm nursing homes again.
The fall and flu season are coming. Again, we ask readers to mask up.