December 4, 2021

How Florida's long-term care facilities are managing the COVID-19 virus

Amy Keller | 8/26/2020

On the Front Lines

Amy Runkle has been working as a certified nursing assistant in a nursing home for more than 30 years and considers it her calling. Her father was a firefighter, and her mother was also a CNA. They inspired her to help others, she says. “I feel like I serve the public. It makes me feel good to be able to help (the elderly) and sit with them and hear their stories,” she says — but COVID-19 is putting a strain on residents and staff.

Before the virus came along, Runkle says she could take her time with residents as she tended to their daily needs, such as feeding, bathing, grooming and helping them go to the bathroom. “Now, it’s rush, rush, rush, rush,” she says. “We’re working with less staff than we were before (COVID). It’s so much more stressful now than it was. Things are so much more difficult.”

On a recent nightshift, Runkle provided care for 19 residents. When she works in the facility’s COVID isolation unit, there’s an added layer of stress. “You have to mask up, gown up,” she says. Because the gowns hold in heat, her arms are drenched in sweat within minutes. There are no N95 masks available in the facility, but her union provided her with a KN95 mask, a respirator mask approved by the Chinese government. They’re supposed to be about as effective as N95 masks, filtering out 95% of particles, although the U.S. government has warned users that a rash of counterfeit KN95 masks has flooded the market during the pandemic. “As far as PPE goes, there’s just not enough to go around,” Runkle says.

Meanwhile, isolation is taking a toll on residents. Since March, family and friends have not been allowed to visit — and in order to maintain social distancing within the facility, residents are confined to their rooms. “More of them are getting depressed and kind of just giving up,” she says. “A lot of them just want you to sit down and talk to them. We don’t have time to even do that right now. Our stock answer anymore is, ‘OK, honey, I will. I’ll be back. I just have to finish what I’m doing.’ And trust me, you never get a chance to go back.”

Learning Curve

In an April video posted on Facebook, Ashley Roberts, executive director of Grace Manor at Lake Morton in Lakeland, talked about the steps the memory care facility was taking to protect its residents from COVID. She said the company was sanitizing its building several times a day and all staff were wearing protective equipment. “So far, all of our residents and our staff are COVID-free, and we are hoping to remain that way,” Roberts said.

Weeks later, beginning in May, an outbreak ripped through the 50-bed assisted living facility. By June, 33 residents were hospitalized with COVID-19 and seven eventually died. On June 2, the state stepped in and temporarily halted admissions to the facility.

Inspectors noted that while staff at the facility were wearing masks, they weren’t wearing gloves or other personal protection equipment — and they weren’t washing hands or changing masks in between caring for patients. The facility was also failing to keep sick residents away from others. A coughing, COVID-positive resident was observed seated in a dining room with several other residents as she awaited transfer to the hospital. The facility’s executive director told the Agency for Health Care Administration that the facility was struggling to keep residents from wandering around and removing their masks. A staffing shortage — some workers were out sick, and others had quit — added to the confusion.

Grace Manor at Lake Morton appears to have made swift changes after the state action. Three subsequent inspections found no deficiencies and a Facebook video posted by the assisted living facility on July 14 showed new infection control strategies in place, including new outdoor handwashing stations for employees and third-party vendors and supply cabinets stocked with gowns and N95 masks. The facility has also built interior walls to separate hallways from common areas and allow for social distancing of residents. Staff now work 12-hour shifts, as opposed to eight-hour shifts, to limit the frequency of people coming and going and reduce potential exposures to the virus.

As of July 6, all residents and staff at Grace Manor Lake Morton tested negative for COVID-19. Staff will continue to get tested every two weeks under a pair of rules handed down in mid-June by the DeSantis administration.

Dana Mercaldi, director of sales and marketing for Mainstay Senior Living, which operates Grace Manor at Lake Morton, says the company has “worked hard” to protect its residents during the unprecedented health care crisis and continues to adhere to CDC guidelines, “including disinfecting practices, aggressive hygiene, proper distancing and mask wearing,” along with its new protocols. “That’s why the moratorium was lifted so quickly. There is nothing more important to us than protecting our residents and staff,” she said in an e-mail.


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