Long-Term Care Facilities Work To Keep Virus At Bay-Brevard NC


Last updated 7/6/2020 at 5:11pm

Long-term care facilities in Transylvania County persist in keeping an outbreak of COVID-19 at bay with facility-wide testing protocols amid a national climate in which nursing homes are being impacted the most by the pandemic.

Transylvania County has six facilities, including two nursing facilities, Accordius Health at Brevard on North Country Club Road and The Oaks on Morris Road; and four assisted living facilities: Cedar Mountain House on Sherwood Ridge Road, College Walk on North College Row and Tore’s Homes on Tore’s Drive.

“Since March, leader-ship from all six facilities have been meeting with Transylvania Public Health’s Licensed Care Facility (LCF) COVID Response Team to develop and implement best practices to prevent outbreaks of the virus in these facilities,” said Tara Rybka, with Transylvania Public Health, in a press release. “N.C. Department of Health and Human Services (DHHS) recently announced its plan to offer diagnostic testing for COVID-19 to residents and staff in all skilled nursing facilities throughout the state starting in July. Facility-wide testing before any outbreak occurs is an important way to find asymptomatic carriers or early infections, and early detection will help to limit the impact if infections do occur.”

According to Rybka, testing had already been initiated in Transylvania County, with several on-site testing options available.

“Facility-wide baseline testing for all staff and residents began in mid-June and is expected to be completed by July 7,” she said. “In addition, these facilities are already working on plans for periodic testing in the future, with a focus on staff and the highest risk residents.

Community volunteer and physician Rik Emaus leads the LCF Response team, she said, and serves as a liaison between Transylvania Public Health and Pisgah Health Foundation’s Physicians Roundtable.

“Transylvania Public Health nurses Kim Rogers and Velina Netherton were assigned to the team, which also consults with Transylvania County Health Director Elaine Russell and Transylvania Public Health’s Medical Director Tim Shea,” Rybka said.

Russell said the effort was inspired by a desire to learn from and avoid the impact of outbreaks in eldercare facilities seen in other counties.

According to reports, long-term care facilities in Henderson County have been hit especially hard since the pandemic began to spread in the neighboring county.

While cases have since slowed in these facilities, they are still tied to 47 of the 49 deaths reported in the county.

Henderson County currently has four active COVID-19 outbreaks in congregate living facilities.

In a congregate living setting, a COVID-19 outbreak is defined as two or more laboratory-confirmed cases, according to DHHS.

Congregate living facilities include nursing homes, residential care facilities and correctional facilities.

The Laurels of Hendersonville has the most coronavirus cases and deaths of facilities in Henderson County with current outbreaks.

As of the DHHS’ report released Thursday, the nursing home has 97 cases and 27 deaths.

All deaths are in residents, along with 81 of the total cases.

The Brian Center Health and Rehabilitation in Hendersonville has 50 COVID-19 cases and eight related deaths. All deaths are linked to residents.

The overall cases count includes staff and residents.

At Hendersonville Health and Rehabilitation, the case count is low and does not include residents.

The nursing home is reporting to two cases, both of which are staff.

Carolina Reserve of Laurel Park, a residential care facility in the Western part of the county, currently has 12 cases and no deaths.

Ten cases are reported in residents, and the other two in staff members.

Other congregate living facilities in Henderson County were previously included in state reports.

They were slowly eliminated over the last few months due to the outbreaks ending under the state’s definition.

This is measured as 28 days after the latest date of onset in a symptomatic person or the latest date of specimen collection in an asymptomatic person, whichever is later, according to DHHS.

Cherry Springs Village, a residential care facility in Hendersonville, hasn’t been included in DHHS’ report in over a month.

But at its peak, Cherry Springs was linked to 58 cases of COVID-19 and 10 deaths.

Facilities in Transyl-vania County are not just testing but also screening for symptoms frequently, as well as emphasizing personal protective equipment (PPE) and implementing plans for isolating any possible sick residents.

“I’ve been impressed with both their initial level of preparedness and also their willingness to collaborate with each other and with the health department to face common challenges together,” Emaus said.

Rybka said that in May the LFC Response Team released a Standard Operations Guidelines document that serves as a living reference for critical information to help county facilities prevent, mitigate, and respond to cases of COVID-19.

The document includes checklists for immediate actions, information on accessing emergency PPE supplies, resources for testing staff members, procedures to follow when interacting with emergency services and fatality management, emergency contact information for Transylvania Public Health and links to reference resources.

“Clear identification of the necessary people, equipment and processes will enable an effective collaborative response under stress,” Emaus said.

The LCF Response Team has assisted facilities with obtaining access to supplies of PPE, recently distributed across the state by N.C. Emergency Management, local facilities needed to care for its residents.

“But Transylvania County facilities already had access to a supplemental PPE reserve established in April and May thanks to grants from Pisgah Health Foundation, Brevard Rotary and Pisgah Forest Rotary,” Rybka said. “Facilities have also supported each other by sharing PPE as needed until supplies could be restocked.”

The LCF Response Team and facility leaders meet remotely using Zoom to “update the guidance document, identify needs and concerns and make plans to address new challenges.”

“The dedication and investment of these organizations to protecting the most vulnerable citizens of our community is noted and respected,” Russell said.

Emaus said the team is committed to the health of the seniors.

“Our entire community requires that we act diligently and with a compassionate spirit, and that we not let our guard down,” Emaus said.

The Oaks – Brevard

According to a press release to family of residents at The Oaks-Brevard, the facility has established an isolated COVID-19 unit to assist local medical providers during this pandemic.

It installed isolation walls and an air filtration system, ensured a full inventory of personal protective equipment (PPE), and designated staff to care solely for COVID-19 patients, the press release said.

All test results on current patients and staff are negative.

It admitted its first COVID-19-positive patient on Thursday, July 2, which means The Oaks – Brevard is now operating at Alert Code Pink status.

“At this level, The Oaks – Brevard will continue to implement enhanced infection control protocols, including increasing clean-ing frequency; postponing communal activities; ceasing visitation; and screening staff and patients daily,” according to the press release.

Justin Morrison, facility administrator at The Oaks – Brevard, said the facility has completed 100 percent of its testing, with all residents testing negative, and, currently, all staff testing negative as well, though testing has not been completed for staff.

“We are in the works with Transylvania Public Health to receive a rapid response-testing machine that would give us the ability to have test results in 15 minutes,” Morrison said. “We expect to have that machine by mid-July. We currently have the capability to do baseline nasal swabs right now with a turn around of about 48 hours.”

The facility’s isolated wing has 20 beds, with an air filtration system and separate staff to treat COVID-19 patients from the community.

Currently, it is housing two COVID-19 patients from the community.

“We have staff members who are only at assigned to that unit, and they can enter and exit through a separate door, so they have no contract with any other staff members or other residents throughout the rest of the building,” Morrison said. “It’s truly an isolated, sealed off part of the building. So, we really do have a legitimate wing set up in which we have the ability that if the community needs were to arise, we could house people in the community that have active COVID-19 cases.”

What the isolated wing provides is a more skilled level of care between the Intensive Care Unit (ICU) at Transylvania Regional Hospital and the self-care and occasional check ups one would have while at home.

“We are the next level of care, a step down from ICU, checking vitals every six hours, providing fluids,” he said. “It’s freeing up the beds from the hospitals for them to focus on the sicker patients.

“These two patients are at a level of care with which we can take care of them. They need more than they would at home, but they are not at the high level that they would need to be put on a ventilator.”

He said The Oaks is the only health care facility in the county that has this amenity.

Rybka said the county is “better off” for having the COVID-19 patients in one place, as opposed to scattered in separate facilities.

“The Oaks have created a separate place with separate staff, so that there is not overlap and opportunity for spread from COVID-19 patients to people who don’t have it,” she said. “It is a good thing that a facility in Transylvania County has been willing to step up and say, ‘We’ve got a spot, so you don’t have two at Accordius, two at The Oaks and two somewhere else.”

For more information, visit http://www.transylvania health.org/covid-19 or call (828) 884-4007 to speak to a local public health nurse about COVID-19.


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