W-S nursing home with two confirmed COVID-19 cases has history of deficient care

One staff member and one resident at the Oak Forest Rehabilitation Center in Winston-Salem have tested positive for COVID-19, according to Forsyth County officials.

The nursing home, located off Windy Hill Drive in the northern part of the city, provides rehabilitation and long-term care for residents and has a 170-bed capacity, and currently houses 147 residents, according to a facility administrator.

The state Department of Health and Human Services defines the event as an outbreak because the location is classified as a congregate living setting with two or more confirmed cases.

“While we are saddened by the two cases at the center, we are confident that our public health department will follow guidelines to help the facility protect other patients and staff,” said County Commissioner Gloria Whisenhunt, who serves on the Health and Human Services Board, in the press release.

Both individuals are in isolation, according to the release, and the county’s public health department is working closely with employees at the facility, DHHS and Baptist Hospital to screen and test staff and residents. The release also stated that public health officials are identifying close contacts to those infected to monitor symptoms and contain any potential spread.

Alicia Brown, the administrator for Oak Forest, told Triad City Beat that the unnamed employee who tested positive for COVID-19 is not getting automatic paid time off. Rather, she said, that employees can use paid time off if they’ve accrued hours prior to the outbreak. In recent weeks, pastors and activists called for all nursing home employees to receive paid time off during the pandemic.

Long-term health facilities like Oak Forest are particularly susceptible to the spread of COVID-19 because most residents are 65 years or older — a vulnerable age bracket for the disease — or have pre-existing medical conditions, or both. Across the country, nursing homes have reported huge outbreaks of COVID-19.

According to a recent report by the New York Times, at least 7,000 people living in or connected to nursing homes have died from the coronavirus. One of the first major outbreaks of COVID-19 in the United States happened in a facility in suburban Seattle in late February, where two-thirds of the residents and 47 workers at Life Care Center became ill. Thirty-five people ended up dying.

In North Carolina, there have been more than 2,400 confirmed cases of COVID-19 in nursing homes and residential care facilities and more than 250 deaths, as of Tuesday, according to the DHHS.

According to a recent report by WRAL, long-term care facilities with a history of deficiencies could lead to the spread of infection. Looking at Medicare reports compiled by ProPublica, TCB found that on several occasions in the last three years, staff at Oak Forest failed to provide adequate care to residents. In one severe instance, the facility was fined $13,905 for putting a resident in “immediate jeopardy” by failing to properly transfer the resident from the nursing home.

Since March 2017, Oak Forest has racked up 32 deficiencies based on reports conducted by the DHHS. An inspection from December 2019 revealed three deficiencies at the center, two of which stemmed from the fact that staff didn’t “provide safe and appropriate respiratory care for a resident in need,” and “the facility failed to maintain infection control procedures” for a resident.

While all of the listed deficiencies were recorded prior to the outbreak of COVID-19, on at least two occasions, the facility received an “E” score on the severity range, according to ProPublica’s scoring, which indicates an emerging pattern within the facility. According to Oak Forest’s federal Medicare profile which lists information like recent health inspections, staffing details and penalties — in addition to general data like address and ownership — the facility has a below average rating based on recent health inspections, staffing and quality measures. In its most recent health inspection on May 10, 2019, the facility received seven citations, compared to the average of five in the state.

Forsyth County Assistant Public Health Director Tony Lo Giudice reiterated the fact that a team of nurses is providing outreach and education to all long-term facilities in the county during an interview on Wednesday.

The CDC and DHHS recommend that long-term care facilities take a number of steps to handle the threat of the virus, including appointing a committee or team dedicated to address COVID-19, providing alcohol-based hand sanitizer to every resident room, posting signs with precautions, and properly identifying and managing residents with symptoms of respiratory infections are included on the lists. Limiting visitors and taking temperatures of employees is also included.

Lax regulations have plagued the nursing home industry for years, according to Carole Herman, founder of California-based Foundation Aiding the Elderly.

“They all have patterns of deficiencies,” Herman said. “I think the problem is that there is lack of enforcement all over the country.”

One of the main concerns for Herman is the history of lax infection controls in nursing homes.

“In my experience, I have filed a lot of complaints across the country for lack of infection controls,” she said. “Everything from filthy bathrooms, dirty furniture, dirty urinals, it all goes on deaf ears to regulators. So, I’m shocked that this is going on in nursing homes, but I’m not surprised.”

According to a public statement provided to TCB by Brown, Oak Forest voluntarily tested all residents and employees, resulting in the discovery of the two positive cases. For the past two months, the facility has also restricted visitors, cancelled group activities and social dining, screened staff, residents and others who enter the building, and taken resident vital signs and respiratory assessments.

Brown did not directly respond to questions about the facility’s past deficiencies.

Herman said she is jaded after years of advocating for better care in nursing homes, adding that exposing the lack of regulation in facilities like Oak Forest may be one of the silver linings of COVID-19.

“Maybe this is the wake-up call,” she said. “If one good thing comes out of this virus, it’s exposing the nursing home industry and how terrible they are and how regulators and operators have failed us.”