Area care centers fighting stiffer battle with COVID

Several administrators say federal agencies were more help than state

BY CHUCK VANDENBERG
PCC EDITOR

LEE COUNTY - The long-term care facilities in north Lee County are still facing a myriad of hurdles in dealing with COVID-19 and the novel coronavirus that causes it.

Area care centers have the added pressures of confined space living and compounding medical issues in dealing with the virus, and most have seen substantial outbreaks locally.

Outbreaks at care centers around the state have been a focus of Governor Kim Reynold's regular press conferences, but several locally have indicated it's been the federal government, and not the state, that has offered the most help.

Mallory Hymes, the administrator at Montrose Health Center said the coronavirus has been more of a concern than she anticipated when she was hired in March, right when the virus started to take hold in the U.S.

"Initially, I wasn't concerned. I just thought it was something that wasn't really effecting us, but then nine months later - here we are," Hymes said.
"It's certainly been prevalent and we definitely had an outbreak here. But as we went through that process, I do feel like there was a lack of assistance."

Hymes said officials with the state did little in the way of supporting efforts to get a handle on the outbreak

"The state inspectors are there to do a job, but they weren't here to help. They just pointed fingers. It was very difficult for everyone," she said.

Chris McKay, the administrator at The Madison said it really wasn't an issue of anyone doing anything wrong, but more of just "bad luck".

"I don't think there's nursing home out there that is not doing their damnedest to keep it out of their building," McKay said. "If it's in there, the odds are they didn't do anything wrong, it just got there."

But McKay agreed that the state did very little outside of testing. He said the U.S. Department of Health and Human services was a strong ally in the fight inside care centers across the country.

"Aside for the State Hygienic Lab, the state really hasn't done very much. but HHS on the federal side has been awesome with rapid testing supplies, and earlier in the pandemic FEMA was providing N95 masks and isolation equipment."

McKay said currently The Madison doesn't have any residents positive for COVID. They had two residents in June, but none since that time. He said they have had 12 staff test positive with the first being in June.

"It's still a huge concern for congregate living centers. If this gets in a nursing home it can spread like wildfire. But honestly, from what I've seen and heard, its probably just as much bad luck as anything," he said.

He said the center tests residents weekly and screens all staff at the door. Everyone on duty is wearing personal protective equipment, including masks.

McKay said there is still no visitation being allowed except for compassionate care visits. The Madison is considering some outdoor visitation, but he said the county infection rate is still too high to make any changes at this point.

Ashley Gloystein-Klatt, National Marketing Director for Agemark, the parent company of The Kensington in Fort Madison, said COVID has impacted their operations as well, but didn't release any data on infections inside the facility.

"We have had positive cases of COVID-19 in our community (staff and residents) but are pleased to be COVID-19 free currently. We are, however, extremely cautious as we know this status could change at any moment," Gloystein-Klatt wrote in an email to Pen City Current.

The Kensington provides not only assisted living but Memory Care, which presents additional challenges mitigating COVID-19.

"Managing any illness in a memory care community especially is a challenge. Due to the unique diagnosis of those with dementia, concepts such as isolation, social distancing and wearing a mask are more challenging because they are extremely difficult for those with cognitive issues to understand."

For a period of time The Kensington even stopped taking new admissions to help reduce the chance of infection at the facility.

Gloystein-Klatt said Agemark has been purchasing COVID tests since May and has also purchased supplies of rapid response testing to help identify asymptomatic individuals, at their cost. But they are happy with the support they've received from local, state and federal resources.

"Our company has been happy to receive support from local public health departments and from ICAL (Iowa Center for Assisted Living). While developing our own policies, we are following the recommendations of CMS (Centers for Medicaid and Medicare Services) as well as the state."

Hymes said Iowa leaders should have done more to help keep the virus at bay because some of the residents and patients at Iowa's care centers haven't seen loved ones in nine months.

"The state can't get numbers down so we have to go these measures. We have to limit visitation because of county levels and we can't do anything until we've been under 10% as a county for two weeks. These people miss their families," Hymes said.

She said the regular public needs to be more vigilant masking up and doing the right things based on recommendations from local, state, and federal health agencies.

"I just wish people would be more respectful day-to-day, These families here haven't seen each other for nine months. We are their family right now. It makes it difficult and its hard emotionally," Hymes said.
"We went eight months with no positive cases and we thought we were doing fantastic. Then it was unfortunate that our state didn't enforce things a bit stronger.
"Because people outside of this building choose to do what they do that makes our rules tougher. My staff did a wonderful job, but we don't get to do anything. We go to work and we go home and that led us to be COVID-free. But then we got it all at once."

McKay said there are some things taking place during the pandemic in care centers that will probably stick around after the virus is in the mirror.

"I don't think we'll restrict visits or continue with facemasks and that kind of thing, but is has spurred a lot of infection control policies," he said. "Enhanced cleaning, infection control and a more vigorous monitoring of employees may stick around."

He said there me also be an accelerated push for more private rooms in care centers.

Hymes said she sees ventilation improvements as something that will come out of the pandemic in long-term care centers.

"To me, this is an airborne virus and these types of facilities our size have certain air systems," she said.
"Everybody's destined to get it when you think about how those systems take air in and then push it down the system. It's truly circulatory in nature and I believe that's what's happening when you see the outbreaks."

Gloystein-Klatt said Agemark is hoping for access to vaccines soon, but admitted it may be a while before things are back to normal in the company's facilities across the country. She said they are looking for the positives that have come from learning to deal with the virus.

"One positive that we've seen come out of COVID-19 is being reminded the integrity, commitment and compassion of our employees, who continue to provide exceptional care for residents of The Kensington during an extremely tough challenge."

West Point Care Center officials were not available for comment when the center was contacted.

As of Monday at 3:30 p.m., Lee County had a 14-day positivity rate of 21.8% with 2,366 total cases with 58% listed as recovered. Twenty-one county residents have died from the disease. Fifty-five new cases were reported since Friday at 3:30 p.m.