Nursing homes in state may reopen soon

Nolan Clay The Oklahoman
Bartlesville Health and Rehabilitation Community has reported 20 COVID-19-related deaths even though the entire facility was environmentally cleaned April 11 after the first positive case and even though state inspections in March and April found no violations. PJC file

Heath officials are developing a plan to reopen state nursing homes and long-term care facilities in weeks even as the number of locations with known COVID-19 infections has climbed above 100.

More than 900 residents and more than 500 staff at those locations have been infected, the Health Department reported last week. More than 180 residents and at least three staff workers have died.

Eight facilities have had 10 or more COVID-19 deaths, according to data released Friday.

Hardest hit has been the Bartlesville Health and Rehabilitation Community. The outbreak there killed 20 even though the entire facility was environmentally cleaned April 11 after the first positive case and even though state inspections in March and April found no violations.

“The source of the virus in our community likely will never be known,” administrator Sandra Brown wrote in a May 18 letter.

The next most deaths — 16 — were associated with Grove Nursing Center.

Health officials have asked leaders of senior care organizations for quick input on a June 5 draft plan.

“You have all heard the comments for us to move on this so that some forms of visitation can be offered,” an assistant deputy health commissioner, James W. Joslin, told them in an email last week. “As such, we have a short turn around and would appreciate comments by Monday.”

Visitations at nursing homes and long-term care facilities have been restricted since mid-March to try to prevent COVID-19 outbreaks. The elderly are particularly vulnerable to the respiratory disease. Almost 100 of those who have died in Oklahoma from COVID-19 were 85 and older, according to health records.

The number of senior care locations with known infections has more than tripled in the past two months, records show. The dramatic jump comes in part because of the Health Department’s effort to test every resident and staff at Oklahoma nursing homes and long-term care facilities. More than 35,000 were tested in May.

Health officials had talked in May of reopening as early as this Friday, The Oklahoman was told. Then, on May 30, Gov. Kevin Stitt extended his ban on visits to nursing homes and similar facilities for 30 more days except in end-of-life situations. The governor, though, could shorten that ban like he did in April on the prohibition on elective surgeries.

The draft plan allows a facility to reopen if it has not had any new COVID-19 cases for 28 days, if it has hired an infection prevention specialist and if it has adequate staffing, personal protective equipment and cleaning supplies.

Also at play are the pandemic conditions in a facility’s county. A facility can cease visitation if conditions worsen.

Most visitations would be outside on facility grounds or in an outbuilding. Some indoor visitation would be allowed if a facility has a designated area big enough for social distancing. For residents unable to leave their rooms, visitation would be by appointment only and during designated hours.

Visitors would be screened for signs of COVID-19 beforehand. Both visitors and residents would have to wear cloth face coverings or masks. Exceptions to social distancing standards may be made at the facility’s discretion in end-of-life and compassionate care situations.

Nursing homes already are required to have an expert on infection prevention and control. Assisted living centers, residential care and other similar facilities have not had that requirement in the past.

The draft plan also allows residents to eat in the same room again as long as tables are spaced at least six feet apart and the number at each table is limited.

The draft plan also addresses how to resume salon services at the facilities, how to handle unsupervised outings by individual residents and how to conduct group activities.

The Health Department said Sunday it “is working collaboratively with the provider community as well as its customers in developing a plan and providing supportive resources to safely reinstate visitations for nursing homes and long-term care facilities.”

“We cannot speak towards any elements of a plan as discussions are still underway with the various Oklahoma populations it would impact.”

The draft plan calls the reopening as moving into “a new normal.”

Among those asked for input was the trade association Care Providers Oklahoma. Its president, Steve Buck, said Sunday, “Certainly we knew that this was going to be an important bridge for us to cross at some point. Visitation … is important. It’s good for the residents, their mental health. It’s good for their continued recovery and it’s certainly good for the families.

“To safely reopen, it’s going to require extraordinary amounts of collaboration so that we can be on the same page in terms of a reemergence of virus or any other threat that might surface.”