After widespread deaths of residents, nursing homes begin to see glimmers of improvement

Signs that say 'heroes work here' in a yard in front of a building.
The Lyngblomsten Care Center in St. Paul has followed guidelines in fighting COVID-19, but saw more than 80 cases among residents and more than 50 cases with staff. The nursing home has seen cases decline since facilitywide testing began in mid-May, giving them a better picture of asymptomatic spread.
Peter Cox | MPR News

Three months into the COVID-19 pandemic in Minnesota, nursing homes believe they may have a better idea on how to fight the coronavirus spread.

Statewide, the number of cases reported by staff and residents has fallen since facilitywide testing began — from over 1,000 cases over one week in mid-May to around 370 by the end of the month.

While the spread in long-term care facilities, which includes nursing homes, has slowed, many facilities in the state are still dealing with cases. They’re also trying to keep staffing levels high, knowing that more cases could come in the fall.

Lyngblomsten Care Center in St. Paul had its first confirmed case of COVID-19 on April 28.

“We were doing everything we felt we needed and following all of the guidelines and very diligently paying attention to all those resources that we had available to us,” said Greg Wainman, director of nursing at the facility. “So when we did have our first positive case, it was upsetting.”

Wainman said his colleagues in the nursing home community warned him that it was not a matter of if, but when. And then “it'll just run through your building,” he said.

Since that first case, more than 80 residents and 50 staff have tested positive. And 20 people who lived at Lyngblomsten have died from symptoms of COVID-19.

Weekly housewide testing began a month ago at Lyngblomsten. Now, the infection numbers are trending down. As of Wednesday, the facility had five active cases among residents.

Wainman said some of the staff who tested positive did not have symptoms.

“When some of these when some of these staff found this out, it was mortifying to them that they were putting the people they care for and love at risk,” Wainman said.

A state inspection of COVID-19 protocols at Lyngblomsten in April revealed no violations. The residence reduced visitation, housed positive residents together, and limited access to those patients.

When infections occur there’s a perception that nursing homes have done something wrong, said Jon Riewer, president and CEO of Eventide, which operates centers in Moorhead, Minn., and Fargo, N.D.

“We did not bring this to our communities. We are not the reason COVID-19 is here. And so it's frustrating when you advocate on behalf of your staff who are doing the hard work,” he said.

Earlier widespread testing in North Dakota helped determine who was infectious — including those who were asymptomatic — at Eventide’s Fargo facility. Riewer said as a result, they were able to limit the spread in homes earlier than in their Moorhead facility, where universal testing arrived about a month later.

Residents of Minnesota’s long-term care facilities make up 79 percent of the COVID-19 deaths. The state’s Health Department on Wednesday reported a total of 1,041 residents had died. As of early June, more than half of the state’s deaths from COVID-19 were from nursing homes.

Katja Olson, vice president for clinical services at Eventide said it’s tough to keep staff morale up.

“The fact that we're struggling to find [personal protective equipment], that we're having to reuse PPE. It's really hard to wrap your head around that. That's where we're at,” Olson said.

Staffing levels were already low before the pandemic hit. With more out for illness and quarantine, nurses and aides are being asked to work more hours.

“During this time, of course, we can always use extra staff,” said Marc Halpert, COO of Monarch Healthcare, which runs around 40 senior living facilities.

Monarch Healthcare rolled out financial incentives to keep staff while trying to find more to fill-in. For four weeks between April and May, staff with perfect attendance got $500 bonuses. They also receive bonuses for extra shifts and hourly pay increases for work with COVID-19-positive residents.

Halpert said sweetened hiring bonuses for nurses and certified nursing assistants probably helped the company set a hiring record last month.

At Lyngblomsten, Wainman said they celebrate every time residents of the complex beat COVID-19.

“We give them a little medal. It's just a laminated sign that says, you know, I beat COVID, and we take pictures,” Wainman said. “And it's something nice for everybody to kind of have a moment of success.”

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