Published May 14, 2020
By MAUREEN DOHERTY
NORTH READING — Positive progress is being made at the Royal Meadow View nursing home two weeks after the Board of Health issued an emergency order outlining changes it wanted to see enacted concerning daily operations due to rise in the number of residents and staff who had tested positive for COVID-19.
While updating the Board of Health on the overall COVID-19 caseload in town at last Thursday’s remote meeting, board member Pam Vath spoke about the progress Royal Meadow View has made in managing this situation since there since the board issued its order April 24. COVID-19 has been disproportionately affecting the elderly population particularly hard worldwide.
Vath, who also serves as the town’s public health nurse, has been monitoring the effect of the virus throughout the town and the Board of Health has been meeting weekly throughout the pandemic to address all facets of its effect on daily life locally.
“Right now in our town we have 102 total COVID-positive that have been reported to us that are actually residents in town, and it includes the group home patients and some of the residential patients in congregate living,” Vath said on May 7.
She added that they have “released 68 of those (patients) because they have met the requirements to not have to stay in isolation or quarantine anymore. And we are continuing to monitor 32 people actively.”
“In the nursing home, they currently have a census of 73 and two patients out on a medical leave. The total number of patients testing positive as of this morning was 61 and there were 22 staff that were tested positive. And in last 24 hours they have had no deaths, however, they have had 11 deaths since March, when we started capturing data from the nursing home.”
Town-wide, “the number of patients being reported to me as positive each day varies and actually, I think we had a high of six today but we had primarily one family that had several positives…that was a little bit different, but it varies between one to a high of six in one day,” Vath said. Some days no new patients have been reported as testing positive in town.
“We have a wide distribution of ages. Our lowest was 5 years old and our highest at this point was 89. And we’ve had one death and one suspect death here in the town,” Vath said.
The numbers cited by Vath for the town were up to date through May 7. Five days later, the state DPH reported that the town’s caseload had increased to 170. Of those, there have been 70 recoveries, 13 confirmed deaths and 1 suspected death, with 86 people continuing to be monitored by the Board of Health. A dozen of the confirmed deaths have been “at or associated with Royal Meadow View,” according to state statistics released May 12.
Statistics provided by the Mass. Department of Public Health (MDPH) on Monday indicate that 60% of the state’s more than 5,000 deaths attributed to COVID-19 have occurred in long-term nursing facilities. More than 78,000 people in Massachusetts have been diagnosed with contracting the virus.
Board Chairman Gary Hunt asked Vath how her communications have been with the nursing home. “I know you’re on those daily calls with the DPH and them. Is it proceeding well?”
“It has gone really well. I think the difference has been dramatic. They have gotten very clear with their cohorting. It’s automatic now. If they get somebody who is reported positive, that patient is immediately moved into another room,” Vath said.
Cohorting means separating patients or residents when they are ill, either in different rooms, different sections of a floor or when possible, different floors.
The staff assignments have also been cohorted each shift. “If they are taking care of COVID-positive patients today, that is who they take care of (for their shift). They do not go from COVID-positive to congregate patients,” Vath continued. “They’ve really got quite a good system going. They’ve got a good supply of PPE and they have a lot of support for getting extras, which has included the state supply as well as their vendors and their sister nursing homes.”
Vath also noted that North Reading Fire Chief Don Stats “has made arrangements and sent several deliveries of gowns and masks and things that they need, so it has been a very cooperative venture.”
Another good sign of the progress being made between the Board of Health and the nursing home, according to Vath, has been the reduced length of time they spend in conference calls. Initially, she said each of their daily updates were close to an hour long and now they are “closer to 15 minutes.”
Royal Meadow View also fulfilled the Board of Health’s request cited in the April 24 emergency order to submit in writing its Operational Plan detailing its response strategy by April 29. This included floor plans demonstrating that positive and negative patients had been separated; daily screening logs (with names and recorded temperature) of all employees during all shifts; and providing employees with proper PPE, including fit-tested N95 masks, eye protection, gowns and gloves.
Health Director Bob Bracey followed up Vath’s report by commenting on a letter received from Steve Reardon of MDPH, which he said was “based on last week’s meeting of the complaint that we had forwarded to DPH” regarding “the original concerns that we had and some of the complaints we had received.” Bracey had forwarded Reardon’s letter to board members and other town officials prior to the May 7 meeting, which was being held remotely.
Bracey said, “Clearly, they’re looking for information from the nursing home as well, and he goes on to state ‘clearly there are some issues there and some challenges, and the state is going to continue to work with them through the DPH outreach surveyor.”
Has the state DPH “actually gone in there and done a quasi audit for compliance with the procedures?” Hunt asked.
Bracey said as he understood it, he did not believe his state contact had done so personally. “He may be getting some of this information from the COVID-19 response team that they have in there.”
Vath said that she had not heard “that they’ve had their section group in there to do an audit. I know that the first two weeks of May they’ve promised that every facility will be visited by their special infection control people. That is a 24-point checklist that (the state) will evaluate every facility on.”
She added, “They have sent in a rapid response team for staffing; that’s a 12-person team that goes to the facility when they are in a difficult position of needing staff, and I believe it was five or six days last week, ending this past Monday morning (May 4). But I don’t believe their job is to audit or evaluate” a facility. Rather, their job is to “take care of patients.” She noted that if they “had found some gross errors that prevented them from doing their job, I am sure they would have reported that. And on the daily call there is an infection control person and a quality control person.”
Hunt said, “It is obvious to me that with all the persistent communication and meetings and daily (updates) that we’re making progress with the nursing home and we’re getting more cooperation that we did initially. Is that true?”
Vath commented that “whoever Mr. Reardon represents is more attentive at this point and yes, the daily phone calls and the guidance that’s provided on those phone calls, even if it is just to ask the question, has really been an educational opportunity for everybody at the nursing home.”