Published April 30, 2020
By MAUREEN DOHERTY
NORTH READING — Following a precipitous rise in the number of residents and staff at the Royal Meadow View Center testing positive for COVID-19 last week, the town’s Board of Health has issued an emergency order outlining necessary changes in day-to-day operations and reporting protocols.
Last Friday, the Massachusetts Department of Public Health (MDPH) notified the town that there were 135 cases of COVID-19, up from the 66 cases reported the previous Friday. These 135 cases included 80 town residents and 55 patients at or associated with Royal Meadow View nursing and rehabilitation center (meaning they may have been taken to a hospital for treatment but the nursing home is their official residence).
Of those, 52 people have recovered, and the Health Department continues to monitor 78 individuals. To date, four residents of the town with confirmed cases of COVID-19 have died, and resident suspected to have contracted the disease, has also died.
The town’s Board of Health, led by Health Director Bob Bracey, along with Public Safety Director Michael Murphy, and Town Administrator Michael Gilleberto, subsequently took part in numerous meetings with officials at the nursing home and rehabilitation center as well as officials from the Mass. Department of Public Health, including over the weekend. Like all such facilities in the state, it is licensed by the state. Data related to suspected COVID cases was submitted by Royal Meadow View to MDPH, as required. Going forward, per the emergency order issued by the town’s Health Department, data will be more readily shared with town health officials as well.
The emergency order states that the Board of Health, through its Health Director, would be taking “additional measures to protect the public health during the COVID-19 public health emergency and in light of current conditions at the Royal Meadow View Center Nursing Facility” through the authority granted to the local board on March 20 following the declaration of a public health emergency
The findings in the Board of Health order dated April 24 are as follows:
Royal Meadow View Center (“Royal Meadow”) is a 113-bed licensed nursing facility located at 134 North Street offering long and short-term care for elderly residents who are unable to care for themselves (the “Facility”).
On March 12, 2020, representatives of the Facility met with the North Reading Health Department and advised the Health Department that the administration of the Facility had received and was in compliance with Governor Baker’s guidance on Long Term Care and Nursing Facilities with respect to cohorting (separating) positive and non-positive COVID-19 residents and other required measures to prevent the spread of the virus amongst residents and staff at the facility.
On Thursday April 23, 2020 and Friday April 24, 2020, representatives of the Facility had a conference call with the MDPH, North Reading Health Department, and other MDPH and Town of North Reading officials. As of April 24, 2020, there were a number of positive COVID 19 cases reported within the Facility and despite their prior representations, it is readily apparent that the Facility had not cohorted positive and non-positive COVID-19 residents, and that they had failed to take necessary precautions to prevent the spread of the virus at the facility.
As of April 24, 2020, there were 52 residents with confirmed cases of COVID-19 and 17 staff members with confirmed cases of COVID-19 at the Facility. Two residents are reported to have passed away due to COVID-19 related illnesses.
It is believed that 84 residents remain at the facility, at least 52 of whom have tested positive for COVID-19.
Administrators have not provided proper notice of COVID-19 related illnesses and deaths to town officials and they have not delivered documentation requested by the town.
Administrators of the Facility have failed to demonstrate that they have implemented sufficient protocols and procedures to ensure the safety of remaining residents and staff and to prevent further spread of the disease within and beyond the Facility.
The current conditions in the Facility represent a source of sickness within the Town of North Reading and a significant threat to public health, safety and welfare, such that the issuance of this order is necessary to protect the residents, staff and the public at large.
Based on the above stated findings and in accordance with the statutes and regulations cited the town’s Board of Health, acting by and through its duly authorized Health Director, Robert Bracey, has issued the following Order:
• Royal Meadow is hereby prohibited from receiving any new residents/patients from any other Massachusetts licensed long term care, nursing home facility or the general public, until further order of the Board of Health.
• Royal Meadow is hereby ordered to immediately adopt and adhere to the Massachusetts Department of Public Health guidance on Long Term Care and Nursing home facilities as outlined: https://www.mass.gov/info-details/covid-19-guidance-and-directives.
In addition to the requirements of the Department of Public Health, the following safety measures shall be adopted immediately and proof of compliance shall be e-mailed to the Town within 24 hours of service of this Order at bbracey@northreadingma.gov:
• Cohort positive and non-positive COVID-19 residents to separate areas of the Facility and provide the Town with a floor plan showing the COVID-19 and non-COVID-19 areas.
• Implement appropriate staffing needs per the Massachusetts Department of Public Health
• Properly screen all employees daily, prior, during and leaving the Facility. Each employee shall be screened in the lobby of the Facility prior to allowing them to enter by taking their temperature and verifying that they do not have symptoms of COVID-19 and have not had close contact with anyone with COVID-19 symptoms while off-duty. If any employee does not satisfy the screening requirements, they shall not be permitted to enter the Facility.
• If the Facility cannot provide adequate employee screening or if it fails to comply with this requirement, the Facility shall retain the services of a third-party independent screening contractor.
• Maintain daily log of names and recorded temperatures of staff and e-mail said log to the Health Director every day by 5 p.m. at bbracey@northreadingma.gov.
• Provide adequate and appropriate personal protective equipment (PPE’s) for all staff during all shifts, which shall consist of, at a minimum: N95 Masks properly fit-tested to each employee, eye protection, gown, and gloves.
•Organization list with ICS chart showing primary roles and relationships, and primary 24/7 contact person(s) information.
Royal Meadow is hereby further ordered to submit to the North Reading Health Department and the Massachusetts Department of Public Health (MDPH) no later than Wednesday, April 29, 2020 an “Operational Plan” that includes, but is not limited to the following:
• Written policies and procedures demonstrating the proper separation of COVID-19 positive patients from non-COVIID-19 Patients, including a floor plan of the Facility which designates which patients will be housed in which locations.
• Provide a list of employees who have been properly assigned and outfitted with N95 masks.
• Incident goals (where the response system wants to be at the end of response)
• Operational period objectives (major areas that must be addressed in the specified operational period to achieve the goals or control objectives)
• Response strategies (priorities and the general approach to accomplish the objectives)
• Response tactics (methods developed by Operations to achieve the objectives)
• Staffing assignment list with specific tasks.
• Critical situation updates and assessments forwarded to local BOH and MDPH upon discovery or at least every 48 hours.
• Composite resource status updates.
• Health and safety plan (to prevent responder injury or illness)
• Communications plan (how functional areas can exchange information)
• Such other information as the Health Director deems necessary
This emergency order shall be effective immediately and shall remain in effect until the Public Health Emergency declaration has been lifted, or until issuance of such further order by the North Reading Board of Health.
To the extent necessary, this Order shall be enforced by Board of Health officials and the Massachusetts Department of Public Health (MDPH) and other Town of North Reading Public Safety Divisions. This Order may be enforced through any lawful means, including but not limited to the assessment of fines through lawful process of up to $1,000 per day each day a violation exists.
The North Reading Board of Health order authorizes the Public Health Director (Robert Bracey) or Public Health Nurse (Pamela Vath) to further request such other information and to issue such further orders as necessary to prevent the mitigating and spread of the COVID-19 virus and safeguard the residents and employees of the Royal Meadow Nursing facility and to promote public health, safety and welfare in the Town of North Reading.
Meeting held April 29
After press time, the Board of Health met remotely on Wednesday night and among the agenda items was discussing with Royal Meadow View its progress and response to the April 24 emergency order.