AUSTIN (KXAN) – COVID-19 cases were nearly nonexistent just a month ago in Texas nursing homes. But now, as the virus’ delta variant rages through the state, long-term care facilities are seeing a rise in cases yet again.

The escalating number of active cases has advocates for vulnerable long-term care residents concerned about the vaccination rate of facility staff and resident visitation rights.

Long-term care facilities were ravaged by COVID-19 in 2020. In Texas alone, there have been more than 70,000 total cases and about 9,000 resident deaths. Most of those cases and deaths occurred from June 2020 through January 2021, according to Texas Health and Human Services Commission records. But after the disastrous first two waves of the virus, state and federal officials pushed hard to get nursing home residents vaccinated quickly.

Active resident cases plummeted in January from a high of nearly 7,000 down to just 34 in June 2021, according to the state.

The latest summer 2021 surge has seen cases grow 10 times in less than a month, HHSC records show.

While most residents in nursing homes are vaccinated, many of the elderly people living in those facilities have underlying health conditions, making them more vulnerable.

Amanda Fredriksen, Director of Advocacy with AARP Texas, said, “the real challenge is on the staffing side and making sure that staff are getting vaccinated.”

Only about 56% of nursing home staff members in Texas have gotten their COVID-19 shots, according to federal data from the Centers for Medicare & Medicaid Services.

Only about one in five nursing facilities has more than 75% of their staff vaccinated, said Fredriksen.

“The flip side of that is that means four out of five facilities are at some level below that,” she said. “That’s really concerning. And for that reason, AARP is now essentially saying that nursing facilities should be requiring staff and residents to get the vaccine.”

Advocating for a vaccine mandate in nursing homes is a new position for AARP, said Fredriksen, but it’s “too risky” having unvaccinated staffers in close contact with vulnerable residents.

Fredriksen said the pandemic has spotlighted chronic nursing home staffing problems. However, those payroll issues should have improved since state and federal authorities injected more than $1 billion, including financial incentives for staff retention and hazard pay, to help pay and keep workers.

“It’s really going to be important to see what facilities do with that money, and to ensure that they really invested in getting the right staff in the building and making sure residents are safe and well cared for,” she said.

Even with high vaccination rates, facilities are still seeing COVID-19 cases.

Longhorn Village, a retirement community with a skilled nursing facility, said it has nearly 100% of its residents and more than 70% of its staff inoculated. State data shows that location had nine staff and two resident cases as of July 29, which is the latest available data from HHSC.

“The positive cases have affected our vaccinated residents and staff,” Longhorn Village said in a statement.

HHSC’s data does not show breakthrough COVID infections, which are cases among vaccinated individuals.

Longhorn Village is not alone. Throughout Texas, 84 facilities had at least one case, according to the state’s July 29 data. At that time, Inspiration Hills Rehabilitation Center in San Antonio had 32 active resident cases — the most in the state.

According to Austin Public Health’s long-term care dashboard, more than 130 cases had been reported at nursing homes, assisted living facilities and state supported living centers in the area over the last month. Half of those cases were reported in the last two weeks.

A spokesperson for APH said the number of cases being investigated as breakthrough infections is “small, in comparison to the population that is fully vaccinated.”

Dr. Desmar Walkes, the city’s health authority, told city council and commissioners they were not seeing as many severe cases and hospitalizations because of a high rate of vaccination among these residents.

State-run facilities also getting hit

Texas has 13 State Supported Living Centers for medically-fragile people and those with developmental disabilities and behavioral problems. There are currently seven confirmed cases in residents, six of those in Austin. There have also been 50 confirmed employee infections, according to HHSC data.

Tammie Parker visits her sister Jackie in the Austin State Supported Living Center (Photo provided by: Parker family)
Tammie Parker visits her sister Jackie in the Austin State Supported Living Center (Photo provided by: Parker family)

Tammie Parker’s sister, Jackie, lives in an SSLC due to her intellectual disability. Over time her sister has developed additional underlying health problems and Alzheimer’s disease. In an interview with KXAN, Parker credited the state facility with saving her 68-year-old sister’s life after she contracted COVID-19.

“Had she not been in the center, with that stellar care, I really have my doubts that she would have survived this,” Parker said.

She said the facility leadership told families that 98% of their staff was vaccinated against the virus.

Parker cried at the thought of hugging her sister again one day, without a mask.

“I hope that it happens. I don’t know that it will, but I hope,” Parker said. “I just love that girl.” 

Keeping facilities open

Mary Nichols, with nursing home visitation advocacy group Texas Caregivers for Compromise, said the new surge in delta variant cases should not close nursing homes to visitation.

Nichols’ organization advocates for nursing home visitation rights and has the slogan “isolation kills, too.”

Mary Nichols mother, who lives in a nursing home, pictured prior to the pandemic. (Photo provided by: Nichols family)
Mary Nichols mother, who lives in a nursing home, pictured prior to the pandemic. (Photo provided by: Nichols family)

Not only does visitation give residents the contact and mental stimulation they need, it also brings “outside eyes” to provide an extra layer of vigilance for neglect or abuse that may be happening, she said.

Nichols said her mother is in a nursing home in an advanced state of Alzheimer’s disease. During the COVID lockdown, while Nichols said she was shut out of the facility, her mother’s condition went downhill fast.

“She lost the ability to recognize me,” Nichols said. “She lost the ability to make eye contact, and she fully and completely lost her speech capacity.”

As cases escalate again, Nichols said facilities must follow state guidance and continue allowing essential caregivers, such as herself, access to their loved ones.