AUSTIN (KXAN) — Even with trained infection control experts on-site, COVID-19 continues to spread in Central Texas nursing homes.
As of November 2019, federal guidelines required nursing homes to have a trained Infection Preventionist (IP) on staff, at least part-time. This individual can be a nurse or staff member with other responsibilities, who has also completed a free training course on infection control provided by the Centers For Disease Control and Prevention.
After a KXAN investigation revealed more than 30 Texas nursing homes had failed to follow federal infection control guidelines in the past 3 years, KXAN checked if all area nursing homes had an IP on staff and how much time that individual actually spent in the home.
So far, eight nursing homes reported having a full-time IP on staff — more than what’s required by the Centers for Medicare and Medicaid. Those facilities with a full-time IP still reported at least one case of COVID-19 among their residents or staff. Some of these homes reported having as many as three trained IPs on-site.
Infection control experts said a trained IP can help keep residents from getting sick, but there’s always a chance of infection among this at-risk population.
“Outbreaks can occur in any facility, even good facilities, because someone can bring it in,” said Connie Steed, president of the Association for Professionals in Infection Control and Epidemiology (APIC). “They have no symptoms — they either see someone, take care of someone, or it could be a contract worker and they spread it, and no one knows.”
Trinity Care Center in Round Rock, which has reported a large outbreak of more than 45 positive COVID-19 tests, said their Infection Control & Prevention team includes three trained IPs.
Westminster Senior Living had reported two confirmed cases of COVID-19, but both people have recovered. Westminster’s executive director said they’ve had the same, full-time IP for 8 years. Before receiving IP training and certification, the director said that employee served as Westminster’s infection control nurse.
Wesleyan Homes in Georgetown said they have several trained Infection Preventionists and Infection Control nurses in each of their facilities. A spokesperson said they take the position extremely seriously, saying “it’s a lot of responsibility as far as education and surveillance.”
Park Manor Bee Cave reported one staff member testing positive, who has since recovered. A spokesperson for the facility said they currently have a full-time IP on staff.
Regency Integrated Health Services operates several Central Texas facilities that have had COVID-19 outbreaks, including West Oaks Nursing and Rehabilitation Center, Riverside Nursing and Rehabilitation Center, and Onion Creek Nursing and Rehabilitation Center. A spokesperson for the company said every Regency facility has one full-time trained IP.
KXAN is still waiting to hear back from several nursing homes with positive cases about the status of an Infection Preventionist in their facility.
Steed explained trained IPs help enforce proper hygiene and cleanliness in a facility, but if someone with a virus is asymptomatic, it’s hard to stop the spread of infection.
Steed emphasized the importance of testing for that reason.
“They can spread the infection. So, if we want to do a better job at controlling the infection, we have to know who’s infected, so we can do that,” she said.
KXAN asked the Governor’s office and state health officials for more clarity about when the testing will begin, which homes will receive tests first, what kinds of tests will be used and if re-testing will be part of the plan.
The Governor’s office has not responded to those questions.
“Pushing, calling, emailing, following up on my emails… Simply to get the adequate resources to nursing home residents who are the most vulnerable.”Cissy Sanders, daughter of a nursing home resident
The Texas Health and Human Services Commission said, “Regarding testing, we are working closely with local partners (such as local fire departments, local/regional public health departments, Emergency Medical Task Force and National Guard Mobile Testing teams) to schedule testing at nursing facilities as soon as possible.”
Other details about the widespread testing initiative from the state have yet to be released.
Families ask “Should more have been done?”
For weeks, Dawn Maracle’s step-dad has been fighting for his life, in and out of the ICU.
“We’ve had hopeful moments, and then absolutely dire moments when we thought we’d be hearing that he had passed away,” she said.
He was rushed there from his home at Riverside Nursing and Rehabilitation Center for different health complications, but she said when he arrived, she asked that he be tested for COVID-19.
The tests came back positive.
“It just should have never happened,” she said.
She was shocked to hear her step-dad’s nursing home had a trained IP on-site.
“Nobody ever let on to that,” she said. “They’ve never mentioned or given me any information about the people who worked there or their training.”
She said she’s glad to know there are experts trying to help, but she’s confused why the virus has still spread so rapidly.
“How could these people, if they are trained, not know that there’s a problem?” she asked. “When they did find out there were cases in there, why didn’t they do more? Why didn’t they try to test more? It’s beyond me. I’m shocked.”
Cissy Sanders, the daughter of another Riverside resident, has been fighting for testing for more than a month.
“Pushing, calling, emailing, following up on my emails… Simply to get the adequate resources to nursing home residents who are the most vulnerable,” Sanders said.
Because of the way this virus is spreading, she doesn’t think it’s enough just to test everyone in these homes once.
“My question is: When am I ever going to be able to see my mom again, beyond through a window?” “Is Texas going to take a responsible approach to this and say, ‘We’ve got to get these rapid testing machines on-site in the facilities so family members arrive, they can swab them, test them, and either accept or decline to let them in.”