As coronavirus crisis hit, most nursing homes avoided major staff outbreaks

Jun. 22--Ten nursing homes in Western New York reported that two dozen or more of their employees contracted Covid-19, including 81 at Beechwood Homes in Getzville, the facility with the most confirmed staff cases.

But nearly two-thirds of the 62 facilities that responded to a federal survey had only a handful of confirmed cases among their staffs, if any at all, according to a Buffalo News analysis of federal data released Friday.

In all, 602 employees from 43 nursing homes tested positive for Covid-19. That number could rise as more facilities report their data.

Forty of the 62 nursing homes reporting data indicated they had five or fewer staff who tested positive.

The data from the Centers for Medicare and Medicaid Services offer an initial -- yet incomplete -- statistical look at the extent to which the new coronavirus swept through some staffs while leaving others without any confirmed cases at all. Nineteen nursing homes in the region reported no confirmed cases among their staffs.

Beechwood's 272 beds make it the fourth-biggest facility among the nursing homes included in The News' analysis. The facility reported 191 occupied beds.

Not all 81 Beechwood staffers tested positive for the Covid-19 virus at the same time, said Daniel O'Neill, CEO of Beechwood Homes. So Beechwood did not report a shortage of nurses or aides.

"Of the total 81 positive staff since mid-March, 58 have returned to work after completing their 14-day quarantine and testing negative for the virus," O'Neill said. "The remaining 23 are completing their 14-day quarantine. That is less than 5% of our workforce."

Since Beechwood started weekly testing of staff May 20, 97.8% have been negative. There have been 40 positive test results out of 1,802 tests conducted.

Two other large nursing homes, Erie County Medical Center's Terrace View Long Term Care Facility (390 beds) and Kaleida Health's HighPointe on Michigan nursing home (300 beds), each reported only six staff members contracted Covid-19.

But four of the 10 facilities with the most confirmed cases among employees did report shortages of nurses and aides.

Brothers of Mercy Nursing & Rehabilitation Center in Clarence, which reported 37 employees had contracted the coronavirus, had to close half a wing, or 20 beds, because it lacked enough aides. It is a 233-bed facility, and it reported 200 occupied beds.

"We definitely have staff shortages and we are doing a lot to fix that," said Peter C. Eimer, chief executive officer at the Brothers of Mercy. "A lot of the staff are out because of the testing. When they test positive, they quarantine for two weeks."

If after two weeks the employees still test positive, they can't come back until they test negative.

"It is really hard on us," Eimer said. "From what the research is saying, it looks like at two weeks, those that test positive are not 'shedding' the virus, spreading it anymore. But they stay home until they test negative and that is one of the things that is really hurting us."

As for the facility's nursing staff, its registered nurse level is "pretty good," Eimer said. "But the licensed practical nurses, a lot of them are out because they tested positive or they have other illnesses, and it is hard to replace them."

While the federal data provide some insight into the level of infections among nursing home employees, the picture is incomplete. Eight facilities in the region still have not reported data, and the uneven availability of testing early on in the pandemic means that at least some infected workers may not have been included in the counts.

The parameters facilities used to report their data also makes comparisons among nursing homes difficult.

For example, Absolut Center for Nursing and Rehabilitation at Aurora Park in East Aurora reported 54 confirmed cases among employees, the second-most among the facilities that reported data.

The requirement was to report from May 8 forward, and probably most facilities did this, said Jason Newman, a spokesman for RCA Healthcare Management LLC, which operates the Absolut facility. But there was also an option to report back to Jan. 1.

"We chose the latter option," he said. "We are, therefore, the more complete and transparent. And we think we ... deserve credit for not taking the easy, shorter road. But clearly some of the numbers you've received from other facilities only cover the last three weeks, well after the local Covid peak, not the five months' worth that we reported covering the worst of it."

What's more, the data doesn't mean the employees were necessarily infected at the nursing homes, Newman said.

"Employees go home, they shop, worship and interact with other people all over our region for the 16 hours a day they are outside our facility," he said. "There's no way of telling where any staff contracted the virus. None, arguably, could have caught it at our facilities. No one knows, or can say for sure, because the county and state provided inadequate tracking."

Staff shortages

Thirteen nursing homes reported being short of nurses and aides in their June 7 reports, including the Rosa Coplon Living Center, a nursing home on the Weinberg Campus in Getzville.

Staffing in health care was the number one challenge before the Covid-19 outbreak, said Robert T. Mayer, president and CEO of the Weinberg campus.

"As a result of the Covid-19 situation, staffing shortages occurred due to staff exposure in the community, illness, the need to care for family members at home and the general uncertainty about Covid-19," Mayer said.

The closing of schools and the lack of available daycare made it difficult for some staff members to come to work. Also, normal hiring procedures were disrupted due to the restrictions on access to nursing homes and the "stay at home" orders that were in place, he said.

"We had prepared for potential staff shortages and had a plan in place to mitigate any shortages," he said. "We held daily meetings to assess staffing needs and made adjustments as necessary."

Specific job duties, like delivering meals to resident rooms, were identified that could be performed by non-clinical, non-licensed staff.

That allowed the clinical staff to focus on resident care. The facility adjusted staff schedules to provide more flexibility for staff that allowed them to care for their families while at the same time still being able to continue to work.

Management staff, activities staff, social work staff, therapy staff and nursing supervisory staff assisted in completing daily resident tasks. Contract staff was used when necessary to fill open shifts. And staff routinely picked up extra shifts to make sure that the residents were properly cared for. The facility also limited requests for time off during this period of time, he said.

The data provided to the federal government by nursing homes is a snapshot in time. So in some cases what a nursing home reported in May changed by the June reporting date.

Elderwood at Cheektowaga, like other facilities, has been battling the Covid-19 pandemic since early March.

"In that time, we have been both vigilant and fortunate," said Chuck Hayes, Elderwood's vice president for marketing and communications. "As of this writing, none of our residents have suffered from the effects of the virus."

For one week in May, "we reported transparently that we were temporarily below our staffing model," Hayes said. "Staff, who are often faced with caring for family members, challenges with child care needs, or who may feel ill themselves, will occasionally call off before their shift, creating a temporary reduction in available staff. We have seen no impact on resident care as a result, and there have been no prolonged staff shortages."

Elderwood at Cheektowaga did not report a shortage of nurses or aides in its June 7 report, which was released publicly on Friday.

In a recent unannounced CMS infection control survey, and a New York State Department of Health infection control focus survey on June 3, inspectors noted no deficiencies at Elderwood at Cheektowaga, Hayes said. State inspectors made positive comments regarding the facility's staffing levels, he said.

Staff Reporter Thomas Prohaska contributed to this report.

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