Clusters of COVID-19 have been found in nursing homes on Oahu, but the Big Island’s long-term care facilities have so far remained free of the disease and are continuing their efforts to keep it out.
All such facilities on Hawaii Island adopted a unified no-visitor policy in March to keep residents safe and free from COVID-19.
In addition to the no-visitor policy, Legacy Hilo Rehabilitation and Nursing Center continues to screen its employees and essential vendors daily, Administrator Alisa Racelo said. Masks are required to be worn by all staff, and residents are requested to wear masks when they leave their rooms.
“In addition, we continue ongoing staff education and audits in relation to infection control practices such as hand hygiene and cleaning practices,” she said. “Residents are screened daily for COVID-19 symptoms, and all new residents that are admitted are isolated to one specific area in our facility.”
At Yukio Okutsu State Veterans Home, there is — and has been for some time — heightened efforts toward infection control and sanitation, said Allison Griffiths, vice president of legal for Avalon Health Care Group, which manages the Hilo facility.
Staff members go through a screening questionnaire and temperature check before beginning their shifts.
“(Yukio Okutsu is) following all those CDC protocols around infection control, with the ultimate goal of keeping the virus out of the building and keeping our residents (safe),” Griffiths said.
Denise Mackey, administrator at Hale Ho‘ola Hamakua in Honokaa, said anyone who comes into the building goes through a screening process, and there’s a “pretty strict” admission process as well.
According to Mackey, new residents must have a negative test within 72 hours of admittance, and are then quarantined for two weeks The new residents are tested again 7-10 days after admission.
After 14 days and two negative tests, “we can feel reasonably safe we’re not bringing COVID into our building,” Mackey said.
Although the no-visitor policy has been in place for more than three months, administrators say residents are adjusting and staff are working to keep them entertained and engaged.
“Of course, it would be difficult on anybody not to see loved ones and not just see them, (but) to be able to touch and embrace them, but I can say the residents are doing very well,” Griffiths said. “These are veterans, so they’re strong folks. So they’re doing really well, all things considered.”
Legacy Hilo has increased activity staffing hours for more entertainment and daily room visits from the staff, Racelo said.
“Our internal activities schedule has become full of bingo games, energetic socially distanced parades and other fun, themed activities to keep the residents happy and engaged,” she said. “We have also acquired new tools that allow for virtual connection and communication between residents and their loved ones. Each room has a television and phone, as well.”
Morale at Hale Ho‘ola Hamakua is “surprisingly pretty good,” Mackey said. Virtual visits and having activities while keeping socially distanced have been helpful.
While they’ve been doing FaceTime and Zoom calls all along, Mackey said virtual visits are not the same as a real visit. In mid-April, though, Hale Ho‘ola Hamakua began enacting “through-the-window” visits between residents and their loved ones, which has proven beneficial.
And having staff that feel like family caring for and about residents,”makes a world of difference probably to the residents’ mental status,” Mackey said.
Seniors, especially those who have underlying health conditions, are at a greater risk for COVID-19.
Across the country, there have been more than 111,500 cases of COVID-19 confirmed in nursing home residents, more than 76,500 suspected cases and nearly 30,800 deaths as of mid-June, according to data from the U.S. Centers for Medicare and Medicaid Services.
The Hawaii Island District Health Office confirmed Thursday that there are no cases of the disease in Big Island nursing and long-term care facilities.
However, more than a dozen cases have recently been confirmed in staff and residents of Hale Nani Rehabilitation and Nursing Center on Oahu, and the state Department of Health said a number of additional cases were associated with community care homes in three locations on Oahu.
“We stand together as an industry to stay strong and vigilant,” Racelo said. “The recent cluster has been a reminder that the pandemic is not over, and we must stay committed to protecting our most at-risk population, our kupuna.”
Mackey said those in the industry are supportive of one another.
“We all know what the other facility leaders are going through,” she said, but added that asymptomatic staff is likely how the disease will get into a facility.
“As many things as you can put in place, nothing is foolproof,” Mackey said. “I don’t want to in any way feel like anyone would think to be judging another (administrator). You can do your best and do your best effort to keep things out. By all accounts, Hale Nani was doing everything (right).”
Oahu lawmakers state Reps. John Mizuno and Rida Cabanilla last week asked all nursing homes to comply with recent guidelines from the U.S. Centers for Disease Control and Prevention and provide testing for all residents.
“With the recent outbreak of positive COVID-19 cases at nursing homes in Hawaii, it is essential that we have nursing homes and community care homes align with CDC guidelines for testing their staff and patients for COVID-19,” Mizuno said in a statement. “The testing will offer a much-needed layer of protection for our elderly and our disabled.”
But COVID-19 tests have already been completed at a number of Big Island facilities.
At Legacy Hilo, Racelo said residents and staff are tested according to the facility’s mitigation plan, but did not elaborate on what that plan entails.
Griffiths said Yukio Okutsu just completed its first full-facility testing for the entirety of its staff and residents, the results of which were all negative.
“Obviously, that’s a very encouraging, and a positive thing.”
Yukio Okutsu does require all new admissions to test negative, otherwise residents or staff would be tested if symptomatic.
In addition to tests for new residents, Mackey said the staff at Hale Ho‘ola Hamakua is part of the Hawaii Health System Corps. East Hawaii Region conducted mandatory COVID-19 testing earlier this month, which found no positive cases, and random testing samples will be done as time goes on.
At the same time, Mackey said, every resident was tested on June 4, and no COVID-19 was found.