Nursing homes must report COVID-19-related deaths within 24 hours
By Terry Miller
Beacon Media has learned that an assisted living facility withing the city of Arcadia is under investigation by the Los Angeles County Department of Public Health.
A confidential source, who works inside the facility and filed an official whistleblower complaint with the county health department, alleges that the facility potentially violated the law by not disclosing deaths from the coronavirus in a timely manner as prescribed by the state and has violated health guidelines by making staff wash their masks and other personal protective equipment (PPE) instead of giving them fresh, sanitary supplies. Beacon Media was unable to substantiate these claims.
Beacon Media contacted the Los Angeles County Department of Public Health for comment about a possible probe of the facility. “Arcadia Retirement Village is an open and active investigation. Public Health has provided the facility with infection control guidance and is conducting site visits,” Public Health said in a written statement to this newspaper on Oct. 13.
The source alleges that some kitchen staff may have contracted COVID-19 and may continue to work in the facility but data from Public Health does not support this. As of Tuesday, Public Health does not report any confirmed cases among Arcadia Retirement Village staff — nine cases have been confirmed among residents as have two deaths from the virus. However, “Data will change based on daily information gathered by public health investigators overseeing, supervising, and closing each investigation,” according to the COVID-19 dashboard on the Public Health website.
“The Arcadia Retirement Village is an assisted living facility. One thing I know for sure is illegal is that they are not reporting the three staff cases to the L.A. Department of Public Health. Otherwise it would be on the L.A. Department of Public Health’s website. Page 3 of the Health Officer Order dictates that three confirmed cases within the span of 14 days must be reported to the LADPH,” the anonymous employee told Beacon Media in several phone calls and emails.
In instances where the county has not provided specific guidance, then state protocols take control, according Public Health’s “Reopening Safer at Work and in the Community for Control of COVID-19.” Under those conditions, “In the event that an owner, manager, or operator of any business knows of three (3) or more cases of COVID-19 among their employees within the span of 14 days, the employer must report this outbreak to the Department of Public Health at (888) 397-3993 or (213) 240-7821.”
However, the department has issued specific guidance for community care facilities. According to the “Prevention of COVID-19 Transmission in Community Care Facilities,” revised Oct. 5, a facility “shall report all confirmed or suspected COVID-19 cases and deaths within 24 hours to the Los Angeles County Department of Public Health by phone at (213) 240-7941 or fax at (213) 482-4856 or during and ongoing outbreak, by calling the number provided by the Public Health outbreak investigator who is managing the Facility’s outbreak.”
Allegations have also been made of test results not being given in a timely manner for staff and in some cases not been given at all, though we could not confirm these reports.
It has been a tough year for all of us during the coronavirus outbreak, but for nursing homes and assisted living facilities the reality of the coronavirus is most prevalent. In some facilities, including at least one in Pasadena, the outbreak has been so severe that in warranted the need for National Guard to step in to help staff.
The Los Angeles County Office of Inspector General and Auditor-Controller recently released their initial report detailing their ongoing investigation into skilled nursing homes. County Supervisor Mark Ridley-Thomas called it a critical first step towards improving operations at these facilities, which have accounted for about 42% of Los Angeles County’s COVID-19 death toll.
“We still have a lot of work to do, but the Inspector General and Auditor-Controller’s reports provide us with a starting point for tackling complex and deeply-entrenched problems that have plagued skilled nursing homes for decades,” said Ridley-Thomas. “We are undertaking the due diligence required to develop long-term solutions for improving quality of care at skilled nursing homes while simultaneously taking timely steps to promote the ongoing safety of both patients and staff.”
Overseen by the State of California but regulated locally by the County’s Department of Public Health (DPH), skilled nursing homes have been the epicenter of the pandemic in L.A. County, with about 16,000 infections and 2,500 deaths among patients and staff. In May, the Board of Supervisors approved a motion directing L.A. County’s Inspector General to investigate skilled nursing homes for the first time. They also tasked L.A. County’s Auditor Controller with monitoring the facilities and creating a public dashboard showing their COVID-19 case totals, testing frequency, mitigation plan status, personal protective equipment supply and other information. The dashboard went live in September.
According to an analysis released Monday by the Kaiser Family Foundation, more than 84,000 residents and staff at long-term care facilities have died from COVID-19, accounting for 40% of all coronavirus deaths in the U.S. In Los Angeles County, skilled nursing facilities account for 2,131 COVID-19 deaths and 17,142 cases.
At least 84,000 residents and workers have died from the coronavirus at nursing homes and other long-term care facilities for older adults in the United States, according to a New York Times database. “As of October 20, the virus has infected more than 540,000 people at some 21,000 facilities.
“Nursing home populations are at a high risk of being infected by — and dying from — the coronavirus, according to the Centers for Disease Control and Prevention. Covid-19, the disease caused by the coronavirus, is known to be particularly lethal to adults in their 60s and older who have underlying health conditions. And it can spread more easily through congregate facilities, where many people live in a confined environment and workers move from room to room,” The New York Times said.
“While 7 percent of the country’s cases have occurred in long-term care facilities, deaths related to Covid-19 in these facilities account for about 38 percent of the country’s pandemic fatalities,” according to The Times.
Skilled nursing homes in California are now required to report coronavirus-related deaths to authorities within 24 hours during declared emergencies. “The law was written in response to concerns that health agencies were slow to respond to outbreaks in skilled nursing facilities because they did not receive timely information about them,” according to the Los Angeles Times.
Emails and calls to the Assisted Living facility in Arcadia were not immediately returned.
For skilled nursing facility protocols and guidance please visit publichealth.lacounty.gov/acd/ncorona2019/snf.htm.