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Kentucky nursing homes facing COVID-19 crisis as communities start to reopen

Long term care facilities are struggling to contain the spread of COVID-19, citing too few resources and not enough testing.

LOUISVILLE, Ky. — As communities start to contemplate reopening, COVID-19 cases at Kentucky's long term care facilities only continue to grow. Thirteen of the 17 deaths reported Tuesday were residents from Kentucky nursing homes. Now, staff representing those facilities say they need help to stop the spread of the virus.

"We are not flattening the curve in long-term care facilities," Betty Johnson, the president of the Kentucky Association of Healthcare Facilities and Nursing Homes said.

Many of the commonwealth’s most vulnerable live in long term care facilities, and even with serious precautions in place, staff working at those facilities say they are limited in how they can keep the residents safe.

"We have always been required under federal law to have an infection control process, we are surveyed on that, so in other words regulators come in and ensure we have that in our buildings but this is a different virus,” Johnson said.

Leilani Krause can attest to that. Treyton Oak Towers, where Krause is the director of nursing, has seen more than a dozen deaths.

"We did everything we could think of to do," Krause said. "The doctors were involved, the CDC and health department were involved, these people were fragile and elderly and this virus is very rapid and very aggressive."

Krause also contracted the infection herself. She has been out of work for weeks overcoming the symptoms of COVID-19, but before she left, she saw how it was affecting residents inside the building.

"At night is when their symptoms would hit, their fevers would spike up, become very short of breath, congested, a lot had pneumonia, a lot had pre-conditions and it just goes so rapid”, Krause said.

In Kentucky, 20% of the total reported cases and more than 40% of reported deaths have come from inside long-term care facilities. Kentucky Governor Andy Beshear developed a task force to work on response to the COVID-19 crisis within these facilities mid-April.

Credit: Andrea Ash
The amount of positive COVID-19 cases in Kentucky connected to long-term facilities.

"I think we've started focusing on the needs of the skilled nursing facilities and the long term care communities in Kentucky but I'm a little concerned that we were a little late on that," Krause said.

She said the biggest breakdown was in the beginning, when nursing homes were shortchanged with personal protective equipment, including masks.

"That has been very difficult to acquire," she said. "Unfortunately the strategic national stockpile that came into Kentucky- most of that went to hospitals and not to long term care facilities."

Now, she said it’s difficult to get ahead of the virus without adequate testing. She says asymptomatic staff are spreading the virus without even knowing it.

"You can have the best infection control program in your buildings, you can have a five start rated facility, you could have the best staff in the entire world and that would not necessarily mean that you would keep this virus out of your building,” Johnson said.

Johnson said wide-spread testing and adequate PPE are the only answers to slowly the spread of the deadly virus within long term care facility walls, but they aren't the only problems. She is anticipating issues with funding in the coming months.

"Because hospitals aren't providing those [elective] services we aren't seeing those patients so our census is down so that's revenue that's being lost and then we have additional costs with requiring PPE, a lot of members are paying their staff hazardous pay," Johnson said.

In terms of lifting strict visitor policies and getting "back to normal," facility reps said they are still far from that. Instead, they said they will likely stay in lock down mode much longer than communities stay closed.

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