Nursing home residents account for 15% of Indiana’s COVID-19 deaths

Nursing home residents now account for 15% of all deaths in Indiana from the COVID-19 pandemic, and state officials on Wednesday ordered long-term care facilities to report any deaths or positive cases within 24 hours to try to protect elderly and confined Hoosiers.

The Carmel mayor is also taking action to ensure nursing home residents in his city are tested.

Dr. Kristina Box, the state health commissioner, said 31 deaths have occurred in 12 long-term care facilities, representing a significant share of Indiana’s 203 deaths so far.

The new order requires any residential facility, jail, prison “or any other congregant setting” to report to local and state health departments if they have residents or employees with a known or suspected case of COVID-19,  if an individual dies of the disease, or if any employee tests positive.

In addition, the state is ordering laboratories to report all negative COVID-19 test results for Indiana residents to the state within 24 hours of completing the tests. Currently, only positive results must be reported.

Outbreaks at nursing homes and other long-term care facilities are serious, because they can quickly spread through a confined space, often with elderly people who are at high risk of contracting the disease.

“This disease creates the potential for a perfect storm in a long-term care facility,” said Dr. Daniel Rusyniak, chief medical officer of the Indiana Family and Social Services Administration, which oversees funding of nursing homes. “Large groups of vulnerable people living together, and a highly transmissible virus that may not cause symptoms, and those who care for them.”

Indiana has 735 nursing homes and standalone residential facilities that house about 65,000 people. As of Wednesday, the state’s “strike teams” of health workers have tested nearly 600 people at 200 facilities.

The strike teams, originally set up in 2017 to help slow a hepatitis outbreak, were adapted last month to deal with the coronavirus pandemic, Rusyniak said.

The state has 12 strike teams, each consisting of a coordinator, nurse surveyor, infection-control expert and an epidemiologist. Their job is to respond to the pandemic in waves, he said.

The first wave is to go into a facility that has reported a COVID-19 problem and test all residents and staff thought to be ill. They also drop off masks, gowns and other personal protective equipment and assess the facility’s COVID-19 readiness plan, he said.

The second wave begins if positive cases are confirmed at a facility. In that case, the nurse surveyor assesses the facility’s plan and a specialist reviews the infection-control practices.

The third wave begins if additional cases are identified in a new area of the facility.

“In those facilities where there are multiple deaths, we will often go back numerous times to assist them in mitigating the spread,” he said.

On Friday, Carmel Mayor Jim Brainard announced the city would begin coordinating COVID-19 testing at local assisted living facilities and nursing homes through Aria Diagnostics, a local lab.

On Monday, Brainard sent an email to his police chief, asking an officer to deliver a note to one nursing home that was being “obstinate.”

The note said, in part: “I do not have the authority to order you to do testing. I do believe, however, that failure to test your staff on a weekly basis now that the tests are readily available constitutes extreme negligence as well as putting you personally at risk for reckless homicide if someone dies as a result of you not testing your staff.”

He pointed out that reckless homicide carries a prison term.

A city spokesman said that nursing home in question changed its mind on Tuesday and agreed to conduct testing.

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2 thoughts on “Nursing home residents account for 15% of Indiana’s COVID-19 deaths

  1. It is not just the nursing home residents who should be tested, repeatedly. Dan and I have brought this issue to the attention of a few people, but have decided it can’t wait for response. I hope anyone reading this can help the patients AND the workers at nursing homes, assisted living and other caregivers. The TESTING ISSUE is especially critical in healthcare settings, such as nursing homes, hospitals and other places where workers regularly touch and care for elderly and vulnerable people.

    We’re seeing the problem in Indianapolis and throughout our state, and this story attests to the extreme importance of this issue.

    My mother, Mary Holland, died Tuesday, 4/7/2020. Her passing was expected, and I am confident that it was not due to COVID-19. But what I saw the last week or two at the nursing home where she resided, a Marion-county-owned facility, is a huge danger to the patients, the staff and to our community and must be addressed ASAP.

    Because my husband and I were so involved in my mom’s care, we were allowed to go back into the Alzheimer’s unit where mom resided up until last Thursday, 4/2. It is very difficult to keep AZ patients 6 feet apart, as they are still ambulatory and love to wander and hold hands, hug, etc. The staff have to touch them all the time. And, what we saw when we went in last Thursday is horrible in retrospect.

    Most of the staff did not have masks, and of those that had them, some were not wearing them. In general, they lack appropriate PPE, and some appear to lack guidance on how to keep safe. At any rate, the protocols keep changing.

    Patients were sitting near the nurses station, and close together, as usual, despite explicit directions to keep them apart. I realize that this is very hard to manage, but that means that extra precautions need to be made that not only patients but also the staff that touch them be tested!

    While patients are being tested, staff are not being tested for COVID-19 until they are symptomatic, and they don’t know when they will be. I have a copy of the guidance that staff had been given as of 4/2 on what they are to do to keep themselves safe. It is not very clear or comprehensive.

    Please understand — The staff there are wonderful, caring people – but their jobs are overwhelming. Many of the ones who actually help bathe, toilet, feed, change the residents are not highly trained in PPE and how to keep themselves safe. And, many are members of vulnerable communities. They go into danger every day, they bring it with them as well – and these facilities become hotbeds for spreading the virus.

    I had already been informed about a week ago that there were people in other units of this NH that had been taken to the hospital – and had tested positive for COVID 19. On Monday, I got a call informing me that at least one patient in the AZ unit had tested positive for the virus. Then, Tuesday at 5:30 a.m., I got the call that my mom had passed.

    As there is paperwork to be done, I have continued to be in contact with staff. The social worker and other staff told me on April 8 that they still don’t know if and when staff are going to be tested. They told me again that staff is tested only when they are symptomatic, which is too late because they would be contagious for days before that.

    I know there are many vulnerable areas in our City – jails, grocery stores, apartments, etc. – but nursing homes and assisted living housing are a huge vector.

    Lilly is now testing for free in a drive by setting, but the criteria for testing is still very restrictive. I believe that it is essential to make sure that all nursing home workers in close contact with patients be tested, repeatedly, for the virus, for the safety of the patients, the workers, their families, and our communities.

    Please, let this go viral.

    Mayor Hogsett needs to address this, the nursing homes, Lilly, and our policy makers.

    I want our healthcare workers and our community to be safe and for us to focus on taking all measures necessary to quash this dangerous virus. I say this in honor of my mother, Mary Holland, and all the healthcare workers in this City.

  2. According to “Current in Carmel” article, Brainard’s letter was sent to more than one facility. I argue that Brainard’s failure to provide the testing (he ordered them to do them without any local funding/support other than name-dropping a company) is misguided use of his authority and not helpful for his most vulnerable residents during his declared state of emergency. He has also now helped secure 50,000 tests from he company being sent (assumed sold) to NY (source: WishTV article). I understand that Mayors should support local businesses, but this looks very shady. Dr. Box specifically addressed claims Brainard made about the abundance of tests via Aria. She stated that some people that used the company have never received their results. P.S. please keep in mind that Mayor Brainard declared a state of emergency on in March. When I looked up Carmel’s disaster plan, the only one I could find was from 1993.

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