A perfect storm of a holiday weekend and nine employees testing positive for COVID-19 left a Reno, NV, assisted living and memory care community in a staffing emergency, testing its policies, its supply levels and its ability to care for residents.

After an employee at Stone Valley Assisted Living and Memory Care, owned by Sunshine Retirement Living, tested positive for the virus outside of the community on June 16, the community immediately tested all of its 32 employees and 47 residents, following up with two additional rounds of testing as a precautionary measure.

All tests in the first round of testing on June 17 came back negative. Some employees and residents tested positive on the second round on June 23, however, at which time the community notified the Nevada Department of Health and Human Services.

After a third round of testing, done “out of an abundance of caution,” the results came back Friday, July 3, at the start of the holiday weekend. The results revealed that several employees who were asymptomatic and had tested negative on the prior two tests were now testing positive.

“All positive employees were sent home to quarantine. This caused a temporary shortage of employees during the national holiday,” Kena Phillips, regional director of operations Southeast for Sunshine Retirement Living, told McKnight’s Senior Living. Two employees, who were asymptomatic and lived together, volunteered to continue working, if necessary, to continue providing essential services to residents, she added.

“In our continuing discussions with the NDHHS, we were advised to keep those employees on shift because of the temporary intense staffing shortages caused by sending employees home to quarantine,” Phillips said, adding that the Center for Disease Control and Prevention’s guidelines allow asymptomatic, COVID-19-positive employees to work in these “special circumstances.” “We contacted all community employees who had tested negative, as well as five local temporary staffing agencies, but we were unable to secure the staffing necessary to provide the essential and amplified care to our assisted living and memory care residents.”

The community also was advised that it could not transport asymptomatic residents to local hospitals since those beds were reserved for the most serious cases. All of its residents who had tested positive, Phillips said, had mild or no symptoms.

The NDHHS Division of Public and Behavioral Health spokesperson told McKnight’s Senior Living that the division “has worked with Stone Valley to ensure the health and safety of residents and staff, and the Division is continuing their investigation into this facility.

The CDC provides Contingency and Crisis Capacity Strategies for healthcare facilities facing staffing shortages due to COVID-19, including allowing “healthcare personnel with suspected or confirmed COVID-19 could return to work before the full Return to Work Criteria have been met.” 

Those strategies include each affected employee reporting his or her temperature and absence of symptoms before each shift, wearing a face mask and leaving work if “even mild symptoms” develop. Facilities also should restrict those employees from contact with severely immunocompromised patients (or residents) but can allow them to provide direct care for patients with confirmed or suspected COVID-19 and can allow them to provide director care for patients without suspected or confirmed COVID-19 “as a last resort.” The CDC also notes that these individuals should be prioritized for testing.

After receiving staffing relief on that Sunday afternoon, all employees who tested positive no longer were working at the facility. All employees who tested positive are self-quarantining and will not return to the community until they test negative and no longer are exhibiting symptoms, Phillips said. As of Friday, the community was caring for 10 residents who tested positive for COVID-19.

“We created a separate quarantine area in the community for these residents to recuperate, keeping the positive residents separate from those residents who tested negative or recovered,” Phillips said. “Additionally, we continue to test employees and residents to ensure there are no unknown positives. We are also continuing to work closely with the Nevada Department of Health and Human Services.”

Advance planning proved to be key to the community’s success when it encountered this challenge. As soon as it became apparent that the virus was spreading throughout the country, Sunshine Retirement Living immediately began purchasing additional personal protective equipment from all possible sources, Phillips said.

“Because of this early action, we were able to provide comprehensive PPE, including N95 masks, disposable gowns, face shields, gloves and shoe covers for our employees at each of our communities, including Stone Valley,” she said. “All employees, including those two who volunteered to stay that day, continue to wear PPE to help protect them and our residents.”

Phillips expects that studies will “shed crucial light on what has transpired and how policies and procedures might evolve” in the coming months and years. For now, Sunshine Retirement Living’s focus remains on the health and safety of its residents and employees “by implementing the strictest health and safety policies guided by the CDC and other health authorities,” she said. 

“We do believe, however, that because we were so proactive in securing significant amounts of PPE in the very early days of the pandemic, purchasing Vikor Scientific’s Respira-ID tests for all of our communities, and strengthening our already vigorous infection prevention protocol, we were in a better position to help protect our residents and employees,” Phillips said. 

In other coronavirus-related news:

  • Assisted living communities and nursing homes in Minnesota will be allowed to open their doors to certain resident family members and outside caregivers in an effort to help monitor residents’ health and alleviate the effects of long-term i­so­la­tion and lone­li­ness. Facilities will designate the “es­sen­tial care­giv­ers,” who will be permitted to make sched­uled vis­its of up to three hours per day un­der new guide­lines is­sued Fri­day.
  • Oregon health officials have a plan to test everyone at assisted living communities in the state for COVID-19. Testing will be offered to all residents and staff members, with the goal of testing 25% of staff members every week. Those communities in areas with high testing rates will see widespread testing first.
  • Omnicare is partnering with the state of Texas to provide COVID-19 point-of-care testing for assisted living facilities and nursing homes throughout the state, Gov. Greg Abbott announced Friday. The partnership will provide on-site, same-day testing and results for both facility staff members and residents. The test sites will help enable a goal of processing up to 100,000 tests in the first month alone, the partners said. Testing in assisted living began the day before the announcement.
  • Data from Virginia suggest that the prevalence of COVID-19 in assisted living is similar to that in nursing homes, thereby warranting similar resources. Of the 241 outbreaks in long-term care facilities to date, 82 were in nursing facilities and 71 were in assisted living, according to the Department of Health.
  • Florida Gov. Ron DeSantis said the state received the results of 57,000 COVID-19 tests of long-term care staff members and found a 2.3% positivity rate, which he called “low” and “good news.” Almost 200,000 staff members work at long-term care facilities throughout the state. 
  • With COVID-19 cases urging in Dallas County, TX, some long-term care facilities are answering a desperate call for help. Presbyterian Village North in Dallas was one of the first communities in the county to be designated to operate a stand-alone COVID-19 unit. It is now at capacity, with 16 patients. In June, just five long-term care facilities were designated to operate COVID-19 units. Today there are 14. 
  • Atlanta-based law firm Troutman Pepper has launched a new multistate tracking survey to help nursing homes and other long-term care facilities navigate the ever-changing guidance related to COVID-19. The survey covers federal and state orders and guidance documents concerning operations, emergency measures and partial immunity for nursing homes and long-term care facilities. 
  • Owners, operators, workers, agents and volunteers of independent living communities and age-restricted housing should strive to maintain confidentiality and remain cognizant of federal privacy laws in sharing COVID-19 information. The Centers for Disease Control and Prevention advises that communities maintain confidentiality in accordance with the Health Insurance Portability and Accountability Act privacy rule and offers suggestions on how to inform the community that a fellow resident has the virus.
  • Students from Bnai Brith Synagogue in Savannah, GA, showed up outside Buckingham South, an assisted living facility, to blow bubbles and share signs of encouragement with residents. The children held up signs reading “we love you,” “We miss you,” “have a happy day” and smiley faces.