Officials with the Centers for Disease Control and Prevention and the Alabama Department of Public Health toured long-term care facilities in Alexander City on Tuesday amid the COVID-19 pandemic.
Dr. Nimalie Stone, a medical epidemiologist for long-term care at the CDC’s Division of Healthcare Quality Promotion, visited Chapman for more than two hours noting how the staff had interpreted and used the CDC guidelines to help mitigate the spread of COVID-19 within the facility.
“Dr. Stone made note of several things our facility has implemented to remind staff to don and doff personal protective equipment and sanitize surfaces that she wanted to share with other nursing homes,” Chapman Healthcare Center administrator Ashleigh Taylor said.
Dr. Melanie Chervony, an epidemiologist in the Infectious Diseases and Outbreaks Division of the Alabama Department of Public Health, joined Stone on the tour.
“At the conclusion of the tour, they commended us on our efforts (to stop the spread of COVID-19),” Taylor said. “They told us we were doing all the right things in relation to the CDC’s guidance for COVID-19 infection prevention and control in nursing homes.”
Prime Management also brought in leadership staff from Dadeville Healthcare Center and LaFayette Extended Care to learn what they could to implement at their facilities.
“We have a four-tier plan to mitigate the spread,” Prime Management director of operations Brantley Newton said. “Prior to any confirmed cases, we implemented our response plan that included the use of personal protective equipment and education on infection control, prevention, COVID-19 symptoms and social distancing. Every tier is triggered by an event. It is the plan used at Chapman and all of the Prime Management facilities including Dadeville Healthcare.”
Officials with Prime Management shared with Stone and Chervony they had used the services of both ServPro and the Alabama National Guard for sanitation services in facilities where there was a confirmed COVID-19 case.
Just because Stone and Chervony are experts in their fields, staff screened the pair for COVID-19 symptoms before allowing them to enter the facility and ensured they wore personal protective equipment.
Dr. David Grabowski, a professor of health care policy at Harvard Medical School, said there was no trend as to whether a long-term care facility had cases of COVID-19.
“It’s about where you are and not who you are,” Grabowski said. “What we’re seeing in our data is it tends to be larger facilities, in urban facilities in areas with more cases that tend to be the facilities with COVID cases.”
Dr. Vincent Mor, a professor of health services, policy and practice at Brown University School of Public Health has studied data from long-term care facilities in 20 states and came to the conclusion the more residents in a community with COVID-19 and the larger the long-term care facility, the more likely to have a case of COVID-19.
“It’s a function of traffic,” Mor said. “If you’re in an environment where there are a lot of people in the community who have COVID, the patients in the building are more likely to have COVID. If you are a larger facility versus a smaller facility, there is more traffic. Larger facilities simply have more staff, more people coming in and out of them. That’s more traffic and more likelihood that someone will be coming in from the outside with COVID.”
Grabowski added, “This is a system problem, not a bad apple problem.”
John Matson with the Alabama Nursing Home Association said 131 of Alabama's 231 nursing homes have had at least one resident or employee test positive for COVID-19. Those homes with positive cases are in 59 of Alabama's 67 counties.
Other nursing homes in Tallapoosa County have had cases of COVID-19. The smaller facilities have not yet had a positive case amongst residents following the conclusions of Grabowski and Mor.
Stone and Chervony left Chapman to visit with staff at Bill Nichols State Veterans Home.
For Taylor and Newton, they were happy to hear the experts’ thoughts on the handling COVID-19 in Chapman Healthcare.
“It was uplifting to be reassured by representatives from the CDC and ADPH,” Taylor said. “They told us we are doing everything we can to protect our residents and staff.”