When nursing home Chapman Healthcare Center called Jimmy Peoples earlier this month to tell him his mother tested positive for COVID-19, Peoples had reason to be concerned — Peoples' mother is in her 90s and has had four coronary bypasses.
Chapman, located in Alexander City, tried to find a hospital to transfer her to but to no avail, Peoples said. Russell Medical had no available COVID beds, nor any of the facilities the nursing home called in Wetumpka, Montgomery, Birmingham and even Carrollton, Georgia, Peoples said.
"How far they looked for my mother, I didn't ask," said Peoples, a retired principal at Horseshoe Bend School. "I don't know if they have a radius that they try to stay in."
His mother is instead being kept isolated in a converted COVID ward at Chapman, where fortunately, her condition remains stable, Peoples said.
"She wasn't having to have any oxygen or anything; she was able to breathe on her own," he said. "That's the first thing that they would be concerned about was the oxygen level dropping but that has not been a problem."
Whether his mother would have been prioritized had her symptoms been more severe, Peoples did not know.
"Based on what they told me at Chapman's, (they) couldn't find a bed," he said.
Amanda Bruner, director of nursing at Ivy Creek Healthcare's Elmore Community Hospital, said they were having to make a lot of transfers.
"It is extremely hard to find beds anywhere," Bruner said. "We have sent patients across state lines to get the bed placement when necessary."
Neither Elmore Community Hospital nor Lake Martin Community Hospital, also owned by Ivy Creek Healthcare, have intensive care units. As such, they're unable to take critical COVID-19 patients. However, while a blood oxygen level below 90% is considered low, no benchmark oxygen level can determine the severity of a patient's illness alone.
"I wouldn't put a number on it; you just have to watch your patient and see what their acuity is," Lake Martin Community Hospital resident nurse Ginger Robinson said. "They may be sat at 84% and be tolerating just fine, but you may have somebody else that's sat at 89% and they're really struggling."
For those patients who are struggling, without an ICU, neither Ivy Creek hospital would be able to get them on a ventilator. Ivy Creek has an "emergency ICU plan," Bruner said, but only as a temporary measure until they can get a patient transferred.
"We have to be really careful, because we don't have those ICUs and ventilators in either hospital, so those critical patients can't come here they have to be able to go somewhere that can handle those people," Ivy Creek marketing director Heidi Smith said.
At present, however, many of the local ICUs are at or exceeding capacity. As of last week, 122% of Russell Medical ICU beds were filled as the hospital has begun to rely on flex beds, according to U.S. Department of Health and Human Services (HHS) data. Coosa Valley Medical Center's ICU is at 92% capacity, East Alabama Medical Center is at 100% and Clay County Hospital is at 153%.
According to Bruner, transferring patients across state lines can involve a lot of paperwork.
"It’s hit or miss as to how hard it is — but due to COVID, generally it’s a hard, complicated process unfortunately," Bruner said.
Peoples' mother was lucky her symptoms permitted her to stay in the nursing home. An acquaintance of his was not so lucky.
"It was a matter of get her transferred or she was going to pass," he said. "They couldn't find a bed anywhere in this part of the state. They found two beds out at Atlanta."
Before they could go through the motions of getting her transferred, however, both beds were filled by local patients in need of critical care. Eventually, they were able to find her a bed in-state, Peoples said.
"They actually just stumbled onto a bed in Dothan — one room became open and the doctors were able to make the calls to get the transfer ready," he said. "If it had not been for the intervention of God, this would not have happened."