There were 156 COVID-19 cases at the Annandale Healthcare Center, which is more than any other nursing home or assisted living facility in Virginia, and 55 deaths, according to the VDH.
According to Fred Stratman, spokesperson for CommuniCare, a company based in Cincinnati that operates the Annandale Healthcare Center, the data listed on the VDH website is incorrect. There were just 28 COVID deaths, including a nurse, he said, and the 55 number refers to deaths from all causes. “We reached out to the health department to get that corrected,” he said.
Stratman said the number of COVID cases, 156, listed by VDH is correct and that includes 56 staff members, six contractors, and 94 residents. The most recent case involved a resident on June 24.
The facility, at 6700 Columbia Pike, has 222 beds. It’s name was changed from Sleepy Hollow Healthcare Center a year ago.
According to a report on the Annandale Healthcare Center by the Office of Licensure and Certification issued in May: “Based on observations, staff interviews, clinical record reviews, and facility documentation, staff failed to ensure infection control measures were consistently implemented to prevent the development and/or transmission of a communicable disease (COVID-19) among staff and residents.”
CommuniCare is working on a corrections plan to address all the deficiencies cited in the report, Stratman said.
Staff screening inadequate
The report says staff “failed to adequately implement their planned screening process at shift change, as well as maintain social distancing.”
A reviewer on May 5 observed there was no one in place at the front desk to screen staff entering the building. Staff who had been waiting in line took their own temperature or skipped the screening to clock in for their shift. Staff in a hurry to access the time clock crowded onto an elevator, disregarding social distancing rules.
In another deficiency cited in the report, Annandale Healthcare Center staff failed to dispose of personal protective equipment to prevent possible transmission of infection and failed to properly store reusable PPE. At one point, a blue disposable isolation gown and gloves were found on the steps.
Staff also “failed to perform appropriate hand hygiene” in accordance with CDC guidelines, the report says. A housekeeper was observed entering and exiting rooms occupied by COVID-19 patients and one room with a resident who tested negative for COVID without washing hands or changing PPE between rooms.
In another incident, a certified nursing assistant was observed entering a resident’s room without first washing his hands and frequently adjusting his face shield and mask without wearing gloves.
The report says the Annandale Healthcare Center has agreed to undertake a plan of correction, although the plan “does not constitute agreement with the alleged deficiencies.”
Under that plan, the center has initiated screening of all staff, vendors, and visitors entering the building, and a nurse was assigned to monitor the screening process. All staff will have their temperature taken at the beginning and end of each shift.
Procedures were implemented for storing PPE, and staff was educated on proper disposal of PPE. Staff was also educated on social distancing and hand hygiene.
Neither the VDH nor the Fairfax County Health Department will talk about specific cases.
“If a facility has an outbreak they work with the local health department,” said Sarah Lineberger, healthcare-associated infections program manager at the VDH.
Health Department procedures
The Fairfax County Health Department “has been actively engaged with long-term care facilities to prevent and mitigate the spread of disease within these high-risk settings,” said Communications Director John Silcox.
After a single case at a congregate care facility, Silcox said, an experienced communicable disease public health nurse is assigned to the facility to lead an investigation and provide recommendations.
A rapid response team is dispatched to the facility to provide training on appropriate PPE use by staff, conduct respirator fit testing and training, instruct staff on testing, and provide guidance on disinfection. he said. A liaison public health nurse is assigned to each facility and visits each day to observe infection prevention, make recommendations for improvement, and provide support.
The Health Department provides PPE to facilities as needed and trains “PPE champions” for each shift at facilities to train other staff on their shift to appropriately use PPE, Silcox said.
The Health Department has conducted 15 point prevalence surveys – which are point-in-time tests for all asymptomatic residents and staff – in long-term care facilities, and more are scheduled.
While the Annandale Healthcare Center had a big COVID-19 outbreak, other Northern Virginia long-term care facilities were able to better protect their residents and staff.
Similar reviews carried out by the Office of Licensure and Certification at Goodwin House in Bailey’s Crossroads and Leewood Healthcare Center in Annandale this spring found those facilities “in substantial compliance” with state requirements for long-term care facilities.
According to the VDH, the Leewood Healthcare Center had 114 cases and 35 deaths from COVID-19.
A proactive approach at Goodwin House
Seven residents of the Goodwin House in Bailey’s Crossroads had COVID-19; two were hospitalized and passed away, said Lindsay Hutter, chief strategy and marketing officer at Goodwin House Inc., which operates the Goodwin House facilities in Bailey’s Crossroads and Alexandria. The other COVID patients were isolated in a dedicated space with dedicated staff assigned to them. Most have fully recovered.
“Our organization chose to be very proactive,” Hutter said. Early on, Goodwin House administrators procured testing kits and PPE and provided training to staff.
The Goodwin House at Bailey’s Crossroads has 327 independent-living apartments, 54 assisted-living apartments, 85 skilled-nursing units, and 16 memory care units. The Goodwin House in Alexandria has a similar breakdown but is smaller.
All residents and staff were tested to establish a baseline at both facilities. All direct care partners who help residents with activities for daily living are tested weekly, Hutter said.
Staff who tested positive must be quarantined at home for 14 days, she said. After that period, they are tested again. If they test negative, they are given another test two days later. They can’t come back to work until they have two negative tests in a row.