A single nursing home has had a dozen residents die from COVID-19, the disease linked to the coronavirus, and nearly 200 nursing home residents across Travis County have tested positive for the virus, Austin officials said Tuesday.
Overall, as many as 26 residents of nursing homes and long-term care facilities have died in Travis County — about two-thirds of all deaths in the county. Another 192 residents have tested positive for the disease. Additionally, 88 staff members of such facilities have tested positive for the virus, including one, Maurice Dotson, who died.
Austin Public Health authorities reported at a Tuesday City Council meeting that one facility has had 12 of the 26 deaths.
“This really does reinforce the message that we have to do better,” said Mark Escott, interim health authority for Austin and Travis County. “We do strongly believe that we need across-the-board increases in staffing, improvement in practices at these really vulnerable populations, so we can substantially impact the death curve associated with our COVID-19 pandemic.”
The city is only reporting numbers for facilities that have had three or more cases, and officials refused to release any information on facilities that have had less than that, citing patient confidentiality. During the meeting, Escott did not name the nursing homes where the clusters have occurred and did not identify the facility where 12 patients have died.
However, documents show the unnamed facility also had a staff member death. The American-Statesman previously reported that West Oaks Nursing and Rehabilitation Center in South Austin had a nurses aide die.
Dotson worked at the 125-bed nursing home for 25 years before dying April 17 after contracting the coronavirus. The facility was among the first to confirm in March that it had two residents who had tested positive for the virus, but it has since declined to say how many residents have been diagnosed.
West Oaks is owned by Regency Integrated Health Services of Victoria. Company officials did not immediately respond to emailed requests for comment Tuesday.
The revelation of the fatal cluster of cases comes as local and state officials have been opaque about which facilities have had any infections and how many cases those facilities have. The Statesman has requested information under the Texas Public Information Act from Austin Public Health and the Texas Health and Human Services Commission that would name the facilities that have reported at least one COVID-19 case, as well as more details about the origins of the infections. The state agency is seeking an attorney general’s opinion to withhold the information in response to the Statesman and others’ requests.
Health and Human Services reports that 282 nursing facilities and 85 assisted living facilities in Texas have had least one staff member or resident test positive for the disease, as of Monday. It’s not clear how many total staff and residents have been infected statewide, but COVID-19 has killed 231 residents of nursing facilities and 59 residents of assisted living centers. Texas has 1,220 licensed nursing facilities and 2,004 licensed assisted living facilities.
Of all the state’s COVID-19 deaths, about 44% have been in nursing homes and assisted living facilities.
Prior problems at West Oaks
West Oak was cited six times by governmental officials for deficiencies in 2019, according to latest Medicare data. The average number of citations in Texas that year was about seven.
The deficiencies at West Oaks in 2019 included not properly indicating flu and pneumonia vaccines for at least one resident, failure to provide a comprehensive care plan for another resident and not having enough staff members to meet the needs of residents.
In 2018, the facility got five citations, including one for not doing enough to prevent the spread of transmissible diseases, which included not storing catheter tubing correctly and allowing it to touch the floor.
More than 80% of nursing homes in Texas were cited in the last three years by the federal government for not following proper protocols to prevent infections, raising concerns about the safety of such facilities amid the coronavirus outbreak.
Government watchdogs cited 74% of the 57 nursing homes in Travis, Williamson, Hays and Bastrop counties for violations between 2017 and 2019, according to latest available federal data collected by the USA TODAY Network, of which the American-Statesman is a member.
Escott said local officials have deployed strike teams that the state has funded to three unnamed Travis County facilities suffering outbreaks. The teams will assist with containment, control and treatment of COVID-19 and help alleviate staffing shortages.
A fourth strike team has been redirected to Williamson County to help with nursing home outbreaks. Officials with Trinity Care Center in Round Rock reported over the weekend that 45 residents and staff members have tested positive. On Tuesday, officials reported one of the residents died.
Insufficient nursing home testing
Patty Ducayet, the state ombudsman for long-term care facilities, said facilities with reported cases of COVID-19 should test all residents and staff to tamp down on the spread of the disease.
However, a shortage of test kits and sluggish laboratory turnaround times have made it difficult for nursing homes to follow this best practice.
“Many facilities are not getting testing of all their staff and all their residents, and without that, there are very likely unidentified cases of COVID-19 where someone doesn’t have symptoms that could be passing it,” Ducayet said.
According to Austin Public Health, officials have completed testing at one facility and are testing people at the other nursing homes with outbreaks.
“As (testing) capacity is improving, we’re going to continue to improve our ability to test both the staff and residents of these facilities. This will be one of the functions of the strike teams deployed … to do more aggressive testing at these facilities,” said Jorge Ortega, a city spokesperson.
More personal protective equipment is also needed, Ducayet said.
“The message that facility management can often give to residents and families is, ‘We’re following CDC guidelines about PPE or even testing,’” Ducayet said. “And I actually think what they may be really saying, ‘We’re doing the best we can to follow the CDC guidelines that they’ve given us leniency on.’ They probably would agree they need more PPE.”
Most nursing homes have cut off non-essential visitors to facilities. Austin Public Health has directed all facilities to check employees and residents for COVID-19 symptoms.
Health and Human Services has advised facilities to isolate patients with COVID-19, provide them with their own dedicated staff, and clean and disinfect the facility, among other measures. The agency does not provide a strict rule on testing but instead tells nursing facilities to work with their local health authority on it.
Additional material from staff writer Nancy Flores.
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