By Michelle Price
UCBJ Managing Editor
ALGOOD – When faced with a nearly incomprehensible situation of 44 residents and staff members testing positive at a home for the most vulnerable, Lee Rooney didn’t wait for someone else to solve his problem. He gathered his team and devised a solution – the first COVID-19 unit of its type in the state.
Shortly after recording multiple positive COVID-19 tests, the staff at Signature HealthCARE converted a portion of their facility into a separate, secure unit staffed with infectious disease specialists just to treat the 29 total residents who have the virus.
In the beginning, Signature seemed to take all the right steps.
On March 9, following Centers for Disease Control (CDC) directives, Signature put a stop-order on anyone entering the building who was not work or emergency related. All visitors were stopped that day. The facility even delayed an internet upgrade when the technician went to install it. No outsiders were allowed to enter.
“We were screening all employees from March 9 on, which meant taking temperatures every time they come in, checking off their symptoms – making sure they didn’t have any COVID symptoms – and even with that, we developed a case,” said Rooney, Signature Healthcare of Putnam CEO/Administrator.
On Friday, March 20, almost three weeks after the facility was essentially locked down, staff members recognized that there was an elder who fell into the category, “could this potentially be COVID?” The patient was tested for COVID-19 and immediately put into isolation awaiting test results. Positive test results came back on Friday, March 27.
Rooney and his medical director, Dr. Richards, stayed in constant contact making sure that there was a plan in place in the event this virus spread. They determined that if another positive test was associated with the facility, they would request the Tennessee Department of Health to do facility-wide testing.
Two more tests were performed with one positive and one negative result.
“With the concern, I had for my facility and staff, partnering with the local health department, here locally with Dr. Grisham and the health department in Nashville, I requested that they do a sweep of my facility by testing every person – every patient and every staff member, because I know this is in other nursing facilities, other nursing homes,” said Rooney. “My facility is definitely not the first and won’t be the last.”
Testing facility-wide was no small feat.
“We tested 320 employees and patients, the majority of which – I’d say 95% of those – had no symptoms, but we tested them anyway,” Rooney explained. “Well that took place on Tuesday (March 31). On Wednesday (April 1), we got results back that showed that we had 16 staff members and 28 patients that tested positive. One inconclusive result has since come back as positive.”
With that, Signature staff mobilized into crisis intervention to transition a unit of the facility into a special COVID-19 care unit to better care for the 29 positive cases.
“We have a special infectious diseases physician-nurse team,” said Rooney. “We are actually taking our patients that are COVID positive and are putting them in one special unit.”
Signature staff spent last Thursday and Friday completing the transition and moving all COVID-19 positive patients into this special unit.
The COVID unit will be isolated with barrier system in place and have its own separate entrance. It will have segregated staff that is going to take care of only those patients, who will remain separate at all times from the rest of the facility and staff. Personal protective equipment (PPE) will be provided and worn per CDC guidelines.
“And with that we will have virtually the only COVID special unit, in this area for sure and maybe in the neighboring states,” Rooney added.
Families have been very understanding of Signature’s experience.
“We’re in constant contact with the families, updating them on their conditions,” said Rooney. “I can gladly report that there is only one who has symptoms related to COVID. The remaining 28 show no symptoms, and we wanted to make the families aware of that.”
Signature’s COVID patients don’t follow the “typical” symptoms and characteristics that healthcare officials have conditioned healthcare workers to look for.
“I want to say that out of the 28 patients that tested positive right now, we don’t have anybody that actually has a temperature over 100. There’s no temperature,” said Rooney. “You wouldn’t even know that they were positive. That’s what’s scary about this right now. The staff and the residents aren’t feeling sick, so we just need to be extra careful.”
With neither the majority of patients nor caregivers showing the typical symptoms, it is difficult to ascertain just how the virus got in.
“This is a difficult situation,” Rooney added. “I would not want to wish this on any facility. It is extremely difficult. Every day we’re dealing with death and dying with the elderly and we’re dealing with the sickest of the sick. So, our normal day is always difficult. My staff love our residents, and they would be devastated if they thought they had a hand in bringing this in.”
Rooney warns that the public should look upon their facility as a warning that you can be positive for the COVID-19 virus, show no symptoms and spread the virus to family friends and strangers.
“You have to assume you are positive and keep distance,” explained Rooney. “Now in healthcare we can’t always do that. We have to be in there. And in a nursing home like my own, Signature HealthCARE, we create a home environment. We make sure they are loved. Up until just recently, we provided hugs daily, pats on back, braiding hair, brushing, bathing, we’re as close as anybody is with their own family. It’s because of that, if you don’t know you’re positive, it could turn into a situation like this. So, I implore everyone to be careful.”
Rooney is confident that his facility can provide the best care possible in the situation.
“If it did have to happen to one facility, I know my facility is the one that could handle it,” said Rooney. “I have tremendous support from my corporate office. I have a tremendous team. We are managing as best we can, and I think we are doing everything we possibly can do.
“We have grown our facility to be a five-star facility,” Rooney added. “What that means is CMS rates facilities across the U.S., and our facility is actually in the top 10% of nursing homes in the U.S. So, there’s tremendous resources in this community meeting the needs of our elders.”