Inspectors: MediLodge failed to follow virus protocol
ALPENA — Staff members at MediLodge of Alpena — where 92 residents and employees have been infected with the coronavirus and nine infected residents have died — did not follow many safety protocols designed to prevent the spread of the disease, state regulators say.
The Michigan Department of Licensing and Regulatory Affairs also criticized the facility’s administrator for continuing to work after being exposed to the virus, according to reports posted on the LARA website.
While LARA says MediLodge’s “deficient practice resulted in the potential for the spread of COVID-19,” the agency does not explicitly blame any infections on the safety lapses and says residents at facilities with safe practices may still get infected.
MediLodge of Alpena told LARA it had trained staff on safety regulations and defended the administrator’s decision to continue working as allowable under federal guidelines for critical workers, according to state documents.
Bill Gray, corporate spokesman for MediLodge, refused to comment. No one at the Alpena facility could be reached for comment.
Hearing stories about outbreaks in nursing homes, and knowing 61 residents at his mother’s facility have gotten sick with COVID-19, Alpena’s Randy Neumann is surprised his 97-year-old mother hasn’t contracted the virus, he admitted.
While he said he trusts MediLodge and its staff, he wonders if he ought to consider moving his mother somewhere else.
“Once she would get it, then you think in your mind, ‘Why didn’t I do that?'” Neumann told The News.
The MediLodge inspection, completed May 12 and 13 by LARA’s Bureau of Community and Health Systems, was conducted as part of a statewide effort to assess all long-term care facilities for COVID-19-prevention measures.
Of 475 facilities surveyed statewide, 123 received citations for violating infection control policies, LARA says. Six surveys are still in process.
Between March 2 and July 8, LARA received 439 complaints alleging infection control violations across Michigan nursing homes. The MediLodge of Alpena inspection addressed specific complaints against the facility by the Alpena-area public health officials.
After the LARA inspection, MediLodge of Alpena was cited for four violations of infection control regulations regarding proper sanitation of equipment, hand hygiene, and use of personal protective equipment.
At the time of the inspection, 55 residents and 27 staff members had tested positive, with seven residents dead.
Several specific incidents were cited by the publicly available report.
In one case, while inspectors were present, certified nurse aides used a lift to transfer a resident who had not been tested for COVID-19 onto a bed and then took the lift into the hallway, neglecting to wipe it down before going about their duties.
Another staff member assisted a resident with toiletry care, then left the room to get linens without performing hand hygiene, the report said. That resident had been diagnosed with COVID-19 a month prior to the incident.
A registered nurse tending to an uninfected resident pulled off an exterior gown while exiting the room, exposing a gown underneath that had been used to care for infected patients. The gown was then hung up on the door of the resident’s room for reuse with the same resident.
The resident had tested negative for COVID-19, but lived in B Hall, which MediLodge administration said was, at that time, the COVID-19-active hall.
On the same day, a nurse was observed leaving the room of a resident with suspected or confirmed COVID-19, removing her face shield and hanging it in a bag alongside other bags holding uncontaminated masks and gowns.
The bag was not marked to ensure other employees would know the mask had been contaminated.
MediLodge provided LARA written policies, proving staff was required to observe proper hygiene procedures and to properly handle personal protective equipment, medical supplies, and other objects used in patient care.
MediLodge also told LARA the employees cited in the inspection received followup training.
Management will monitor staff for compliance and make regular reports to LARA, the plan stated.
None of the patients specified in the incidents noted by LARA inspectors showed symptoms of COVID-19 in the days following the incidents, according to MediLodge.
Ossineke resident Tom Jarvi, who fills bird feeders and feeds chipmunks outside his 90-year-old mother’s room at MediLodge of Alpena daily, said he’s not scared for her safety.
She tested positive for COVID-19 in April, he said, and was nursed back to health by caretakers who fed her by spoon when she was unable to eat on her own.
“I think they really care about the people they work for,” Jarvi said.
As of Wednesday, 61 residents — 46% of the facility’s capacity — and 31 staff members had tested positive for the coronavirus. That’s equal to 83% of the infections attributed to Alpena County, and the nine MediLodge residents who died equal 82% of the county’s deaths.
A complaint dated May 7, filed by a District Health Department No. 4 employee, alleged MediLodge of Alpena Administrator George Sobek had close contact with an infected person but continued working and refused testing for himself, state records show.
A representative from the Health Department told the administrator he needed to quarantine and several times challenged his decision to continue to work, the Health Department told LARA.
Sobeck provided LARA a letter from the Michigan chief medical executive, Dr. Joneigh Khaldun, addressing guidelines for health care staff with known exposure to COVID-19.
“There is no requirement for 14-day quarantine of healthcare workers with high risk exposures,” the letter stated.
At the time, the letter said, the state advised against testing asymptomatic people — including health care workers — even if they had been exposed to COVID-19.
According to current guidelines by the U.S. Centers for Disease Control and Prevention — which were also in effect at the time of the inspection — health care workers with prolonged, on-the-job exposure to COVID-19 when not properly protected by personal protective equipment should stay home from work for two weeks and get tested if they develop symptoms.
However, health care employees classified as critical infrastructure workers may remain on the job even if they are exposed, as long as they don’t develop symptoms of the illness.
The administrator said he classifies as critical because he needed to address fears of staff, residents and their families, and the community.
He was also needed onsite, he told LARA, because of the extensive logistical requirements created by the pandemic, especially in the facility’s interactions with medical facilities, service providers, and government agencies as regulations were being updated up to several times a day.
Staff members who showed symptoms of COVID-19 stayed home, MediLodge reported, and extra staff had been called in to work in specific portions of the facility to avoid cross-contamination.
Sobeck told LARA the Health Department never told him he was not allowed to work.
The administrator, also a registered nurse, sometimes helped with patient care, allowed by CDC guidelines to mitigate health care personnel staffing shortages, MediLodge reported.
Though not showing symptoms or required to do so, the administrator was tested for COVID-19 on May 14. It isn’t clear from the LARA records whether he tested positive.
As of June 15, the state requires all residents and staff of long-term care facilities to be tested for COVID-19.
OTHER FACILITY CITED
Lincoln Haven Nursing and Rehabilitation Community, which has reported no infected residents or staff, was also cited by LARA for several violations.
Staff members at the 39-bed facility were observed cleaning rooms of two residents in isolation after virus exposure without proper personal protective equipment or hand-washing and without following proper sanitation procedure, state records show.
The facility promised training and improved supervision of workers in response.
Lincoln Haven was also the subject of four investigations since September 2019, prompted by complaints regarding cleanliness, physical safety of residents, and improper handling of paperwork leading to resident endangerment.
No violations of COVID-19-related safety protocols were discovered during LARA surveys at other nursing homes in Northeast Michigan, also completed in April and May. Adult foster care homes and assisted living facilities have different reporting standards and were not included in the survey.
MediLodge of Rogers City, which received no citations from the mandated COVID-19 inspection, has one resident and one staff member who have tested positive for the illness.
Julie Riddle can be reached at 989-358-5693, firstname.lastname@example.org or on Twitter @jriddleX.
To file a complaint
To file a complaint or ask for help regarding a long term care facility:
Speak to facility staff
Email the Michigan Department of Licensing and Regulatory Affairs Bureau of Community and Health Systems at BCHS-Complaints@michigan.gov.
Call the LARA complaint hotline at 800-882-6006.
Call for free and confidential help from the Michigan Long Term Care Ombudsman Program at 866-485-9393.
Check out Monday’s edition of The News for a look at how families have adapted to coronavirus-related restrictions at nursing homes.