Most residents at Olympia memory care facility have tested positive for COVID-19
The majority of residents at Garden Courte Memory Care, an assisted living community in Olympia, have now tested positive for COVID-19, data and information from facility leadership shows.
A weekly data report from Thurston County with numbers current through Sunday, Oct. 25, showed a total of 50 residents and 27 staff members had tested positive, and that three deaths were connected to the outbreak.
Though an Oct. 27 update posted to the facility’s website showed lower case numbers, the county COVID-19 spokesperson confirmed Wednesday that the Public Health department believes its case counts are accurate.
In total, Nanette Wilkins, director of operations for the facility, told The Olympian that the facility is home to an average of about 60-62 residents and employs a staff of roughly 55-60. Using those totals and county numbers, that would leave just 10-12 residents who hadn’t tested positive as of Sunday.
“I think it’s important that the community know that we have been working very closely” with Thurston County Public Health and the state, Wilkins said.
Garden Courte’s outbreak is one of six ongoing outbreaks in congregate care settings as of this week in Thurston County, where there have been 16 outbreaks total since the pandemic began. The ongoing outbreaks accounted for 123 cases and four deaths as of Sunday, according to the county.
The Tuesday update from Garden Courte also included four additional deaths, for a total of seven. Of the 10 deaths the county reported between Monday and Tuesday, nine of them were associated with outbreaks at long-term care facilities, according to spokesperson Magen Johnson.
After the first two congregate-care setting outbreaks in Thurston, the local Public Health department stopped identifying facilities by name, with the exception of an outbreak at the county jail. In general, the county’s COVID-19 spokesperson has cited a policy that they won’t share the site of an outbreak unless there’s a threat to public health.
In the case of Garden Courte, though, Johnson said the name was shared because the county reported its biggest jump in new cases in a single day — 47 — and it was part of the explanation. Garden Courte accounted for 28 cases that day.
The state maintains a list of skilled nursing homes and assisted living facilities with reports of open COVID-19 cases, using information available to the Aging and Long-Term Support Administration.
Facilities such as Garden Courte have been a concern for public health officials since the beginning of the pandemic, when the coronavirus made a brutal debut at Life Care Center of Kirkland and 39 residents died of complications related to the disease within four weeks.
The communal settings and high-risk populations put residents of long-term care facilities at increased risk for severe illness from the coronavirus.
Statewide, as of Oct. 26, 8% of total cases and 55% of total deaths had been associated with a long-term care facility, according to a broad count from the Washington state Department of Health that includes employees, residents, and visitors, not all of whom were exposed at a facility.
Candace Goehring, director of the Residential Care Services division of the state Department of Social and Health Services, said that numbers of cases and deaths from COVID-19 in long-term care facilities have mostly trended downward since a “huge spike” in March and April. Data showing that trend is available in the state’s latest COVID-19 Long-term Care Report.
“From our perspective, facilities are working very hard to do whatever they can to remain COVID-free. And when they do have an outbreak in their facility, then they are, again, working really hard to make that outbreak under control,” she said in an interview with The Olympian last week.
But, Goehring said, it’s important to be “vigilant as ever about the transmission risk and the vulnerability of people in long-term care facilities.”
With COVID-19 transmission rates in the area on the rise, local public health officials have expressed concern about the potential for staff members to bring the virus into the facilities from the community. In her most recent letter to the community, Thurston County Health Officer Dr. Abdelmalek included that the county’s death rate is rising “in large part due to outbreaks in our long-term care facilities.”
The Garden Courte outbreak
According to its website, Garden Courte offers care for people with Alzheimer’s disease and other forms of dementia as well as respite care. Wilkins said these residents cannot be completely isolated, which presents a challenge for infection control.
They’re a mobile group, she said, who do not stay in their rooms, making it “nearly impossible to stop the spread.”
Candace Goehring, director of Residential Care Services division of the state Department of Social and Health Services, confirmed that concern in an interview with The Olympian.
Goehring didn’t comment on Garden Courte specifically, but said facilities with memory care units or that are devoted to memory care generally hold greater risk for transmission and have resulted in larger outbreaks.
It doesn’t mean those facilities haven’t been providing “just as good of care,” she said. People with dementia or other cognitive impairments, she said, may not be as cautious, and a facility cannot just lock residents in their rooms or keep them from walking around the building.
An asymptomatic Garden Courte staff member notified the facility they had tested positive for COVID-19 on Sept. 30, according to a letter from Wilkins to families posted on its website. The staff member was taken off the schedule and tested positive again Oct. 3, according to the letter.
As of last week, staff and residents in the facility had been tested three times, according to county spokesperson Johnson: The facility conducted testing Oct. 5, and Public Health staff collected the tests from the facility and delivered them to the state lab that day. County Public Health conducted testing Oct. 13 and 20.
Staff who tested positive quarantined at home, according to the letter, and residents who tested positive were separated from those who tested negative, who were asked to isolate in their rooms.
Garden Courte had been allowing visitors in accordance with the state’s Safe Start plan, according to Wilkins, but visits were immediately discontinued in light of the outbreak.
The facility is trying to accommodate visits through windows, she said, but the first priority is making sure there’s adequate staff to care for the residents and it can be hard to pull staff away for the visits.
Small-group activities and congregate dining also were halted, and additional precautions were introduced, including a kiosk that takes staff and residents’ temperatures.
State and county health officials inspected the facility for infection control, Wilkins said, and gave some direction for improvements but were overall “happy with what we had been doing to try to stop the spread,” she said.
When asked to confirm that statement last week, county spokesperson Johnson responded via email with this statement:
“Thurston County Health Officer Dr. Dimyana Abdelmalek has been partnering with the management of Garden Courte Memory Care to support their efforts to contain the outbreak and spread of COVID-19 in their facility. She participated in a follow-up walk through of the facility in conjunction with the State Department of Health to inspect the infection control processes and procedures and provide additional directions and guidance for areas of improvement.”
The email also included a prepared statement attributed to Health Officer Abdelmalek:
“An outbreak in a long-term care facility is always difficult because the residents are often the most vulnerable population to the virus. On Tuesday we deployed our strike team to the facility to conduct COVID-19 testing of all residents and employees. The facility will continue to have weekly testing until the outbreak is resolved.”
An investigation underway
The state Department of Social and Health Services placed the facility in “stop placement” on Oct. 22 until an investigation into the outbreak is complete, DSHS spokesperson Chris Wright wrote in an email to The Olympian. So it can’t accept any new residents until that’s lifted.
Facilities have to report positive COVID-19 cases to their local health jurisdiction and to Residential Care Services, according to Candace Goehring, director of RCS, the regulatory body for long-term care facilities within DSHS. The local health department does contact tracing and public health work, and RCS does the regulatory work.
When facilities or members of the public report any concerns to RCS about care or services, the reports are triaged, Goehring said. Any report of COVID-19 is treated as the most critical type, referred to as “immediate jeopardy,” and an investigation is initiated within two days, Goehring said.
It can take a few days to determine whether there was any breach of infection-control practices that would increase the risk for spread in a facility, she said. In COVID investigations, Goehring said that, more often than not, there hasn’t been a failed practice.
“We are going out intending, you know, to provide technical assistance and consultation, when that’s appropriate,” Goehring said. “And when we have found cases of immediate jeopardy, then we have cited.”
If investigators find a facility isn’t in compliance with a regulation, they write a “statement of deficiencies” that lays out the failed practice, and the facility has to provide a plan of correction, Goehring said. Then RCS visits again to verify compliance.
Reports from investigations and routine inspections from the last few years are archived online. Available reports show Garden Courte has been fined twice in recent years — a $500 fine in May 2018 and a $100 fine in January 2018.
The May fine stemmed in part from the facility failing to have a system to complete fall risk assessments when there was a change in condition for two residents and failing to “institute appropriate prevention and safety measures” for three residents “when reviewed for falls.”
Those failures, according to public record, were found, in part, to have allowed a resident to suffer a hip fracture and two others to fall repeatedly and kept staff from “having accurate information related to fall risk.”
The January fine stemmed from the facility failing complete a “specifically focused assessment” to identify the needs of a resident to guide their care, which was found to have allowed them to develop a pressure ulcer “requiring additional wound care and medical interventions.”
Resources for families
A website specifically for family members of residents in long-term care facilities is maintained by DSHS and includes answers to frequently asked questions: https://bit.ly/3kFrCIM.
Making a complaint
Complaints to the RCS Complaint Resolution Unit (CRU) can be submitted over the phone at 800-562-6078, or online: https://bit.ly/31O9kxy.
Telling your story
If you or a loved one has experienced one of the outbreaks in Thurston County firsthand and you’d like to share your story, please reach out to The Olympian at news@theolympian.com.
This story was originally published October 29, 2020 at 5:45 AM with the headline "Most residents at Olympia memory care facility have tested positive for COVID-19."
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