Two nursing home's unique approach to fighting covid-19

The bonds created during the 75-day lock-in remain strong and motivate compliance with rules. “We built a forever bond,” Williams says. “You cannot hurt someone you care about. You cannot

take a shortcut with someone you care about. We are family." But Moore knows that they must stay vigilant and that their story could have unfolded differently. They planned well, but

sheer luck may have helped spare them, too. Also, if not for the ample space and the support of owners who fed everyone and paid overtime and a bonus stipend to workers during the lock-in,

they couldn't have pulled this off. Because Park Springs is a private organization, Moore cannot share financial information, but says: “I can tell you that we were not focused on the

cost throughout the lock-in.” When it comes to ordering supplies or equipment to keep everyone safe, “we are going to do the right thing regardless of cost." Her heart aches for 

facilities that were hit with COVID-19 outbreaks. “They love their residents, too,” she says. “It's like a wave that knocks you over in the ocean, and you never saw it coming."

DOING EVERYTHING POSSIBLE TO KEEP THE VIRUS FROM RETURNING David Ross sobbed as he drove home from work. It was mid-July, and the 300-bed nursing home that he runs in New Hampshire, the one

that once registered 30 new cases of coronavirus per week, had just reached an important milestone: a week of no new positives. These tears were driven as much from relief and joy as they

were from the accumulation of two months of sadness, pain and frustration. Ross, the administrator of the nursing home, remembers that state representatives wanted to know how a major

outbreak could have happened at Hillsborough County Nursing Home, a nonprofit facility in Goffstown. In May, when the first residents came down with symptoms, the staff administered

coronavirus tests to all residents in one 50-bed unit and rushed samples to the state lab. About half the residents in the unit were positive, most of the rest soon joined them, and the

virus later spread to three more units, infecting 209 people in all, including 57 staff members. Forty-two residents died, but no staff members did. Employees and residents were being tested

each week, although because of an increase in cases in the community, the facility was gearing up for the possibility of twice-weekly tests. When the nursing home is in “outbreak status,”

meaning at least one positive case in the building, about 20 members of the National Guard come in weekly to test everyone, Dubois says. She and other nurses scramble to take over the

testing of residents who are war veterans, not wanting the military uniforms to trigger PTSD. Staff also use a rapid-test machine whenever anyone has sniffles, a headache or other minor

symptoms. The federal government, through the Centers for Medicare & Medicaid Services (CMS), supplied the machine without cost, but the nursing home still must cover the expense of

testing materials. One test runs about $23, Ross says, already costing the nursing home $50,000. Ross understood why the state officials asked their questions, but the answer was simple: His

staff had done what they could with the information and testing protocols available. And while other institutions, like schools and churches, could go virtual, his residents had no place

else to go. “It's not like you could shut us down,” he says. A staff member (in blue) with a team from the National Guard (in white) who were at the Hillsborough facility to help with

testing. Courtesy Hillsborough County Nursing Home Before COVID-19, signs asking visitors with flu-like symptoms to stay out were about the only restrictions on outsiders, Ross says. That

was when 50 visitors a day might stream in, residents gathered in common spaces, and college-student volunteers flitted in and out. Nurses concerned themselves with preventing falls,

aspiration control, managing common contagious infections and keeping surgical wounds clean, says Tonya Dubois, the director of nursing. And even before the pandemic, they followed strict

protocols for handwashing, sanitizing equipment, and proper disposal of needles and other medical gear. While all those priorities remain in place today, “the water has been muddied with

this pandemic,” Dubois says. “It's taken over a large portion of what we do in our building now and how we do things."