By Paul Sisson, Los Angeles Times, July 10 2020
State data shows that a San Diego skilled nursing facility is coping with what appears to be the largest COVID-19 outbreak among nursing homes in the state.
Early Thursday evening, Reo Vista Healthcare Center in San Diego’s Paradise Hills neighborhood updated a short statement on its website, indicating that it had 100 COVID-19 patients, 15 more than it had Wednesday. The total is significantly higher than the next-highest total listed in a database run by the California Department of Public Health, though figures listed in that resource reflect totals from Wednesday, not Thursday.
Though the facility with an estimated 135-bed capacity does appear to currently house the most COVID-19 patients among the state’s 1,223 nursing homes, that has not been the case until quite recently. Though it now has 100 COVID-19 patients, the total for the entire pandemic is 112. The record for the whole pandemic, according to state records, is 205 at a convalescent hospital in Los Angeles.
The burden now being felt by Reo Vista staff is one that has been shared in recent weeks by many area communities.
Chula Vista hospitals have been reporting higher-than-average numbers of COVID-19-related emergency visits and admissions for months, and many attribute the numbers to American citizens and guest workers legally crossing the border when they begin experiencing severe symptoms.
COVID-19 activity continued to follow a more active pattern Thursday with 6% of the 8,950 tests returned to the county health department coming back positive, adding 560 cases to the regional total and pushing the area’s 14-day moving average of positive tests to 6%, a figure not seen since before local testing efforts expanded beyond high-risk groups and those with severe symptoms.
There were 18 new COVID-19 hospitalizations reported Wednesday, significantly fewer than the record-tying 38 reported Tuesday. Nine additional COVID-19-related deaths were reported Thursday, pushing the local total to 415.
Reo Vista has felt the bite of the pandemic deeply.
Curtis White, the facility’s administrator, said in a series of emails Thursday afternoon that the center has worked to change the way it operates since COVID-19 appeared, restricting access to essential medical personnel, locking all outside doors during business hours, screening all staff, curtailing communal activities among residents and requiring staff to follow infection control protocols laid down by the U.S. Centers for Disease Control and Prevention.
Routine testing of all residents and staff has been in place since a baseline assessment occurred on May 28. A second round of all-hands testing on June 16 turned up no significant number of additional infections. According to state data, Reo Vista’s total number of COVID-19-positive residents and staff was less than 11. Citing privacy concerns, the state will not list specific numbers smaller than 11.
It was shortly after a third round of whole-facility testing on June 25, White said, that significant numbers of tests started popping positive. On June 27, Reo Vista notified the state that 13 of its workers were currently infected. That number had been zero just one day earlier. And one day later, on June 28, the skilled nursing facility told the state that 61 of its residents had tested positive, nearly tripling the total of 19 reported just one day earlier.
White said the outbreak seems to have started in the eight-day span after broad-based testing on June 16 but before the next testing interval on June 25. Three patients, he said, were hospitalized in that time frame, and all subsequently tested positive.
“All were located in Reo Vista’s transitional unit, the wing of the facility that holds new residents,” White said. “We don’t know exactly how they or the others became infected.”
Six residents, he said, have died after becoming infected, and four others are hospitalized in stable condition. All others who have tested positive have been isolated at Reo Vista. A total of 33 staff members have tested positive since the outbreak began, with 16 having recovered and the remainder self-isolating at home with mild symptoms.
“This incident underscores the service and sacrifices made by our dedicated team every day,” White said. “We’re grateful for the continued efforts. Our top priority remains the health and well-being of everyone in our facility.”
The administrator did not respond to questions about whether any gaps were found in the facility’s infection-prevention practices. In a statement, the California Department of Public Health said it dispatched a strike team of infection prevention specialists to Reo Vista, working “to help mitigate any further infections and assess for potential exposures.” The organization, the statement added, continues to be “heavily involved in the ongoing situation at Reo Vista.”
The results of the agency’s assessment were not available Thursday, and the agency did not indicate whether the facility might be cited.
Reo Vista does not appear to have been under significant scrutiny prior to the current outbreak.
The facility has a five-star overall rating from the U.S. Centers for Medicare and Medicaid Services, which judges performance based on a wide range of criteria, from staffing levels to safety inspection findings. In 2019, according to the CDPH facilities database, the state agency’s compliance division received 19 complaints about Reo Vista, compared to an average of 40 per facility statewide. All complaints in 2019 were unsubstantitated or substantiated without deficiencies.
Paul Sisson writes for the San Diego Union-Tribune.