By Mallory Moench and Lauren Hernández, San Francisco Chronicle, October 9 2020
WATSONVILLE — Information was scarce and access to loved ones restricted Thursday as the worst possible scenario played out for family members of residents of the Watsonville Post-Acute Center — a coronavirus outbreak that has killed nine people and infected 61.
“I’ve heard the new numbers only from the news, not from within. That’s the part that’s scary,” said Catherine Bobeda, 58, of Watsonville as she stood outside. Her 91-year-old mother, Mary Tegenkamp, a resident of the center for roughly two years, tested positive for the coronavirus last week and is in isolation there.
“She’s not showing any signs of COVID, and she hasn’t. No fever, no respiratory, however she’s getting weaker and I think it’s just because of the age and her dementia … and not really knowing what’s going on,” she said.
Santa Cruz County announced the five most recent deaths at the center on Wednesday, calling it a “serious outbreak.” Of those who tested positive, 46 were residents and 15 were staff, public health officials said. The facility is licensed for 95 beds.
Federal and state authorities last year cited the facility for insufficient infection control practices and inadequate staffing.
Even though devastating early outbreaks in nursing facilities abated in past months, the recent spike underlines that the risk still runs high, advocates for the elderly say. California has seen 4,540 COVID-19-related deaths among skilled nursing facility residents, out of 16,427 deaths in the state.
“It is way too soon for Californians to breathe a sigh of relief that their loved ones are safe in these facilities,” said Mike Dark, staff attorney with California Advocates for Nursing Home Reform. “The same problems that existed at the beginning of the pandemic still exist there now.”
Dark said common shortcomings in skilled nursing facilities include understaffing, lack of infection protocols and insufficient protective gear, which could set the stage for a coronavirus outbreak. The cause of the most recent outbreak is still under investigation.
Visitors have been barred from skilled nursing facilities under a county public health order during the pandemic, which is why Bobeda recently bought her mom a cell phone outfitted with Zoom and messenger applications. Now Tegenkamp can chat with Bobeda and her four siblings. On Wednesday night, Bobeda said she had the first video chat with her mom in a long time.
She said despite misgivings with communication, she knows facility staff members are “doing the best they can and they are all working very hard, and they always have.”
Santa Cruz County has recorded 2,535 total coronavirus cases and 18 deaths, according to the county’s data dashboard. This facility’s outbreak was reported Sept. 17 to the county, which deployed a rapid response team to conduct 15-minute tests and contact tracing, spokeswoman Corinne Hyland said. The deaths occurred between Sept. 24 and Oct. 5, Hyland said.
The California Department of Public Health, which is responsible for inspecting and licensing the facility, conducted infection control surveys once in April and once in May and a COVID-19 mitigation plan survey on Aug. 4. From May to September, agency staff visited the site weekly. After the outbreak, infection prevention specialists conducted two onsite visits and submitted a report with recommendations to the facility and local health department. Local agency staff have been onsite daily for the past two weeks to make sure protocols are being followed.
The California National Guard provided emergency staffing because of the high number of infected staff. Earlier this year, the facility was approved for lower staffing requirements due to the pandemic, state records show.
Facility administrator Gerald Hunter directed questions to the county public health department Wednesday. A statement on Watsonville Post-Acute Center’s website said the facility is taking “all necessary cautionary measures” and adhering to Centers for Disease Control and Prevention guidelines.
Dr. David Ghilarducci, the county’s deputy health officer, said in a statement that Post-Acute officials alerted county and state health officials “as soon as the first resident tested positive.”
“Our staff is focused on the outbreak and we will continue to work closely with (Watsonville Post-Acute Center),” Ghilarducci said.
Officials said staff worked with the county’s seven skilled nursing facilities at the start of the pandemic to develop strategies for testing staff and residents, maximizing personal protective gear, containing infections, and responding to outbreaks. Hyland said weekly meetings take place between local officials and facilities to make sure state health department guidelines are followed.
State and federal inspections of Watsonville Post-Acute Center last year reported several deficiencies, including insufficient infection control protocol and inadequate staffing. It had no state or federal deficiencies this year.
Although Medicare reported much above average quality of resident care in the facility, the most recent inspection report from May 16, 2019, documented nine health citations, classified as “minimal harm or potential for actual harm” to “few” or “many” patients. The average for a facility in California is 13.
In the most concerning for a coronavirus outbreak, the report said the facility “failed to assure proper infection control practices” last year.
Medicare said the facility had below average staffing for nurse aides and physical therapists and much below average staffing for registered nurses, who spent 15 minutes with a resident compared to a statewide average of 38 minutes.
The California Department of Public Health also reported inadequate staffing at the facility last year.
“All residents have the potential to be affected by the deficient practice,” read a handwritten note in a plan of corrections signed March 23, 2020. The plan required the administrator to meet daily with a staffing coordinator to review staffing hours and recruit more staff. But the note also says the facility was approved for lower staffing and would apply for a waiver for lower patient-staff ratios through 2021.
Certified nursing assistant Bernardo Jaime, 25, stepped up to the glass doors of the facility on Thursday morning to apply for a job to assist with COVID-19 patients. Jaime, of Salinas, told The Chronicle he saw an urgent job opening on Indeed to work in the facility’s COVID-19 unit and jumped at the opportunity to help people impacted by the coronavirus. He said he was not aware of the extent of the coronavirus outbreak at the facility, but said that does not concern him.
“It’s OK, I want to help people out. I want to be a nurse, and that’s the main goal, you know?” Jaime said.
Mallory Moench and Lauren Hernandez are San Francisco Chronicle staff writers. Email: mallory.moench@sfchronicle.com, lauren.hernandez@sfchronicle.com Twitter: @mallorymoench, @ByLHernandez