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An Action News Investigation analyzed data to see which local facilities had a history of infection control problems.
The American Health Care Association, which represents nursing homes, called COVID-19 a perfect killing machine of the elderly.
And, with cases in nursing facilities, the rising potential spread of the virus is leaving families with loved ones in homes on edge.
Mirian Williams' 93-year-old mother suffers from congestive heart failure and upper respiratory problems.
She lives at ManorCare Health Services in Yeadon, Pennsylvania.
"I am concerned because I can't check on my mom," said Williams.
Medicare and Medicaid gave the nursing home a 1-star rating for overall care, the worst designation.
Action News found health inspectors cited the home for poor pest control earlier this year.
"We've seen a lot of unclean conditions there, under-staffing, German cockroaches, insects flying around and mice," she added.
Inspectors also cited ManorCare Yeadon for poor infection control in September of 2018 and October of 2019.
With nursing homes locked down to visitors, the family is concerned.
"My mother is 100% dependent on ManorCare Yeadon," said Williams.
An Action News Investigation analyzed data to find out which nursing homes had a history of infection control problems.
Despite ManorCare Yeadon's 1-star rating, Action News found ManorCare is not even our region's nursing home with the most infection control related citations.
Infection control covers a wide range of nationally recognized standards.
The Investigative Team did a deep dive into state inspections over the last five years and found these nursing homes had the most citations in our area for either failing to have adequate infection control plans or failing to implement them properly.
We found these facilities cited four times during the five-year analysis: New Castle Health and Rehabilitation in Delaware, Atrium Post Acute Care of Woodbury in New Jersey and Immaculate Mary Center for Rehab and Healthcare in Philadelphia.
New Castle Health and Rehabilitation had its last citation in 2017.
ManorCare Health Services Pike Creek in Delaware and Brinton Manor Nursing and Rehabilitation in Pennsylvania were cited three times, most recently in March 2019.
Martin Kardon, an attorney and nationally recognized expert in the field of elder abuse and neglect said people are placing their trust in nursing homes to incorporate best practices, provide quality care and prevent a COVID-19 outbreak.
"I'm concerned that with the coronavirus out there, some of these places are going to consider it a free pass to fall asleep on the job," Kardon said.
He acknowledges there are challenges.
"It's hard to keep people healthy when they're bunched together with everyone else," said Kardon.
The Action News five-year data analysis found of the 25 most cited nursing homes for infection control in our region, 20 were for-profit corporations and partnerships.
Advocates for the elderly will tell you nursing home staff are poorly paid and overworked, but they're on the front lines for the elderly in this outbreak.
Dr. Thomas Lawrence, who is the director of geriatric medicine for Mainline Health, said a lot has been learned since a COVID-19 outbreak at a nursing facility in Washington state.
"It was a medical mess...literally a disaster," he said.
So far, nearly three dozen people have died there.
Dr. Lawrence said handwashing, restricted visitation and screening for symptomatic patients and employees are critical.
"The message to nursing home staff: isolate and keep yourself away from people because you have a duty to care," said Lawrence.
Lawerence also said that for nursing homes meeting the CDC requirements, "the safest place to be actually is in the hallways of a nursing facility where the staff has been screened coming in and the residents have not had travel exposure."
New Castle Health and Rehabilitation, Immaculate Mary Center for Rehab and Healthcare and Brinton Manor Nursing and Rehabilitation did not respond to Action News' requests for comment on our findings.
ManorCare released the following statements:
"ManorCare Yeadon and Pike Creek cleared their previous citations and are currently in compliance with those infection control citations. The infection control citations did not have any harm in scope or severity. We take all surveys seriously and whenever there is a citation, such as infection control, the process to correct that deficiency requires heightened focus on training and self-auditing."
Specific to COVID-19, we have followed and implemented the Centers for Disease Control (CDC) and state recommendations to limit exposure and reduce risk of our vulnerable population. These recommendations include restricted visitation, temperature and symptom checks for entry by anyone entering the center including vendors, employees and authorized visitors. We have also increased our screening and monitoring of patients for fever and respiratory symptoms and reaching out to family and friends to inform them of our processes."
As for the pest citations at ManorCare Yeadon:
"Last year, we did have a pest issue resulting from water issues. We have since corrected the issue, regraded the area and improved the drainage. While we are still working through this issue, we feel we have had excellent results and believe this will soon be completely remedied," ManorCare said.
The spokesperson also said they've been in contact with families since the visitation restrictions went into place and have had many satisfied families on the phone, Skype, Facetime, and visiting through the windows of the center.
"We have an iPad on its way to the center for additional social engagement with loved ones. We realize the COVID19 concerns and our visitation restrictions are causing a lot of stress for everyone and we appreciate our families' and residents' patience as well as our employees' commitment as we work through this together. We are here to make it as easy as possible during this time," ManorCare added.
Atrium Post Acute Care of Woodbury, a Spring Hills managed facility, told us they take the prevention of infection very seriously:
"As two of the listed deficiencies occurred before the management change, we knew that we had quite a bit of work to do to bring this building to its current deficiency-free status as it relates to infection control.
The remaining two deficiencies occurred in our first year of management while evaluating what changes needed to be made. Seeing this, we brought in a new Administrator, Patricia Hedeman.
In September 2019, she received a letter from the Department of Health that stated, "we have accepted your plan of correction and find that as of September 30, 2019, your facility has achieved substantial compliance with all participation regarding the deficiencies stated on the August 9, 2019 survey."
As part of her efforts to correct these deficiencies, Mrs. Hedeman hired a full time Infection Preventionist, Dr. Pat Madden, who has come to Atrium after being the Corporate Director of Nursing for Jefferson Hospital.
Since Dr. Madden was hired, we have invited the Department of Health into the facility to see the changes we are making which includes the development a Sepsis Program designed to identify high-risk patients and treat prior to sepsis, preventing the need for re-hospitalization."
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Action News Investigation: Local nursing homes cited for infection control before COVID-19 outbreak