System's chief executive says nursing homes should overprepare now for COVID-19
By JULIE MINDA
April 3, 2020
Based in New York City and operating long-term care sites there and in upstate New York, the ArchCare system is fighting to protect its patients and staff from COVID-19 spread in one of the hardest hit regions of the U.S.
ArchCare President and Chief Executive Scott LaRue said the system's facilities are running desperately short of personal protective equipment, especially gowns and full-face shields, and need leads on sources for immediate supply. If the Catholic health ministry "could help us now, we'll commit and will help them when this comes their way," he said. "But right now, the rest of the country has supply, and if we had it here in New York it would make the difference between our staff being able to perform their functions safely and not."
Sponsored by the Archdiocese of New York, ArchCare has five long-term care facilities plus a specialty hospital for medically fragile children, and a residential care home for people with Huntington's disease. It also provides home health care. Most of its footprint is in New York City, but it operates a long-term care facility in upstate New York with one of its two long-term care units for patients with Huntington's disease.
As of April 1, there were nearly 45,000 confirmed COVID-19 cases in New York City, and about 76,000 cases in the state. "COVID-19 virus in New York City is everywhere," said LaRue. "It's now community-spread — and spreading rapidly."
Also, as of April 1, 267 patients at ArchCare facilities and in its programs were confirmed to have COVID-19. Thirty patients in ArchCare facilities or programs had died of COVID-19 complications by April 1. Ten employees at that time had tested positive for COVID-19. Fr. John Anderson, vice president of mission integration at ArchCare, said that if employees test positive, they must quarantine for seven days and have three consecutive days without symptoms before they can return to work. Staff members exposed to colleagues who test positive only self-quarantine if they themselves test positive for COVID-19.
LaRue said, "We're nearly a billion dollars in revenue, with 4,300 employees. And the only thing we're doing — the only thing, every resource and every available person — is fighting the COVID-19 virus." Everything else is coming to a grinding halt.
"I would tell anyone else in the rest of the country if they are not spending every waking moment preparing for what is coming your way, you are making an enormous mistake."
Defending against COVID-19
Around March 5, the system locked down its specialty hospital for profoundly disabled infants, children and young adults, many of whom are on ventilators or other respiratory support. ArchCare has posted guards at the specialty hospital's doors. Only staff can enter the facility. LaRue said, "Thank God, so far there is no COVID-19 within that program. But it is my most serious concern because COVID-19 can be very, very lethal in that unit in particular."
On March 12, ArchCare discontinued visitation at all of its nursing homes. It is taking the temperatures of every staff member at all of its facilities and programs that remain open when they report for work. Employees are required to stay home if they have a fever or any symptoms that could flag the onset of COVID-19. Staff members have been designated as infection control monitors in every facility.
It is working with sister facility Calvary Hospital in the Bronx to offer bereavement services to families. LaRue said in some cases, the rapid lethality of the disease has caught families off-guard.
Dire shortages
LaRue said his top priority is securing personal protective equipment for ArchCare staff. Currently, all staff in health care facilities wear face masks. Those interacting with patients who have COVID-19 wear masks, eye protection, gloves and a gown. But surgical gowns are in such short supply that LaRue said members of his staff are wearing rain ponchos purchased on Amazon. ArchCare is trying to buy surgical gowns from China.
"I just want to be sure when we're done that, we did not leave a single stone unturned in terms of what we could have done to protect our staff or treat and serve our patients," he said.
LaRue said, "We have an obligation — it's part of our mission to help people with COVID-19. I'm so proud of the staff. They are not running from this. They're here to do what needs to be done, but with great fear and anxiety."
Patient volume
The state of New York has mandated that hospitals increase their bed capacity by 50 percent, and LaRue said that in addition to opening temporary hospitals, the hospitals are discharging patients to free up capacity. LaRue said the state also has mandated that nursing homes accept incoming admissions, even if the long-term care facility has patients with COVID-19. ArchCare has added 67 nursing home beds in its facilities to increase its capacity.
LaRue said Cardinal Timothy Dolan, Archbishop of New York City, and ArchCare have been engaging in advocacy efforts to address the inequality between nursing homes and hospitals with respect to the allocation of personal protective gear by government entities. Such advocacy helped to remove a ban prohibiting nursing homes from treating patients with COVID-19 with chloroquine and hydroxycholoquine, LaRue said. Research is underway now to establish the efficacy of the anti-malaria drugs in COVID-19 treatment. LaRue said, "We're trying to ensure that the people we serve are treated with the same respect and have the options that anyone else who comes down with the virus has."
Part of ArchCare's ministry is to support Archdiocese of New York chaplains ministering in hospitals. LaRue said ArchCare has been trying to ensure chaplains employed by the archdiocese can minister in-person to offer the sacraments to people dying of COVID-19 related causes in New York City hospitals. Some hospitals have been putting up barriers to this ministry. Fr. Anderson said the hospitals are reserving scarce personal protective gear for clinicians. ArchCare is trying to ensure that chaplains can get the personal protective equipment needed to safely anoint the sick, hear confession and administer communion to patients at the end of life.
Bonus pay
LaRue said ArchCare sees its staff members and their loved ones suffering amid the pandemic — spouses are losing jobs, there are numerous childcare issues arising. In response, ArchCare has provided $1 million in bonuses for staff members, particularly those working at the bedside.
LaRue said in the intense onslaught of COVID-19, he's seen ArchCare clinicians perform heroically, at great risk to themselves. He's seen selflessness from community members as well. Many have donated personal protective gear and provided moral support. "This is bringing out the bright spots in a lot of people, and we'll have the time to reflect on that when this is all over," he said.
He called on the ministry to lend support with contributions of protective equipment and prayers.
To assist ArchCare with supply, visit LaRue's LinkedIn page and view his plea for personal protective equipment in the "Activity" section of the page.