For seven months, Shady Lane Nursing Home in Gloucester County was a happy exception.
In a state where thousands of seniors have died at long-term care facilities during the coronavirus pandemic, residents of Shady Lane were seemingly spared. A small, government-run, nursing home in East Greenwich, it closed its doors to visitors and outside contractors, instituted a “robust” testing program, and saw not a single resident test positive all through the dangerous days of the spring, its administrator said.
Yet despite the precautions, the deadly virus still managed to make its way into the 60-bed facility. And with disastrous results.
The first positive tests came in early October, after an asymptomatic employee is believed to have brought the disease into the building. Five days later, Shady Lane publicly recorded its first death. By late last month, at least 31 residents and 21 staffers had been infected with COVID-19 — and 13 residents had died of its complications, according to the state.
At the time of the outbreak, Shady Lane housed 48 people, federal data shows, meaning that nearly two of every three residents were sickened — and more than a quarter lost their lives. That came as New Jersey is grappling with a second wave of the coronavirus that has not bypassed the state’s nursing homes, which were devastated in March and April and where tens of thousands of vulnerable seniors continue to live.
In the past three months, coronavirus infections have leaped among long-term care residents and staff in New Jersey, an NJ Advance Media analysis of state data showed. So have deaths, another troubling sign of the reinvigoration of a pandemic that ripped through underprepared nursing homes in the spring, causing some of the highest rates of death in the nation.
And state officials and epidemiologists warn the coronavirus’ spread is likely to only get worse as the winter arrives.
In September, 659 residents and staff tested positive for the virus across New Jersey’s long-term care facilities, the review found. In October, the number of new positive tests climbed to 1,137, an increase of 73%. It rose even more dramatically in November, when 3,264 residents and staff tested positive — nearly five times the number from just two months before.
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Deaths, meanwhile, more than doubled. There were 45 deaths recorded at long-term care facilities in September, 65 in October and 111 in November. Among those were three facilities that logged more than 10 deaths, according to the data — including Shady Lane, which said it had taken steps to protect its residents by sanitizing, using proper protective equipment and following social distancing rules.
“Despite all of these measures, Shady Lane Nursing Home experienced its first positive COVID results on Oct. 3,” Michelle Baylor, the home’s administrator, said in a statement. “It sadly has caused subsequent cases and deaths at our facility.”
Shady Lane, which is run by the Gloucester County Improvement Authority, had two infection control inspections by the Department of Health after the outbreak and no deficient practices were found, Baylor said.
“At this time, we have zero positive COVID-19 cases at our facility,” said Baylor, who put the number of infections in the outbreak at two more than the state’s figures. “In total we have had 54 cases and 40 residents and staff have recovered fully. One staff member continues to recover at home.”
The Department of Health does not make it easy for the public to track how the coronavirus is spreading in the state’s nursing homes. While the department regularly maintains a list of facilities with outbreaks, those lists do not show whether a given facility has seen cases increase from the previous list, and the department does not make archived versions available on its COVID-19 information dashboard for comparison.
Further complicating the picture, since July the state has routinely culled its list by removing any facility that has been coronavirus free for 28 days, presenting another hurdle in assessing the breadth of the disease’s reach.
From September through Wednesday, the department published 28 outbreak lists, at a time when the number of facilities with active outbreaks skyrocketed, growing to 359 at week’s end, more than double the 156 of Sept. 2.
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To count increases in new cases, NJ Advance Media compared each of those lists to capture whenever a facility logged new deaths and new resident or staff infections. That offered a fuller picture of the recent spread in nursing homes, assisted-living centers and other facilities for seniors, which have struggled to keep the virus out of their midst.
In total, staff members accounted for 57% of new cases and residents 43%. Over the three months, 83 facilities recorded 221 COVID-19 deaths, three of which were staff.
The Department of Health did not respond to written questions for this article. Gov. Phil Murphy’s administration has expressed concern over rising cases in nursing homes, and on Monday, it announced beefed-up measures that temporarily require long-term care staff to be tested every other day for the coronavirus. Visitors, as well as residents who frequently leave facilities, are also now required to be tested as they enter.
In unveiling the initiative, Murphy cited a surge in New Jersey that is expected to follow the Thanksgiving holiday and said the state fears “a spike in cases among staff or among returning residents who went to be with their families.”
“Making sure that this virus is kept out of our long-term care facilities is a paramount concern,” Murphy said.
The nursing home industry acknowledged that cases are ballooning, but said facilities are better prepared than before, and have stockpiled personal protective equipment and instituted protocols for testing residents and staff and isolating those who are sickened. Visitors, which were already limited, have been largely curtailed as the disease has surged across the state, the industry says.
“Clearly, there’s an increase in community spread and clearly there’s an increase in cases in nursing homes,” said Dr. Stuart Shapiro, the interim president and chief executive of the Health Care Association of New Jersey. “The latter generally follows the former.”
Shapiro said nursing homes are working to lessen the impacts of the second wave, while awaiting plans nationally to distribute vaccines as soon as later this month. On Tuesday, an advisory panel of the Centers for Disease Control and Prevention recommended that the first vaccines go to health care workers and residents of long-term care facilities, saying they are the highest priority given their vulnerabilities.
Shapiro called the increase in cases concerning, but said he could not say whether they will continue to rise this winter.
“The goal is to reduce sickness and death to the maximum extent possible,” Shapiro said. “I’m not going to predict the slope of the curve at this point.”
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The increasing infections show the dangers of the asymptomatic spread of the disease, as it is brought into nursing homes by those who are unaware they are sick, said Theresa Edelstein, a senior vice president at the New Jersey Hospital Association, which also represents long-term care facilities. She said the state’s new testing efforts will hopefully catch more of those cases and help tamp further spread.
“These facilities are parts of the communities where they are located,” Edelstein said. “So what is happening in the community is also happening in the facility.”
The pandemic’s first wave hit nursing homes hard as it caught them, the state and the country flat-footed, flooding New Jersey’s hospitals and morgues. Nearly 45% of New Jersey’s more than 17,000 confirmed and probable coronavirus deaths have been attributed to long-term care facilities, and the state has consistently ranked first or second in the United States in the number of nursing homes deaths per capita.
Yet despite nine months of experience with the disease, nursing homes continue to see it creep into their buildings.
In October, state regulators took the rare step of barring one Somerset County facility from accepting new admissions after a widespread outbreak there. Somerset Woods Rehabilitation and Nursing Center was also ordered to hire outside experts in infection control and nursing home administration to ensure the facility was adequately protecting residents and staff.
From September through October, the 148-bed facility in Franklin Township recorded 11 deaths — on top of at least two earlier deaths — with 77 residents and 15 staffers testing positive for the virus, state data shows. That’s out of a facility that housed about 115 throughout the summer, according to federal tracking — suggesting that two-thirds of residents contracted the disease.
Steven Schwimmer, Somerset Woods’ administrator, did not respond to requests for comment. In a message posted on the home’s website on Nov. 27, he called it a “very difficult time for all of us” and said the facility hoped to get “back to normalcy as soon as possible.”
“There were zero residents and zero staff that have tested positive for COVID-19 this past week,” Schwimmer wrote. “Our current COVID census continues to remain at zero. We continue to follow our guidelines in isolating any resident that develops symptoms for COVID-19 or tests positive for the virus. We remain vigilant in fighting and isolating the virus to the best of our abilities.”
In South Jersey, Cumberland Manor Nursing and Rehabilitation recorded 15 resident deaths in the past month, plus another death that was added to the state’s outbreak list on Friday. In total, 71 residents and 39 staff tested positive for the disease, out of a facility in Bridgeton that federal records show housed 157 residents in the weeks before the contagion.
“State surveyors have been to our facility twice during the outbreak, and confirmed during both visits that the facility has followed and is following all protocols,” Steve Brodt, Cumberland Manor’s administrator, said in a statement. “Although we are deeply saddened by the impact of this virus, we are committed to do all that is possible to limit that impact.”
Brodt said the facility has been working with state and local health officials and has been keeping residents and their families informed of developments.
He looked forward to the future, when there is “a vaccine that can truly protect our residents and staff from this terrible virus.”
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Riley Yates may be reached at email@example.com.