Cedar Rapids facility defies norm, heads for recovery after coronavirus outbreak

CEDAR RAPIDS - In the past several weeks, as the novel coronavirus makes its way into long-term care facilities across the state, the number of cases climbs quickly once a center reaches outbreak criteria.

But Cottage Grove Place in Cedar Rapids is one of only a couple long-term care facilities in the state that have kept their case counts in the single digits even as they retain outbreak status.

One of the largest senior living centers in Cedar Rapids, the facility reported its first cases of COVID-19 among residents in its skilled nursing wing. By the end of April, the virus had spread, prompting Cottage Grove Place to become the fifth site of a coronavirus outbreak at a long-term care facility in Linn County.

The facility currently has seven total cases, including four residents and three staff. Two residents have died as a result of the virus.

Officials note that the state's total case count on its official coronavirus website is incorrect.

The last time Cottage Grove Place saw a new case was April 29, said Amber Taft, director of nursing.

'If we continue to go down this path without any cases, we will be considered out of outbreak criteria,” she said.

As of Saturday morning, the state reported 39 coronavirus outbreaks at long-term care facilities across the state, which is defined as three or more cases among residents and staff.

More than 1,550 individuals who tested positive are tied to those outbreaks. Of those, 247 have died and 704 have recovered, according to Saturday's data.

However, there have been discrepancies in the state's official count on its coronavirus website. On May 27, two days before, the death toll related to long-term care facilities was 256 on the state's website. In addition, the state's count of positive tests among residents and staff was more than 1,600 on Wednesday.

As of Thursday, Linn County is reporting outbreaks at four long-term care facilities, including Cottage Grove Place. Other facilities on the list are Living Center West, Linn Manor Care Center and ManorCare Health Services of Cedar Rapids.

This past week, another Cedar Rapids skilled nursing center that reported the worst coronavirus outbreak among long-term care facilities in the state, announced it officially had 'recovered” from an outbreak.

Heritage Specialty Care, the first long-term care facility in Linn County to report an outbreak, has seen no new cases of COVID-19 among residents and staff in two consecutive incubation periods of the virus, or 28 days.

As a result, the facility officially was removed from the state's list of outbreaks at long-term care centers.

McCreedy Home, a senior center in Washington County, also disappeared from the state's count of long-term care facility outbreaks this week.

‘Aggressive steps'

Cottage Grove Place officials say they are heading toward that same designation, having experienced no new cases among residents and staff since the end of April.

Officials there attribute this, as well as their success to keeping the virus contained to only a handful of individuals, to their mitigation efforts that go beyond requirements from federal and state public health authorities.

'We took aggressive steps to get ahead of it,” said Mark Bailey, executive director of Cottage Grove Place.

Cottage Grove Place created its own isolation ward within the facility by erecting a wall between the ward and the rest of the skilled nursing wing. The ward, which houses 14 private rooms in one hallway, has its own entrance and a dedicated group of staff members who only work with patients in isolation.

The facility has another group of staff members on standby waiting to take over, should enough staff fall ill and are unable to meet the needs of the residents within the ward, Taft said.

Taft noted that Cottage Grove Place may have more resources than other long-term care facilities, and stated the community's medical director had previous experience addressing infectious disease outbreaks in other centers.

Any new admissions into the facility are required to stay in isolation for 14 days.

Current residents are proactively moved to the isolation ward whenever they exhibit symptoms of any kind. Even if the symptom isn't a typical indicator of COVID-19, Taft said if it is out of the ordinary for that patient, the individual is moved into insolation.

That is on top of twice-daily screenings of staff and residents across the facility and the closure of communal spaces. Visitors have been barred from the facility since the beginning of March.

Officials have not required testing among the staff who care for residents, instead advising those employees to stay home when feeling ill and to seek out a test on their own should they believe it's necessary.

'We've taken the stance that staff needs to make the decision for what's best for them,” Bailey said. 'We're not going to dictate that, we want them to have control of their own medical decisions and do what's best for them.”

Concerns

But the family of one Cottage Grove Place resident is fearful that a lack of testing among staff could pose danger to their loved one, a Cedar Rapids woman who lives in the facility's memory care unit. The family requested she remain anonymous.

Paul Schuller, a 62-year-old who lives in Washington State, said he has raised these concerns to leadership at the facility. Without widespread, regular coronavirus testing of the staff, he said there could be asymptomatic individuals spreading the virus before the facility is aware of it, thus putting residents such as his mother at risk.

'Of all the businesses out there, I feel nursing homes need to take the extra precaution and need to function on a basis of fact. Testing does that,” Schuller said.

Schuller said Cottage Grove Place's strategy to wait to test until someone shows symptoms seems 'ill-equipped, especially for a nursing home.”

Schuller pointed to a new executive order issued by the governor of New York, which requires nursing homes to test all staffers for COVID-19 twice a week, as the standard for what should be done in Iowa and other states.

'It spreads so quickly in a nursing home, and the nursing home is where we need to test the staff,” Schuller said. 'Why don't we test the staff?”

Despite their concerns, Schuller said he and his five siblings decided not to move their mother out of the facility. She has been a resident in the community for more than a decade.

Cottage Grove Place officials say they plan to continue the facility's mitigation efforts for the foreseeable future. They intend to reassess whether to ease some restrictions after the first week of June, but Bailey said they are not going to change procedures until the number of new positive cases across the states declines.

'I would say we would stay in precautionary methods until further notice,” Bailey said. 'We will not open until we're positive we can safely protect residents and staff.”

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