Protecting the Vulnerable

The pandemic sweeping through nursing homes statewide reveals a need for change

Nursing homes across the country were hit hard and early by the COVID-19 pandemic, and now as cases spike to their highest levels yet, it’s not unexpected that Lane County care facilities are affected.

In March, many local long-term care facilities, including those in Lane County, were not prepared for outbreaks of COVID-19 due to a bad history of sanitation and health violations. As the state sees a substantial increase in community spread cases, in which people don’t know how they got infected, many facilities lack the proper staff and now struggle to keep the virus at bay. Although some protocols are in place and PPE is available, worker and resident advocates say these outbreaks shouldn’t be happening.

Right now, there are more than 200 long-term care facilities in Oregon with one or more COVID-19 cases. This includes places like nursing homes, memory care and adult foster care homes, according to information from the Oregon Department of Human Services (DHS). In the beginning of the pandemic, roughly 30 or 40 buildings had experienced one or more cases.

“It’s a direct reflection of what we are seeing in the community,” state Long-Term Care Ombudsman Fred Steele says. “My mindset is these cases are going to happen — a single case that reflects society. What really shouldn’t be happening is significant outbreaks.”

Steele says that DHS has protocols in place and keeps in communication with facilities. 

“If they are not following the protocols, that is where we see significant outbreaks,” Steele says.

Avamere Riverpark in Eugene had an outbreak of 12 confirmed cases Nov. 5, including 11 residents and one staff member. According to previous Eugene Weekly reporting in April, Avamere Riverpark has the second most health deficiencies — or violations — in the county. The last recorded health inspection in May 2019 flagged 36 violations, including complaints about being short staffed, residents left on bed pans and utensils not being properly sanitized. Although these facilities are required to remedy these problems, some experts said it was indicative that many homes were unprepared.

SEIU Union Executive Director Melissa Unger says that the continuing pandemic has laid bare the flaws in the way the long-term care industry functions.

“We have to look at COVID as a symptom, or an end result of a longer-term problem,” Unger says. The union represents 50 percent of long-term care workers in Oregon, Unger says, and those workers struggle to make a living wage even though they are on the frontlines of the pandemic.

She says the lack of compensation and support contributes to a high turnover rate in the industry, stretching already thin resources during the pandemic. 

“It’s hard to hire for a CNA [certified nursing assistant] job that’s super hard where you make only a couple more dollars than you make at a grocery store,” Unger says.

Lee Bliven, a former local ombudsman for the county and now an advocate with CareWorks Lane County, says his position as an advocate allows him to be more vocal about issues and what residents share with him regarding their experience. He says he continually hears complaints about employees being short staffed.

“I really don’t know how bad the situation is. The only thing I can tell you is when I talk to residents they are not being fed, and rooms are not being cleaned,” Bliven says. He alleges that because the facilities are for-profit, they often choose money over the wellbeing of residents and employees. 

Bliven argues that DHS needs to put more mandates into place and to better hold long-term care facilities accountable.

In an email, a DHS spokesperson said that because the Oregon Health Authority is responsible for testing and outbreak reporting, some cases associated with care homes may be people not currently at the facility, such as staff who had been working from home. No one from DHS was available to speak as of press time.

DHS also says that, in partnership with the Office of Aging and People with Disabilities, it is closely monitoring the situation, conducting at least weekly onsite visits for more facilities that have a case or suspected case of COVID-19. 

For extra support during an outbreak, the state’s interagency facility support team can step in to help care homes access more PPE and allow residents to choose to receive care while recovering from the virus at what they call a “surge capacity facility.” The interagency support team will also help increase staffing, DHS says.

With her most recent mandate, Gov. Kate Brown is prohibiting indoor visitation to long-term care facilities. This two-week freeze is enacted to mitigate the spread over Thanksgiving.

But as Unger says, although COVID-19 may go away, this pattern of mistreatment needs a long-term solution. 

“All of these issues were all there before COVID. I’m hopeful the government will commit some resources to this,” Unger says.