The Mount Airy nursing home where a man in his 90s died as a result of an outbreak of the new coronavirus received the lowest rating possible from Medicare, largely due to staffing.
The man died Saturday night at the Pleasant View Nursing Home, the same night state and Carroll County officials announced the outbreak there, which has sent 17 others to two local hospitals and resulted in 66 positive tests for the virus among residents.
Carroll County officials said all residents of the 104-bed comprehensive care facility have been tested, as well as any staff members with symptoms.
The man who died had “a lot of underlying health conditions,” Carroll County Health Officer Ed Singer said at a news conference in Westminster on Sunday. Some of the residents who tested positive did not show any symptoms, he added.
As the coronavirus pandemic sweeps the nation, outbreaks in retirement communities and nursing homes are of particular concern because people over 60 and those with underlying health conditions are at greater risk for developing serious and life-threatening complications from the resulting COVID-19 illness. One of the first such outbreaks killed 35 residents in a nursing home in the Seattle suburb of Kirkland, Washington.
Professor Jennifer Nuzzo, a senior scholar in the Johns Hopkins Center for Health Security, said the Mount Airy outbreak was deeply worrisome.
“Long-term care facilities house people who are the most vulnerable to severe illness and death from infection with this virus,” Nuzzo said. “Were there to be more outbreaks like this, it could easily overwhelm local health facilities that will have to treat these patients.”
At least 11 Pleasant View Nursing Home residents needing a higher level of medical care were taken to Carroll Hospital Center on Saturday and six more were taken Sunday to Frederick Health Hospital, Singer said.
He said the facility had been following proper guidelines before the outbreak.
“To the best of our knowledge, the facility was doing everything they were supposed to be doing,” Singer said.
Carroll County health officials visited the facility on Baltimore National Pike after learning Friday that two residents tested positive, he said.
Pleasant View Nursing Home of Mt. Airy received a “much below average," one-star rating from Medicare in its Nursing Home Compare tool. It received “below average,” two-star ratings on its health inspection and quality of care. But its rating was dragged down by a one-star rating for staffing. It appears that Pleasant View relied more on nursing aides to care for residents than other Maryland nursing homes and less on registered or licensed nurses.
J. Tod Fetherling, CEO of Perception Health, a Tennessee-based health data firm said the five-star Medicare Skilled Nursing Facility scale is designed to offer a "snapshot of the quality of the facility at that point in time.” These scores are “at the core” of promoting a safe environment for both workers and residents, he said.
“With the COVID-19 virus spreading rapidly, quality ratings are important to understand how well facilities are managing their overall quality of services,” Fetherling said.
No one answered at a phone number listed for the facility Sunday afternoon. Earlier in the day, media were turned away, and state police said any trespassers would be charged.
At a number listed for Douglas and Vicki Tabler, who are trustees for the owner of the 37-acre Pleasant View property on the state’s property website, a person who answered said the Tablers were not available and hung up when the caller identified themselves as a reporter.
Pleasant View Nursing Home was incorporated in 1972 and Douglas Tabler acquired the property in 1994, according to state records. Tabler is listed as the agent for the for-profit business in state corporate records. The nursing home provides a variety of care services, including respite, palliative, skilled nursing, long-term and hospice, according to its website. It averages about 100 patients and most of them rely on Medicare or Medicaid, according to state and federal records.
Rebecca Travels, administrator of the facility, said Saturday night that facility staff had taken additional measures to limit the spread of the disease, including restricting visits, group dining and activities, performing extra cleanings, and testing staff and residents.
“We will continue to work tirelessly, day and night, for as long as we need to in order to prevent further spread and to take really good care of the residents that we have here,” Travels said previously.
Since the outbreak, the facility has been following necessary federal and state protocols, including isolating residents with symptoms and screening staff as they come to work. Staff are now required to wear full protective gear, including face masks, gowns and gloves. The county had provided additional face shields, masks, and gowns, Singer said.
Singer said health officials are still waiting for more test results of residents and symptomatic staff.
The first two residents who tested positive at the facility were tested by private labs and the results were not available for five or six days, Singer said. After those tests came back positive, additional testing by the state lab began immediately and the 64 additional positive cases were returned in about a day on Saturday, Singer said.
Dr. Leana Wen, a former Baltimore City health commissioner and professor at George Washington University, said the state needs “far more testing so that early cases can be identified and infected patients can be isolated and treated.”
She said nursing homes and their residents are a high risk for COVID-19 and severe illness as a result. She said they follow guidance from the U.S. Centers for Disease Control and Prevention to restrict visitations and cancel group events such as communal dining.
As Pleasant View copes with the outbreak, it’s also experiencing a staff shortage.
“We’re also trying to assist this facility because they are struggling because some of their staff haven’t been able to report,” Singer said. “They’ve been struggling to be able to do their administration and to be able to staff and be able to take care of their patients.”
Singer said it was unclear exactly why some staff haven’t reported. He said some employees might be experiencing symptoms and taking precautions by staying home. He also said some employees are likely scared and reluctant to come to work.
“Personally I think there’s a lot of fear,” he said.
County officials have been reaching out to the state for additional resources and temporary help agencies to deal with staffing shortages.
Carroll Hospital President Leslie Simmons said the hospital has been providing staff support, supplies, “anything necessary to try to help them provide the care as well as prepare ourselves for any influx of patients.”
She urged residents to continue to stay home to prevent the further spread of the disease.
Carroll County Board of Commissioners President Stephen Wantz also asked residents to continue to stay home.
“You have got to make sure you are doing your social distancing,” he said.
“I’ve had reports from around the county, from some of our bigger box stores where aisles were packed with people," he said. “I’m just not sure what folks are not understanding about this deadly pandemic. You’ve got to make sure you are protecting not only yourself but when you go home, your family.”
Mount Airy Mayor Pat Rockinberg said he’s confident in the “swift and strategic response taken to address the outbreak at Pleasant View Nursing Home."
He said the town has taken steps to protect its residents, including commissioning an emergency response team to address closures and other safety measures and to focus on community outreach “to ensure we reach our more vulnerable senior community.”
Baltimore Sun reporter McKenna Oxenden contributed to this article.