Walz announces '5-point battleplan' to address cases at long-term care facilities

Residents make up 1 percent of population, 80 percent of coronavirus deaths

Sloane Martin
May 07, 2020 - 1:45 pm

Minnesota hit a grim miletone of 500 deaths from coronavirus and 9,365 lab-confirmed cases.

The Walz administration Thursday detailed what it calls a five-point “battle plan” to address high rates of cases at long term care facilities.

Long term care residents make up 1 percent of the state’s population, but 15 percent of cases, 23 percent of hospitalizations and 80 percent of deaths from the virus. Unlike the CDC, Minnesota’s accounting of long-term care deaths includes more than skilled nursing facilities to include group homes and other care centers that are congregate living spaces.

Residents’ age, underlying health conditions, plus the congregate care setting make them more vulnerable. 

Health Commissioner Jan Malcolm said the goal of their new plan is to be more proactive, instead of reactive.

“What we’re going to be doing is providing additional support for facilities to keep their staffing levels up, to ensure that they can get the personal protective equipment they need to better train their workers on resident care and infection prevention and building and maintaining enough bed capacity for residents with COVID-19," Malcolm said.

One specific change involves a plan for “facility-wide testing” when a case is confirmed or multiple people develop symptoms. 

“Instead of just testing the symptomatic and their direct contacts, we are now instituting a plan to screen everyone in a facility when there is a confirmed case,” Malcolm said.

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By bringing on the state emergency operations center as a partner, Malcolm says MDH can harness the logistical acumen to mobilize large efforts quickly. That means more on-site attention.

“Infection-prevention support to every facility with even one case,” she said. “And to make sure all facilities have updated preparedness plans. And are able to access staffing support without unnecessarily transferring residents to other sites for care.”

One critical part Macolm called “vexing” is addressing what have been long standing staffing challenges. She says some facilities have workers who are sick, or some who have left the job due to the fear of getting sick. Some facilities have had to scramble to get staff for an overnight shift. The pay is low and the work is difficult.

Addressing gaps more than a shift at a time could involve bringing on furloughed workers, students pursuing healthcare or even the national guard.

“This will include things like tapping funds made available by the legislature like the COVID-19 fund,” Malcolm said. “Tapping that fund to build what I believe Connecticut has used, we’re learning from our peers around the country, to support bridge staffing teams of healthcare workers to provide temporary staffing for a couple of days or a week if needed, so not just covering an overnight shift but looking more broadly at what the staffing need is going to be.”

Malcolm adds the states does need support from the federal government and there are discussions about incentives like hazard pay. They would have to train the workforce to ensure care for the most sensitive patient like those with Alzheimer’s.

The plan before Thursday’s announcement was a weekly briefing with administrators, guidance from MDH, a response team after 1 reported case and a case manager for each facility from MDH to check in daily. 

Out of 330 facilities with a confirmed case, about 43 percent have just one case. One in five skilled nursing and one  in 10 assisted living facilities have reported cases, but Malcolm admits she did not expect so many facilities needing this level of intervention.

“Rather than hoping we can contain it here, we have to be ready for it to continue to spread,” Macolm said. “And that’s I think where we just need to get less reactive and more proactive about assuming this is going to continue to be a challenge.”

Malcolm defines success as containment.

“Just the reality of the progression of this epidemic around our state probably means that many, many more facilities are going to see cases, but we want to keep it in the one, two, three range and not see so many facilities with 10, 20 and more cases,” she said. “And to reduce the proportion of positive tests in long term care even as we start testing more and more people.”

State of MN



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