Hospitals and nursing homes fail to separate COVID patients, others at risk

Nurses at Bates Summit High Medical Center were out of breath as long as COVID-19 patients began reaching hospital spaces that were not reserved for their care.

KHN and The Guardian stick to the deceased physical condition of COVID-19 and write about their lives and what happened in their final days.

The Centers for Disease Control and Prevention has called on hospitals to isolate patients with COVID to restrict staff exposure and assist missing non-public protective appliances.

Still, COVID patients continued to disperse at Oakland Hospital, to court cases filed with the California Department of Occupational Safety and Health. Concerns included the sixth-floor medical unit where veteran nurse Janine Paiste-Ponder worked.

COVID patients in this field did not stay in their rooms, nor did they disassociate the the rules. Staff did not get high-protection N95 respirators, said Mike Hill, a nurse in the hospital’s intensive care unit and a representative leader of the California Nurses Association, who filed a complaint with Cal/OSHA, the state’s occupational protection regulator.

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“It’s only a matter of time before one of the nurses dies on one of those floors,” Hill said.

Two sick nurses, adding Paiste-Ponder, 59, who died of headaches from the virus on July 17.

Concerns raised in Oakland also swept across the United States, according to interviews, a review of government court cases on office protection, and inspection reports of fitness facilities. A KHN investigation found that dozens of nursing homes and hospitals were unaware of the concerns. Official rules to separate COVID patients from those without coronavirus in some places, fueling its spread and leaving them unprepared and inflamed or, in some cases, dead.

Recently, in July, a National Nurses United survey of more than 21,000 nurses found that 32% of the paintings in an establishment that does have a committed COVID unit. By that time, the coronavirus had reached all 17 counties in the US. According to the knowledge collected through Johns. Hopkins University.

KHN found that COVID patients were combined with non-inflamed patients in health care services in states such as California, Florida, New Jersey, Iowa, Ohio, Maryland and New York.

An outbreak of COVID-19 at the height of the New Jersey Veterans Home in Paramus last April when fitness inspectors observed citizens with dementia mixed in a day room: patients with COVID positives and others waiting for the results of the checks. reported COVID infections in 119 citizens and 46 deaths from the virus, according to a Medicare inspection report.

The nursing director of an Iowa nursing home insisted on April 28 that they “did not have COVID in the building” and overstealed a network doctor’s orders to isolate several patients suffering from fever and declining oxygen levels, according to an inspection report.

In mid-May, the facility’s COVID newspaper reported 61 patients with the virus and deaths.

Federal hard work protection officials have closed at least 30 court cases over the combination of patients in hospitals across the country without issuing a subpoena. They arrive with a statement that a Michigan hospital kept patients with negative results for the virus in the COVID unit in May. in New York State there were also patients with COVID in the same unit as those who had no infection, according to a complaint filed with the Federal Occupational Safety and Health Administration.

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Federal fitness and social facilities officials called hospitals to inform them daily if they had a patient who arrived without COVID-19 but had an obvious or demonstrated case of coronavirus 14 days later. Hospitals submitted 48,000 reports as of 21 December. June to August 28, this issue. reflects a double or additional count of individual patients.

COVID patients were combined with others for reasons: some hospitals report limited controls, so patients with the virus are only known after exposure to others; in other cases, they have received effects from false negative checks or their establishment has rejected federal guidelines, which have no force of law.

And while federal Medicare officials have inspected nearly every single nursing home in the U. S. in recent months, and states have imposed fines and disposed of new admissions for periods of isolation, hospitals have been less monitored.

The Sutter scene

At Alta Bates in Oakland, a member of Sutter Health’s network, hospital staff made it transparent in formal court cases before Cal/OSHA seeking directors to comply with the state’s exclusive law on aerosol-borne diseases. sought all the protections required by the state for a virus that was transmitted through tiny components floating in the air.

Regulations require patients with a virus such as COVID-19 to be transferred to a specialized unit within five hours of their identity, or to a specialized facility. Regulations say those patients will have to be in a room with a HEPA certificate. with negative air pressure, which means that air circulates through a window or extraction fan instead of moving down the aisle.

Initially, in March, the hospital supplied a 40-bed COVID unit, according to Hill, but when a wave of patients failed to materialize, this unit was reduced to 12 beds.

Since then, a steady flow of patients inflamed by the virus has been admitted, he said, many of whom underwent the test a few days after admission, and after being in normal rooms of the facility.

From March 10 to July 30, hill’s and others filed 8 court cases with Cal/OSHA, adding allegations that the hospital failed to comply with isolation regulations for COVID patients, some on the cancer floor.

So far, regulators have done little. Governor Gavin Newsom had ordered occupational protection officers to “focus on. . . “”compliance support” that in law enforcement, unless it was “the most serious violations. “

State officials responded to court cases through emails and “ensuring that appropriate virus prevention measures have been implemented,” according to Frank Polizzi, Cal/OSHA spokesman.

A third investigation into shipping personnel who did not wear N95 respirators while moving patients with positive or imaginable COVID coronavirus to a Sutter facility near the hospital resulted in a $6,750 fine, records show through Cal/OSHA.

The court case series also indicates that the hospital failed to provide the required non-public protective apparatus (PPE) under state law, an N95 respirator or something more protective, to treat patients inflamed with the virus.

Instead, Hill said, on floors with COVID, patients gained lower quality surgical masks, a fear reflected in court cases filed with Cal/OSHA.

Hill believes Paiste-Ponder and the nurse on his floor beat the virus to COVID patients who didn’t stay in his room.

“He’s unhappy because he didn’t want it to happen,” Hill said.

Polizzi said investigations into the July 17 death and some other hospitalization were ongoing.

A Sutter Health spokesman said the hospital takes the allegations seriously, adding Cal/OSHA complaints, and that its most sensible priority is to ensure safety and the patient.

The press release also states that the “cohort”, or the practice of grouping patients inflamed by the virus, is a tool that “should be in a broader context, adding patient acuity, hospital census and other environmental factors” .

Concerns in hospitals

CDC rules are not strict on the issue of separation of COVID patients, noting that “institutions would possibly designate complete sets within the facility, with [staff] engaged” to treat COVID patients.

This technique has been a success at the University of Nebraska Medical Center in Omaha. A recent study reported “extensive” viral contamination around COVID patients there, but noted that with “standard” infection techniques implemented, staff members who treated COVID patients did not. contract the virus.

The hospital installed an insulation unit with pumped air outside the aisles, limited access to the unit and trained to use well-developed protocols and N95 respirators, at a minimum. What worked in Nebraska, however, is far from the norm elsewhere. .

Cynthia Butler, a nurse and member of National Nurses United at Fawcett Memorial Hospital in Port Charlotte on Florida’s west coast, said she felt safer running in the COVID unit, where she knew what she was dealing with and had a full personal protective team. – only in a general medical floor.

She believes she hit the virus on a patient who had COVID-19 but was housed in a general location in May. A similar scenario happened in July, when another patient had an unforeseen case of COVID, and Butler said she herself had undergone other positive tests.

She said patients did not meet the hospital’s criteria for evaluating admitted patients and that they left her on site, considerations she passed on to an OSHA inspector who contacted her about a complaint filed through her union about the facility.

“Every time I get to work, it’s like betting on Russian roulette,” Butler said.

A spokeswoman for HCA Healthcare, who owns the hospital, said she evaluates long-term care patients, who have surgery and those with viral symptoms, said staff have access to PPE and practice vigilant sanitation, universal masking, and social estating. .

However, the latter is an option for Butler, who said it cleans, feeds and IVs patients and gives them peace of mind when they are away from their families.

“I give you the only word of convenience or type you can get,” said Butler, who has since taken an unscathed leave for security reasons. “I do that and I’m protected. “

Given studies showing that up to 45% of COVID patients are asymptomatic, UCSF Medical Center is all admitted individuals, said Dr. Robert Harrison, a professor at the University of California San Francisco School of Medicine, who consults on occupational fitness at the hospital. .

This is done to protect and decrease the spread within the hospital, he said. Those who tested positive are separated into one unit for COVID only.

And staff who have spent more than 15 minutes within 6 feet of an unidentified COVID patient wearing a less protective surgical mask are sent home for two weeks, he said.

Outside of university medicine, however, the front line turned to union leaders to push for such protections.

In Southern California, leaders of the National Health Workers Union filed a formal complaint with state hospital inspectors about the dangers posed by combined COVID patients at Fountain Valley Regional Hospital in Orange County, a component of Tenet Health. they were not tested for COVID-19 at the time of admission.

An auxiliary nurse spent two successive 12-hour shifts treating a patient in a general medicine field that required supervision. At the end of the shift, he said the patient had just tested positive for COVID.

The employee had only worn a surgical mask, not an N95 respirator or any form of eye protection, according to the complaint filed with the California. La Assistant Nurse’s Department of Public Health, was not subjected to COVID control or quarantined before her next two shifts. according to the complaint.

The Department of Public Health said it could only comment on an ongoing inspection.

Barbara Lewis, director of the union’s Southern California hospital division, said COVID patients were at the same time as cancer patients and post-surgical patients who sizing the aisles to speed up their recovery.

She said officials had taken steps to separate patients after the union organized a protest, spoke to local media, and complained to state fitness officials.

Hospital spokeswoman Jessica Chen said the hospital had “quickly implemented” state-run fitness adjustments and placed some COVID patients in the same nursing unit as patients without COVID. administered on the doctor’s orders, he added, and workers can access them in other parts of the community.

This contrasts, Lewis said, with high-profile examples of precautions that can be taken.

“Now we see what happens to baseball and basketball: they are tested every day and treated with great caution,” Lewis said. “However, we have thousands and thousands of physical care staff who will paint in a very frightening environment. “

Nursing faces sanctions

More than 40% of those who died from COVID-19 lived in retirement homes or service residences, according to the researchers.

The patient mix was a widespread fear in nursing homes, discovered by Medicare officials when they tested infection practices in more than 15,000 facilities.

Reports highlighted the challenge at an Ohio nursing home and a Maryland home where the state imposed a $ 70,000 fine for failing to keep inflamed patients away from those who were not yet in poor health.

The Fair Havens Center, a nursing home in Miami Springs, Florida, faced sanctions.

Florida regulators cut housing admissions and the Medicare government imposed a $235,000 civil fine, according to records.

The facility’s vice president of operations told inspectors that isolating exposed patients would mean isolating the entire facility: all people exposed to the 32 staff members who tested positive for the virus, according to the report.

Fair Havens Center responded to a request for feedback.

In Iowa, Medicare officials declared an “immediate danger” status at the Pearl Valley Care and Rehabilitation Center in Muscatine. There, they discovered that staff members denied an epidemic among themselves, and a nursing director resurrected a network doctor. orders to pass or send citizens to the emergency room. Instead, officials found, last April, the deputy director of nursing was keeping COVID patients at the facility, and presented a blanket order from his medical director to send patients to the emergency room “if you can help him. “

Meanwhile, several patients have been documented at the center as having fevers and declining oxygen levels, according to the Medicare inspection report. In less than two weeks, the center discovered an outbreak, with 61 inflamed citizens and nine dead, according to the report.

Medicare is investigating the Menlo Park Veterans Memorial House in New Jersey, Senator Joseph Vitale said at a recent legislative hearing. Resident Council President Glenn Osborne said at the hearing that the citizens of the house were sent back to the same dormitories after hospitalizations.

Osborne, a marine released with honor, said he had noticed that more citizens in space died than other members of his army service. Veterans’ homes in Menlo Park and Paramus, where inspectors saw dementia patients with and without the virus combine in a day room. anyone reported more than 180 cases of COVID among citizens, 90 among staff and at least 60 deaths.

A home spokesman said he could comment due to an ongoing dispute.

“These deaths have not occurred,” Osborne said. “Many of those deaths were surely avoidable, in my humble opinion. “

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Nurses at Bates Summit High Medical Center were out of breath as long as COVID-19 patients began reaching hospital spaces that were not reserved for their care.

The Centers for Disease Control and Prevention has called on hospitals to isolate patients with COVID to restrict staff exposure and assist missing non-public protective appliances.

COVID patients in this field did not stay in their rooms or disassociate the the rules. Staff did not get high-protection N95 respirators, said Mike Hill, a nurse in the hospital’s intensive care unit and a leading representative of the California Nurses Association hospital. , who filed a complaint with Cal/OSHA, the state’s occupational protection regulator.

“It’s only a matter of time before one of the nurses dies on one of those floors,” Hill said.

Two sick nurses, adding Paiste-Ponder, 59, who died of headaches from the virus on July 17.

Concerns raised in Oakland also spread across the United States, according to interviews, a review of government court cases on office protection and inspection reports of fitness facilities. A KHN investigation found dozens of nursing homes and hospitals were unaware of the rules. officials to separate COVID patients. of those who do not have coronavirus in some places, which fuels its spread and leaves them unprepared and inflamed or, in some cases, dead.

KHN found that COVID patients were combined with non-inflamed patients in physical care services in states such as California, Florida, New Jersey, Iowa, Ohio, Maryland and New York.

In mid-May, the facility’s COVID newspaper reported 61 patients with the virus and deaths.

Federal hard work protection officials have closed at least 30 court cases over the combination of patients in hospitals across the country without issuing a subpoena. They arrive with a statement that a Michigan hospital maintained patients with negative results for the virus in the COVID unit in May. in New York State there were also patients with COVID in the same unit as those who had no infection, according to a complaint filed with the Federal Occupational Safety and Health Administration.

Federal social facilities and fitness officials called hospitals to let them know daily if they have a patient who arrived without COVID-19 but had an obvious or shown case of coronavirus 14 days later. Hospitals submitted 48,000 reports from 21 June to 28 August, this issue. reflects a double or additional count of individual patients.

COVID patients were combined with others for reasons; some hospitals report limited controls, so patients with the virus are only known after exposing others; in other cases, they had false negative control effects or their establishment rejected federal guidelines, which were not effective. law.

And while federal Medicare officials have inspected almost every single U. S. nursing home, it has inspected almost every senior residence in the U. S. and has been able to do so. But it’s not the first time In recent months and states have imposed fines and cut new admissions for periods of isolation, hospitals have been less monitored.

The Sutter scene

At Alta Bates in Oakland, a component of the Sutter Health Network, hospital staff has made clear on official court cases before Cal / OSHA that require directors to adhere to state-only disease law. transmitted through aerosol. From the beginning, some staff members sought all the protections the state needed for a virus that has increasingly been shown to spread through tiny components found in the air.

Initially, in March, the hospital supplied a 40-bed COVID unit, according to Hill, but when a wave of patients did not materialize, this unit was reduced to 12 beds.

Since then, a steady flow of patients inflamed by the virus has been admitted, he said, many of whom underwent the test a few days after admission, and after being in normal rooms on the premises.

So far, regulators have done little. Governor Gavin Newsom had ordered occupational protection officers to “focus on. . . “support for compliance “that in law enforcement, unless it was “the most serious violations. “

State officials responded to court cases through emails and “ensuring that appropriate virus prevention measures have been implemented,” according to Frank Polizzi, Cal/OSHA spokesman.

A third investigation involving transportation personnel who were not dressed in N95 respirators when moving patients with positive or imaginable COVID coronavirus to a Sutter facility near the hospital resulted in a $6750 fine, according to Cal/OSHA records.

Instead, Hill said, on floors with COVID, patients gained lower quality surgical masks, a fear reflected in court cases filed with Cal/OSHA.

Hill believes Paiste-Ponder and the nurse on his floor beat the virus to COVID patients who didn’t stay in his room.

“It’s unhappy because it didn’t have to happen,” Hill said.

Polizzi said investigations into the July 17 death and some other hospitalization were ongoing.

A Sutter Health spokesman said the hospital takes the allegations seriously, adding Cal/OSHA complaints, and that its most sensible priority is to ensure safety and the patient.

He also states that the “cohort”, or the practice of grouping patients inflamed by the virus, is a tool that “should be seen in a broader context, adding patient acuity, hospital censuses and other environmental factors”.

Concerns in hospitals

CDC rules are not strict on the issue of COVID patient separation, noting that “institutions would possibly designate complete sets within the facility, with [staff] engaged” to treat COVID patients.

Cynthia Butler, a nurse and a member of National Nurses United at Fawcett Memorial Hospital in Port Charlotte, on Florida’s west coast, said she felt safer running in the COVID unit, where she knew what she was dealing with and was in full PPE. – only in a general medical flat.

“Every time I get to work, it’s like betting on Russian roulette,” Butler said.

However, the latter is an option for Butler, who has stated that it cleans, feeds and begins administering patients intravenously and is reassuring when away from their families.

“I give you the only word of convenience or kind you can get,” said Butler, who has since taken a leave of absence without pay for safety reasons. “I do that and I am protected. “

It is done to protect and reduce the spread within the hospital, he said. Those that test positive are separated into a COVID-only unit.

And staff who have spent more than 15 minutes within 1. 80 meters of an unidentified COVID patient with a less protective surgical mask are sent home for two weeks, he said.

Outside of college medicine, however, the front line turned to union leaders to push for such protections.

In Southern California, leaders of the National Health Workers’ Union filed a formal complaint with state hospital inspectors about the dangers posed by combined COVID patients at Fountain Valley Regional Hospital in Orange County, component from the for-profit organization Tenet Health. The complaint, the patients were not evaluated for COVID-19 at the time of admission.

The employee had only worn a surgical mask, not an N95 respirator or any form of eye protection, according to the complaint filed with the California Department of Public Health. according to the complaint.

The Department of Public Health said it could simply comment on an ongoing inspection.

She said officials had taken steps to separate patients after the union staged a protest, spoke to local media and complained to state fitness officials.

Hospital spokeswoman Jessica Chen said the hospital had “quickly implemented” adjustments made through state fitness officials and was affecting some COVID patients in the same nursing unit when patients without COVID increased strength. He said they are placed in single rooms with closed doors. COVID tests are given by prescription, he added, and can be accessed by workers elsewhere in the community.

This contrasts, Lewis said, with high-profile examples of precautions that can simply be taken.

Nursing faces sanctions

More than 40% of those who died from COVID-19 lived in retirement homes or service homes, the researchers found.

The patient mix was a scattered fear in nursing homes, which Medicare officials discovered when they tested infection practices at more than 15,000 facilities.

Reports highlighted the challenge at an Ohio nursing home and a Maryland home, where the state imposed a $70,000 fine for keeping inflamed patients away from those who were not yet sick.

The Fair Havens Center, a nursing home in Miami Springs, Florida, faced sanctions.

Florida regulators cut housing admissions and the Medicare government imposed a $235,000 civil fine, according to records.

Fair Havens Center responded to a request for feedback.

In Iowa, Medicare officials declared a state of “immediate danger” at the Pearl Valley Center for Care and Rehabilitation in Muscatine. There, they discovered that staff members denied an epidemic among them, and a nursing director resurrected a network doctor. orders to pass or send citizens to the emergency room. Instead, officials found, last April, the assistant director of nursing kept COVID patients at the facility, and filed a general order from their medical director to send patients to the emergency room “if you can help. “

Meanwhile, the facility reported that several patients had fever and decreased oxygen levels, according to the Medicare inspection report. In less than two weeks, the facility discovered an outbreak, with 61 inflamed citizens and nine dead, according to the report.

Medicare is investigating the Menlo Park Veterans Memorial House in New Jersey, Sen. Joseph Vitale said at a recent legislative hearing. Resident Council Chairman Glenn Osborne said at the hearing that citizens of the home were returned to the same shared rooms after hospitalizations.

A home spokesman said he could comment due to ongoing litigation.

“These deaths have not happened, ” said Osborne. ” Many of these deaths were surely avoidable, in my humble opinion. “

Kaiser Health News (KHN) is a national data service on fitness policy. It is an independent publishing program of the Henry J. Kaiser Family Foundation, which is affiliated with Kaiser Permanente.

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