BOISE – Two state inspectors who visited Idaho nursing homes in July were unknowingly infected with the coronavirus at the time, according to the Idaho Department of Health and Welfare.
The inspectors were at the nursing homes to review how well the facilities followed federal rules to prevent the spread of COVID-19.
The state notified four nursing homes about potential exposure, “out of an abundance of caution,” Health and Welfare said in an email this week responding to a query from the Idaho Statesman. The department didn’t specify which nursing homes were visited by the COVID-19 positive inspectors.
The department hasn’t been notified of any COVID-19 cases in those nursing homes that trace back to the inspectors’ visits, spokesperson Niki Forbing-Orr said.
“As soon as each of the two nursing home surveyors received the positive test results, we immediately required them to self-isolate, so we don’t know precisely if and when those surveyors were infectious as they conducted their survey work in those four facilities,” Forbing-Orr said. “We want to emphasize that all surveyors are screened by facility staff before they even enter the facility to conduct a survey.”
State records show that several inspectors visited nursing homes around Idaho in mid-July. Three of the nursing homes inspected in mid-July reported their first cases of COVID-19 among staff one to two weeks after the inspections, according to records from the Centers for Disease Control and Prevention.
That timing also corresponds with the weeks in July and August when Idaho hit its peak for new coronavirus cases statewide. Many long-term care facilities were reporting new cases at that point, as the virus became more widespread in Idaho.
Nursing homes will be told of COVID-19 exposure within 24 hours
The state didn’t notify the four nursing homes where the infected inspectors visited “as quickly as we would have liked,” Forbing-Orr said. The state has a policy and process in place to notify facilities within 24 hours of an inspector testing positive, she said.
Nursing homes themselves are required by the federal government to notify residents and their families of COVID-19 cases within a day.
“When we learn that a surveyor has tested positive, the surveyor immediately self-isolates, and the surveyor is not scheduled to be part of another survey until at least 14 days have passed,” Forbing-Orr said. “We are also working with our public health experts to develop a testing strategy that gets us test results quickly.
“We never knowingly send a surveyor with active COVID-19 into a facility.”
The Idaho Department of Health and Welfare’s Bureau of Facility Standards usually sends teams of inspectors into long-term care facilities to do routine inspections and to investigate complaints.
The state and federal governments in March halted routine inspections, only entering the facilities to investigate complaints that alleged “immediate harm to residents,” Forbing-Orr told the Statesman in April.
That decision was made to limit the risk of an inspector bringing the virus into a facility, and to preserve the limited supply of personal protective equipment, Forbing-Orr said in April. “Surveyors travel from facility to facility and could carry the virus from one facility to another,” she said then.
115 Idaho nursing homes inspected for prevention
But with nursing home residents being at such high risk of sickness or death from COVID-19, the federal government required special COVID-19 infection control surveys at those facilities. The inspections take two to three days.
The state completed 115 such inspections at nursing homes this summer. The inspectors found 49 nursing homes with no deficiencies in their practices and 66 with at least one deficiency. Nine nursing homes had deficiencies severe enough to put residents in immediate danger. Failure to properly screen people who entered the facility was one of the more common problems inspectors found, according to the Idaho Department of Health and Welfare.
“With the daily challenges facilities face during this pandemic, a deficiency-free survey is difficult to achieve, so the fact that 49 surveys have been deficiency-free speaks highly of Idaho’s nursing homes,” Licensing and Certification Administrator Tamara Prisock said in a news release from the department. “Nursing homes are deeply committed to preventing the spread of COVID-19, and those facilities with deficiencies are usually quick to address any gaps in infection control. The survey results also help IDHW staff connect facilities with state and federal training and resources to help them strengthen their infection control practices.”
One of the state’s assisted-living inspectors also tested positive for COVID-19 in July but hadn’t been inside a facility for weeks at that point, Forbing-Orr said.
People who need help with daily life but don’t need around-the-clock nursing care at a nursing home sometimes live in assisted living facilities. Those are regulated by the state, so they’re not undergoing the federal COVID-19 inspections.
“For the assisted living team, since mid-July, we have been staying in contact with assisted living facilities through phone, desk review of records, and technology,” Forbing-Orr said. “We are not currently sending assisted living surveyors into facilities until we have a testing solution that processes results quickly.”
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