Berkeley’s Chaparral House skilled nursing facility has had no COVID-19 infections or deaths to date, staff said Tuesday, despite being identified by the state as having had at least one coronavirus fatality there.
That state information is wrong, Chaparral House Chief Financial Officer Rev. Charles Cole told Berkeleyside on Tuesday, and a fix is in the works. The issue stemmed from a data entry problem, Cole said, which resulted in the state counting a non-COVID-19 death in the COVID-19 column.
At Berkeleyside’s request, Cole provided written documentation that shows the state is aware of the error and plans to fix it. Cole originally reported the problem to the state May 22, according to the emails he provided.
Cole called the mix-up “ironic” given how much Chaparral House has done to ensure the safety of its 36 residents and nearly 100 staff members: “We are bulldogs when it comes to protecting our residents and our staff.”
Early Monday evening, Berkeleyside reported on state data showing previously unreported COVID-19 fatalities linked to two skilled nursing facilities in Berkeley. Community members quickly got in touch to say Chaparral House had never had COVID-19 cases, let alone a death.
The other Berkeley facility showing a COVID-19 fatality was the Elmwood Care Center, where two infections had previously been reported. On Tuesday, Terry McGregor, Elmwood’s executive vice president, confirmed that one of those patients had since died.
“Elmwood Care Center admitted a patient from the acute hospital” in May, McGregor said in a prepared statement. “Eight days later, the patient transferred back to the acute, tested positive for COVID-19, and later expired at the acute hospital. In the course of testing all the patients, a second resident was found to be positive. That patient is asymptomatic and doing fine at this time. All other residents and the entire staff have been tested and are negative.”
The city of Berkeley is still reporting one COVID-19 death, which was announced in early April, of a person in their 40s with an underlying health condition. Berkeleyside asked the city Tuesday whether or how the Elmwood fatality would be counted among the local numbers. That information had not been provided as of publication time.
As of Tuesday, 96 lab-confirmed COVID-19 cases have been reported in the city. Seventy-four of those patients have recovered, the city said.
Berkeley has five skilled nursing facilities and one long-term memory care facility: Ashby Care Center, Berkeley Pines Skilled Nursing Center, Chaparral House, Elmwood Nursing and Rehabilitation Center, Kyakameena Care Center and Silverado Berkeley Memory Care Community. Together, the six sites include 418 residents and 297 staff members, according to the city.
Cole said all Chaparral House residents and staff are being tested this week as part of an already-scheduled Berkeley Public Health effort to test all of its senior medical facilities by Thursday. Going forward, staff at each facility will need to perform monthly testing and report the results to the state.
The new reporting and testing requirements have been a challenge, Cole said, part of a new wave of largely unfunded state and federal mandates related to addressing the coronavirus pandemic. But it’s a challenge Chaparral House was prepared to handle and has tackled head-on, he said.
Long before public health agencies issued rules for skilled nursing facilities to limit the spread of COVID-19, Chaparral House had already broached the issue with residents and their families to prepare them, Cole said. They cut off most visits and had discussions with patients and their relatives about what to expect.
The nonprofit already had a robust Skype program in place — launched 4-5 years ago — to ensure patients could stay connected with family and other loved ones no matter where they were, Cole said.
The facility, which opened in 1978, is licensed for up to 49 beds but has not taken in any new Medicare patients during the pandemic as an extra safety measure.
As part of its pandemic response, Chaparral House switched its exercise program from group classes to individual sessions that take place in patient rooms. The facility was able to do that because it has 4.5 positions dedicated to its activity programs; Cole said licensing requirements only demand one fulltime person for a facility of its size.
To help keep spirits up, activities staffers have been wearing costumes as they make their rounds, Cole said. After a particularly high-energy session with one patient recently, a staff member wearing a clown costume told Cole, “I’m winded!”
Amid the coronavirus pandemic, staff have given out extra games and craft supplies to help patients stay busy and engaged.
As part of the facility’s regular program, activities staffers have also distributed iPods to nearly all Chaparral patients. The music players are loaded with songs recommended by patient families as well as songs that may have a particular cultural resonance.
“We have a resident who is Irish. If she’s having a bad day, we will put on earphones, turn on her iPod and play Irish music. She starts tapping her hands and being a totally different person,” Cole said. “The activities department makes notes of those things. We keep them almost like you would keep a prescription.”
COVID-19 testing underway this week
Chaparral House has also made sure to limit, to the greatest extent possible, who comes into the facility, which is located at 1309 Allston Way, at West Street near Strawberry Creek Park.
“Our goal is to have as few as possible outsiders come inside,” Cole said. “It’s just a breeding ground otherwise.”
That came into play recently when the city announced it needed testing done at all six skilled nursing and long-term care facilities in Berkeley. The original plan, Cole said, involved more people coming into Chaparral House than the nonprofit was comfortable with. It also would have required Chaparral staff to go to the city’s testing site to get tested for COVID-19 on their own time.
Chaparral put the kibosh on that approach and instead paid for lab kits so it could test all of its staff on-site during working hours. The facility also took pains to have all the testing that’s happening this week handled by the absolute minimum number of people.
Testing areas have been set up outside this week, Cole said, so staff from Chaparral, Kaiser Permanente and LifeLong Medical Care can collect specimens from employees and residents. Chaparral nurses have already been trained by doctors to collect those specimens in the future for the ongoing screening that is now required by the state.
On a daily basis, all staff who report to work must fill out a health questionnaire, have their temperature taken, wash their hands and use hand sanitizer, Cole said. They don a mask and can only clock in after someone else confirms they are wearing the mask correctly.
Cole said he and others at Chaparral House drew on lessons learned in the early days of the AIDS crisis during the initial COVID-19 response.
With AIDS, he said, “we didn’t know what the transmission source was and we didn’t know how contagious it was. We would have been able to save some lives had we been stricter about contact.”
In contrast, he said, with COVID-19, “We knew that limiting people was going to be the ticket.”
A new landscape
In addition to reporting daily to the state about any known COVID-19 infections on-site, skilled nursing facilities must also report this information to the local public agency — Berkeley Public Health in this case — and to the federal government.
“Never in the past has there ever been a release about who has what in a skilled nursing facility anywhere in the country,” Cole said. “California was the first to realize something needed to be done to appease — as well as placate — the public.”
In March, the state began putting together its database of skilled nursing facility COVID-19 statistics and required facilities to update that information daily.
Several weeks later, the federal government brought down a similar mandate and said all 16,000 nursing facilities in the nation would have to start sharing information within two weeks. But the timeline was unrealistic, Cole said. For most skilled nursing facilities, it took 2-3 weeks to simply get security clearance to use the federal site, meaning they would not be able to comply with data entry rules on time.
But Chaparral House didn’t have that problem, he said. It had already been using that federal system for two years as part of a Centers for Disease Control project to track the spread of MRSA and C-diff infections.
Cole said that research mostly focused on hospitals but that Chaparral House had been invited to participate in the research effort because of its stellar record and high-level nursing staff, which includes a number of certified gerontology experts.
“We’ve been involved in all kinds of things over the years,” he said, “all kinds of beta tests and pilots. That’s kind of who we are.”
When the federal database was first implemented in late April, Cole said, there were all sorts of problems. One day, COVID-19 infections would be listed in Bay Area facilities where there were none. The next day, those numbers would be fixed but there would be a new crop of mistakes.
“There were all kinds of errors,” Cole said. “It was crazy.”
On Tuesday, Berkeleyside asked the California Department of Public Health a series of questions about the erroneous data about Chaparral House on its website and received a brief unsigned response by email: “We are looking into this and will loop back with you.”
The erroneous fatality assigned to Chaparral House may not be the only problem with the Berkeley data. The state database also lists at least one COVID-19 infection of a health care worker at Kyakameena Care Center.
Kyakameena’s administrator told Berkeleyside on Tuesday that none of its staff had ever had a COVID-19 infection and referred further inquiries to a spokesman who was unable to provide further details prior to publication. Berkeleyside will update this report if that changes.
Berkeleyside also asked the CDC about the skilled nursing facility data it is tracking at the federal level, but no response was received as of publication time.
Statewide, according to California Department of Public Health records, there have been about 9,700 COVID-19 cases in the state’s 1,224 skilled nursing facilities. About 1,800 of those patients have died.
Alameda County has 73 skilled nursing facilities, according to the state. Overall, there have been 261 COVID-19 cases linked to them. State records report fewer than 100 deaths in connection with these cases, but do not state the actual number of local fatalities.
In Alameda County, 172 health care workers have contracted COVID-19, according to the state database.