Placing Nursing Homes in ‘Secondary Position’ Costly, Says ArchCare Head

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Looking at the self-reported list of deaths recorded at nursing homes across New York state attributed to Covid-19 is “meaningless” without delving more deeply into the problems nursing homes have faced in caring for their residents, said Scott LaRue, president and CEO of ArchCare.

ArchCare operates five nursing homes in the archdiocese, including two—Carmel Richmond Healthcare and Rehabilitation Center on Staten Island, which has recorded 44 deaths, and Mary Manning Walsh Nursing Home in Manhattan, with 31 deaths—that placed highly on the state’s list, released April 17.

“The problem with these numbers,” LaRue said, “is that not every nursing home reported numbers, not every nursing home did testing, not every nursing home treated patients in place. They transferred them to the hospital even though they were stable and could have remained in the home.”

LaRue spoke expansively and with candor in a wide-ranging interview with Catholic New York this week.

“Why put us in a secondary position to gain the resources we need to fight this virus effectively?” he said. “It seemed counterintuitive to me.”

LaRue was speaking about nursing homes being placed in “a secondary position to hospitals for access to PPE (personal protective equipment)” necessary to protect staff and patients from the spread of the coronavirus.

PPE was allocated “based on the hierarchy established,” LaRue said.

He described a set of cutbacks in PPE from ArchCare’s normal suppliers that ultimately reduced their numbers to zero. Then the PPE sources became the Office of Emergency Management or attempting to locate supplies on the open market.

Putting together such transactions with foreign suppliers proved fruitless, even with the assistance of ArchCare’s bank and a third-party firm to vet them, LaRue said.

“Every single one of them turned out to be fraudulent,” LaRue said. “We identified that this was not something we should do.”

LaRue said he began “begging colleagues and others around the country for PPE,” even posting a video on his LinkedIn page requesting such help.

LaRue reports that staff members at ArchCare nursing homes now have “sufficient” PPE in accord with CDC guidance for prolonged use and reuse. The guidance says staff must be issued one N95 mask per week and one disposable medical gown per shift, lengths far in excess of normal usage, he said.

Another serious issue for ArchCare facilities, and nursing homes in general, was limited access to Covid-19 testing during the crisis.

Carmel Richmond had access to testing offered at Staten Island University Hospital by Northwell laboratory services, LaRue said.

Other ArchCare homes did not have similar access. Those facilities were able to gain access to testing only through personal arrangements by an ArchCare board member, LaRue said.

At the start of the interview, LaRue said, “We’re turning the corner,” meaning that things have progressed from where they were.

Later describing his own feelings about the coronavirus pandemic, LaRue called it “a life-changing-experience,” not only for himself, but also for staff members and patients and their family members.

He said he worried about his employees and how they will cope with the loss of residents who they have known, in some cases, for years.

“It’s something we have to deal with when we get on the other side of this crisis,” he said.

Cardinal Dolan, speaking briefly with CNY late last week, cited the “heroic job” ArchCare and its employees have done in serving a “vulnerable population” without proper protective gear.

The cardinal was scheduled to lead a prayer service for ArchCare on the afternoon of April 21.

During the outbreak in New York, ArchCare established a Covid-19 hotline for its own facilities and for the community and the archdiocese as well.

ArchCare has offered its services to priests and retired religious in the community who had contracted the coronavirus or thought they had. Physicians and clinicians provided assessments and treatments in homes. “This has taken a tremendous toll on retired religious,” LaRue said.

Many retired religious have moved into Mary Manning Walsh and St. Vincent de Paul homes to limit the spread of the virus in their own communities.

LaRue expressed gratitude for the assistance ArchCare has received from other institutions and departments in the archdiocese including Catholic Charities, which has helped provide PPE, and the archdiocese’s purchasing department.

“Everyone has been so supportive and helpful to us and I will always be grateful for that,” he said.

LaRue said 126 ArchCare staff members have been found positive for Covid-19, including two who have died, one a longtime nurse’s aide at St. Vincent de Paul and the other a member of ArchCare’s “finance team.”

ArchCare has also offered many forms of assistance to employees including food and other basic supplies to ensuring their families are not “economically disenfranchised” in the coronavirus fallout, LaRue said.

ArchCare has also made a priority of maintaining open communications. LaRue has hosted a weekly webcast with family members of nursing home residents and members of the community to answer questions about the coronavirus. Frequent updates have also been posted on ArchCare’s website.

ArchCare has also facilitated personal communications via Skype and FaceTime for family members and patients.

“It’s important that families of loved ones be communicated with since they can’t go in and personally visit them,” LaRue explained.

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