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Follow-up: KC public health director calls for state action on state-regulated skilled nursing facilities

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BAKERSFIELD, Calif. (KGET) — The Kern County public health director is calling on the state to do more to assist state-regulated skilled nursing facilities in Kern struggling to curb COVID-19.

“We need to do everything we can to bring about change,” Matt Constantine said Wednesday.

Appearing before the Kern County Board of Supervisors earlier in the week, Constantine expressed several concerns about these facilities, noting they account for roughly half of the county’s COVID-related deaths.

“Our worry is this is going to quickly develop into something we can’t contain,” he stated before the board Tuesday. During an interview with KGET Wednesday, Constantine added some of the facilities have been uncooperative.

“Surprisingly there have been a few facilities that, not only have been resistant to our help, but have not allowed us to enter, not allowed us — at county cost — to provide early identification of positive workers.” To this day, he continued,Valley Convalescent Hospital and Kingston Healthcare Center have not done enough to curb outbreaks at the facilities.

What’s more, Constantine said the aforementioned facilities are “admitting patients while there is an outbreak occurring. That is not appropriate.”

Skilled nursing facilities are solely and completely regulated by the state, but Constantine said the state has not done its part, forcing the county to get involved.

“The state, recognizing there were outbreaks, sent a letter to our nursing facilities, requiring them to put a plan together that said they may test in the future. We felt that was completely inadequate, so we hired a team of nurses to go out in the mornings and start testing.”

But, he said, that has been a challenge given that some of the facilities have not been communicative. Now, he’s calling on the state to do more:

“We feel the state hasn’t taken action quick enough and strong enough to protect our community. We want them to assess what we’ve seen. We want them to mandate testing. Limit admittance to a facility that is having uncontrolled outbreak. We the state to mandate they have stabilized their staffing..”

“These are fundamental minimum requirements that we should ask anybody who’s caring for our community.”

CALIFORNIA DEPARTMENT OF PUBLIC HEALTH RESPONDS:

The CA Dept. of Public Health released the following statement:

Throughout the course of our pandemic response, CDPH has made infection control at nursing homes our priority and have taken difficult and critical steps to reduce the impact of the pandemic in these facilities. 

We have sent strike teams of infection control specialists to skilled nursing facilities in Kern County, and have been in daily communication with all nursing homes. We have also taken a number of enforcement actions in Kern County skilled nursing facilities.


As noted in your story, CDPH has mandated that all skilled nursing facilities complete an infection mitigation plan that includes a regular testing schedule for residents and healthcare workers.

The mitigation plans were due to CDPH by the end of May. One hundred percent of skilled nursing facilities in Kern County have submitted their plans, and CDPH is in the process of reviewing them while doing on site visits to validate the plans and certify the plan as being implemented appropriately. All SNFs will have an initial visit in June and July, and revisits will occur every six to eight weeks.

At these visits, surveyors will review of the required infection mitigation practices as described in the mitigation plan. Surveyors will be there initially to assist in technical assistance and provide guidance. However, if CDPH determines that facility is not implementing its approved mitigation plan and identifies unsafe practices, CDPH will take enforcement actions. You can learn more about these plans here:https://www.cdph.ca.gov/Programs/CHCQ/LCP/Pages/AFL-20-52.aspx


CDPH also mandates that all nursing homes report to CDPH every day, as providing this information is critical for the public. This facility-reported data is publicly posted on the CDPH website athttps://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/SNFsCOVID_19.aspx

And finally, skilled nursing facilities must follow appropriate cohorting (separation) and infection control practices. If appropriate infection control measures are not in place, or if there are other violations of licensure, a facility may be subject to enforcement action. However, many skilled nursing facilities are able to safely accept new residents even if they have COVID positive residents — this can be done safely if  appropriate infection control measures are in place, including separation of COVID positive residents. Transfers/ admittance of patients who are, themselves, COVID positive are done in coordination with the local health department. Details about what skilled nursing facilities must do to meet infection control standards can be found here: https://www.cdph.ca.gov/Programs/CHCQ/LCP/Pages/AFL-20-25.aspx

ELECTED REPRESENTATIVES RESPOND:

Kern representatives from both sides of the aisle weighed in.

Assemblymember Rudy Salas (D-Bakersfield):

“The ongoing situation at our skilled nursing facilities in Kern County and throughout the state is egregious and must be fixed–more needs to be done to protect the health of our senior community. Last week we held an oversight hearing in the Capitol to make sure action is being taken on these serious issues. I will continue to work hard for our seniors and hold the Governor and the Department of Public Health accountable.” 

Assemblymember Vince Fong (R-Bakersfield):

“Holding local skilled nursing facilities accountable is our top priority in controlling the spread of COVID – 19. To that end, I have  coordinated meetings to forge a county-state partnership to ensure that Kern County officials have the authority and ability to keep our residents safe. By working with the Kern County Public Health Department, Kern County Office of Emergency Services, and California Department of Public Health, we want to ensure accurate data is reported and that all safety protocols are maintained at each facility.” 

CA Senator Shannon Grove (R-Bakersfield):

“From the very start of this crisis, we learned of the lack of oversight from the state for these skilled nursing facilities. Early on when this became an issue in my District, I reached out to the Administration requesting immediate action and accountability. Since then, I have been monitoring and receiving daily updates from the state public health agency on new and existing cases. With the alarming number of COVID-19 deaths at these state-run facilities, I have urged Governor Newsom to expand necessary testing, protect our most vulnerable, and ensure the state responds quickly to outbreaks. But the lack of oversight is a huge concern because that means an uptick in cases in these facilities leaves counties such as Kern at risk of losing their regional variance and having a slower economic recovery because the state failed to keep these individuals safe.”

*KGET reached out to the skilled nursing facilities named by KCDPH, but they did not have an immediate comment.

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