Beaumont Rehabilitation and Skilled Nursing Center in Worcester County, Massachusetts’ first COVID-19 treatment and recovery center, has thrived in its new role and can serve as an example for other facilities, its CEO told McKnight’s this week.
“As other states start to have pressure through this wave or a second wave [of COVID-19], it’s a model that needs to be considered,” said Matt Salmon, CEO of SALMON Health and Retirement, a long-term care chain of five facilities that includes Beaumont.
Salmon said that Beaumont’s transformation to a COVID-19 treatment facility earlier this month could not have happened without the support of the Department of Public Health, the state Office of Health and Human Services, and UMass Memorial Medical Center, which partnered on the effort beginning in mid-March.
“What makes the project like this successful is an operator like us willing to take the risk; your Department to Public Health and HHS, who wanted to see this happen from a regulatory and oversight perspective; and support from a hospital that gave us insight into how the disease worked and how to set the building up,” Salmon said. “It got us to a stable and controlled position in terms of our infection control from the beginning.”
Since the facility has been up and running as a COVID-19 treatment center on April 5, it has treated 102 hospital patients and discharged home about 25. The facility currently has a census of 71, Salmon said.
Making the move
The decision to convert to a COVID-19-positive facility emerged from discussions among the state, hospitals and long-term care facilities starting the week of March 16. As the state saw New York struggle with the surge, it believed it needed to take dramatic action to avoid the same scenario, Salmon said. While the possibility of using a closed nursing home, or vacant hotel or conference center were thrown around as possible settings for post-COVID-19 recovery, the likelihood that those options don’t have adequate resources emerged as a central concern.
The best environment, it became clear, “is in a well-run nursing home with a high occupancy because they have sufficient staffing, good policies and procedures, access to PPE [personal protective equipment], and necessary equipment and supplies to do that type of work,” he said.
Salmon’s facility in Worcester seemed to fit such criteria, as it was located next to a major hospital and a healthcare partner, UMass Memorial Medical Center; possessed the infrastructure as a small regional operator; and had the ability to transfer residents to its sister facilities.
“What we tried to do at the time is build a COVID-specific facility so all the local nursing homes wouldn’t have to take COVID-positive residents coming out of the hospital,” he said. “In a month, that’s 100 residents we accepted into the one building that didn’t have to go another nursing home and assisted living.”
The move to transform Salmon’s building “was an incredibly scary decision,” Salmon said. “It was a dramatic change for the residents, staff in that building and others. We had a lot of pressure to have that building open as soon as possible.”
Converting the facility entailed moving 139 residents to sister and area facilities in four days in early April. In a video announcement, Salmon apologized for the disruption but explained that the facility was stepping up for the good of nursing home residents.
While the evacuation caused some friction among families, Salmon said a lack of understanding about the virus turned out to be the main issue. At the time of the evacuation, it was not yet known that asymptomatic people could transfer the virus. Therefore, the facility ended up evacuating some residents who were asymptomatic and who later tested positive for the coronavirus.
“If we had caught it sooner, we wouldn’t have done the move,” he said. “We recognized that. They didn’t’ understand how infectious seniors were at the time.”
Contrary to media reports, the evacuation was never stopped due to a patient who tested positive for the coronavirus, Salmon said, noting that a total of eight residents who showed symptoms of the virus were not moved.
“The media twisted that a bit,” he said. “It was never halted.”
Salmon credits UMass Memorial Medical Center, a teaching hospital located adjacent to the facility, with providing the necessary education to transform the nursing home into a recovery center. Among the hospital’s contributions: One clinical staff person, Gina Smith, director of emergency management and preparedness, who helped the facility set up infection control protocols and procedures.
The hospital also helped the facility to adapt its physical structure. To properly isolate staff from the residents, Beaumont created walls on each of the four resident care floors, separating the last two resident rooms and the sitting room from the rest of the resident care area. The staff use the two resident rooms for “donning and doffing” PPE at the beginning and end of shifts, while the sitting room is used for keeping PPE and other storage.
As part of the new effort, Ava Robotics Inc. donated a telehealth robot to the facility. The robot, which the staff affectionately calls Lindsay, enables clinician visits and connects families with loved ones.
The facility, averaging six patients a day, is busier than it ever was as a skilled facility, Salmon said. To earn payment as a COVID-19 treatment center, the facility receives enhanced Medicaid, Medicare and private insurance rates. The state promised to protect the facility from downside losses. Salmon, who said he did not embark on the effort to make a profit, said the facility likely will break even.
Salmon is pleased that Beaumont is filling a unique need among nursing homes.
“The building is up and running and it’s working as well as or better than we predicted at the time,” he said. “The idea we are cohorting all those COVID-positive seniors makes it a lot easier for us to manage. Staff are in full PPE. The residents are not at risk of infecting anyone else, and we are not adding to the chaos going in nursing homes as they try to cohort and manage clusters in Massachusetts. What we’re seeing is a lot of buildings are closed to admissions. As they send residents out, they can’t accept them back. This building serves a great purpose in being able to admit residents.”
Salmon feels good about stepping up for the cause of COVID-19.
“I’m proud to be on the frontline and doing what we can to help,” he said.