Retirement Home Staff Tested After 6 Residents Die Of Coronavirus

EVANSTON, IL — The top administrator of Three Crowns Park on Friday announced all staff members had been tested for the new coronavirus, two days after disclosing a sixth resident had died from complications of COVID-19, the infectious respiratory disease caused by the virus.

Data from the Illinois Department of Public Health, or IDPH, on coronavirus outbreaks at nursing homes showed 18 confirmed coronavirus cases had been reported among residents and staff at Three Crowns Park, 2323 McDaniel Ave., as of Friday.

Phil Hemmer, executive director of Three Crowns Park, said in letters to residents there had been least nine COVID-19 cases among residents on the facility's memory care floor, known as Elsa House. Three residents of the wing died last week, he said.

"We have finally been authorized to provide coronavirus testing at Three Crowns Park. Until this week, testing was extremely limited and offered only to those clearly already symptomatic or exposed. Testing is critically important to protecting our residents," Hemmer said Wednesday.

"By hiring a private lab, Three Crowns tested Independent Living residents. Thankfully, 90 of 92 of these residents tested negative. A married couple tested positive," he said. "With the support of the Illinois Department of Public Health, we are testing Three Crowns staff."

By that time, at least six staff members had tested positive for the virus. One had recovered, Hemmer said. But it was not clear who made the decision to eventually test all staff — or if administrators had turned down the opportunity to test employees before the virus spread among the wheelchair-bound residents in the assisted living portion of the facility.

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On Friday, Hemmer said all staff had been swabbed for coronavirus, samples had been sent to the lab, and results should be available by May 1. Staff who test positive, he said, would be able to stay home with pay until cleared to return.

Administrators contracted with four new staffing agencies to bring in more employees to avoid a staff shortage and offered incentives for healthy employees to keeping coming to work, according to Hemmer.

The precise role facility administrators, state public health officials and the city's health department played in responding to Evanston's deadliest nursing home outbreak to date could not be determined. Hemmer has not responded to interview requests or written questions about the handling of the outbreak and testing at the facility. Audrey Thompson, the city's long-term care ombudsman, did not return messages Tuesday inquiring about the outbreak.

Evanston Health and Human Services Director Ike Ogbo, appointed to the position on a permanent basis in November 2019 by Interim City Manager Erika Storlie, declined to make himself available for an interview about his department's handling of the cluster of coronavirus cases at the facility. He responded to a series of written questions by explaining his department had followed state public health guidelines when it comes to coronavirus testing at Three Crowns Park.

"I am aware of the situation at Three Crowns. Three Crowns and IDPH have been working together regarding testing at the facility," Ogbo said in an email Tuesday. "The Health Department provided directions regarding testing to Three Crowns by following IDPH guidelines. We will continue to provide such guidelines unless we are provided another guideline from IDPH."

Last month, during question-an-answer sessions with Mayor Steve Hagerty, Ogbo described the city's response to Three Crowns outbreak as it developed.

"We have done a tremendous work at reaching out to pretty much all the groups here in Evanston — our long-term care facilities, our homeless shelters, day cares, our business owners as well," Ogbo said on March 17. "Our focus is to ensure that the right information is provided to our long-term care facilities so that they can protect themselves."

Two days later, during another livestreamed session with the mayor, Ogbo said the health department had consulted with Three Crowns administrators and done contact tracing in an attempt to identify those exposed to the virus.

"When that was determined, we sprang into action to coordinate with our local hospital for testing," Ogbo said on March 19. "What we want to do is to identify those who present severe symptoms, or symptoms that are indicative of the coronavirus, so that they can be tested, and once tested, that will give us a picture of whether they have the virus and whether they do not have the virus so that we can implement public health strategies and public health responses, so that people can be isolated from those who aren't sick, so that those individuals can be monitored."

Ogbo and Dr. Craig Conover, state epidemiologist for IDPH, met with Three Crowns administrators that same afternoon, according to a letter Hemmer sent to residents the following day.

"Their message has not changed. As advised by IDPH: They DO NOT test for COVID-19 UNLESS an individual is symptomatic," Hemmer said on March 20. He went on to provide a synopsis of advice provided by Conover:

Kirkland, WA and Willowbrook learned that testing can identify asymptomatic people who have tested positive, with the consequence of wasting PPE and other resources with minimal shedding of the virus and risk to others. At Willowbrook, none of the asymptomatic patients to-date have evolved into having a COVID-19 illness. Testing didn’t impact their care or outcome; it did use already limited resources. They don’t recommend haphazard testing aimed at identifying asymptomatic people.

The infectious disease specialists are also learning that there can be false negatives in COVID-19 testing. Some of it is operator dependent when a patient is not swabbed correctly. Negative tests, that are false negatives, also come from not having enough viral DNA to be detected the day of the test, yet could be positive the very next day. Having a negative test at a single point in time can give false reassurance.

Dr. Conover’s perspective is that we’re in a “new normal” and we have to assume we’ve been potentially exposed to COVID-19 just as there is sustained community spread in the Chicago area. He stressed the importance of rigorous infection control, surveillance for illness and screening staff at every shift rather than focusing on testing. He was impressed with the work we’re doing and said he feels the measures we’ve implemented are on target and well executed.

Earlier:

• Fourth Coronavirus Death Reported At Three Crowns Park
• Third Resident Of Evanston Retirement Home Dies Of Coronavirus
• First Coronavirus Deaths Reported Among Evanston, Skokie Residents

Just over a month later, Hemmer announced the facility had contracted with a private lab to test independent living residents. He also said administrators planned to test all staff in the future through a state program. Hemmer did not specify whether or not he had turned down the opportunity to test all staff earlier.

The same week, state public health officials announced a new approach to the spread of the coronavirus in nursing homes, which have seen more than a third of deaths in the state. The "two-pronged" approach includes increasing testing at targeted facilities that have yet to detect cases and ramping up testing at facilities with confirmed outbreaks.

After announcing that samples from all staff members had been sent to the lab for testing Friday, Hemmer said a resident who had recently tested positive had been relocated to "an area near others who are in quarantine with the virus," without saying whether administrators had devoted a wing to isolating residents who test positive for COVID-19.

As of Monday, there were 324 confirmed cases and 10 deaths among Evanston residents from coronavirus complications, according to the city.

Despite having more deaths than the rest of the city's nursing homes combined, Three Crowns Park does not have the most reported COVID-19 cases of facilities in Evanston, according to IDPH data, although nursing home coronavirus data released by state public health officials does not always match up with that provided by the individual facilities.

Aperion Care Evanston, 1300 Oak Ave., reported 27 cases among residents and staff, but no deaths. Symphony of Evanston, 820 Foster St., had 13 coronavirus infections and one death. There were 11 cases and one death at The Grove of Evanston, 500 Asbury Ave. Westminster Place, 3200 Grant St., had nine COVID-19 cases and no deaths, and Albany Care, 901 Maple Ave., had no deaths and two case, according to the state health department's tally.

For instance, The Mather, 425 Davis St., reported three confirmed coronavirus cases in its assisted living facility, but it does not yet appear on the IDPH list of long-term care facilities with coronavirus clusters. According to a message from Mather staff Monday, the Evanston Health and Human Services Department was tracing contacts of confirmed cases and would notify nursing home staff if the department believes specific residents should be tested.