There have been at least 39 cases of COVID-19 at Maplecrest Rehabilitation and Living Center in Madison, seen last month. In addition, there have been seven deaths attributed in part to the virus, the Maine Center for Disease Control announced last week. Rich Abrahamson/Morning Sentinel file Buy this Photo

MADISON — A staff member at the Maplecrest nursing home failed a coronavirus screening questionnaire yet was still allowed to work a 10-hour shift, an oversight in violation of federal regulations, according to newly released documents.

The Maplecrest Rehabilitation and Living Center is still reeling from an outbreak of the COVID-19 illness that’s led to at least 39 cases and seven deaths there.

Documents provided by Maine Department of Health and Human Services following a survey of the facility suggest Maplecrest was not in compliance of federal requirements for infection prevention and control practices.

The facility has been directed to develop a plan of correction to address deficiencies. Additionally, the U.S. Centers for Medicare and Medicaid Services requires Maplecrest hire an independent nurse consultant to ensure the health and safety of residents and a temporary manager to ensure compliance with requirements.

The facility must file a plan of correction within 10 days of Sept. 16, when the results were issued to Maplecrest.

North Country Associates, the business that oversees Maplecrest, has not responded to multiple requests for comment, including a Wednesday afternoon message for spokesperson Mary Jane Richards.

The nursing home announced last month through a Facebook post that all visitations would be restricted after an employee tested positive for COVID-19.

A patient at Maplecrest recently told the Morning Sentinel about the emotional toll the outbreak is taking on the nursing home community, as all residents are confined to their rooms, and has called for greater transparency amid the outbreak.

The outbreak at Maplecrest has been linked by state health officials to a now-infamous Aug. 7 wedding in Millinocket, where crowd restrictions were ignored and masks were not required.

None of those who died at Maplecrest were attendees of the Aug. 7 wedding, but rather an adult wedding guest later came into contact with someone who then came into contact with a staff member at the nursing home.

In an email, a spokesperson for Maine DHHS said that in April, they contacted Maplecrest as part of the statewide Infection Control Assessment and Response survey. At that time, the facility was provided with education and responded that they had infection and control policies in place.

The Maine DHHS Division of Licensing and Certification subsequently conducted on-site visits at Maplecrest on Aug. 25, 28 and Sept. 4 to ensure compliance with federal requirements for infection prevention and control practices to prevent the development and transmission of COVID-19.

According to the documents, an employee or visitor should be considered to fail a screening if they have a cough, difficulty breathing, new shortness of breath, fever, loss of sense of smell or taste, new muscle aches or soreness not from exercise, repeated shaking with chills, sore throat or headache.

On the Aug. 11 questionnaire, a certified nursing assistant answered “yes” to having a cough, new muscle aches, repeated shaking with chills and sore throat, according to the documents. The employee then worked a 10-hour shift. A day after these symptoms were documented, the employee called and informed the facility that she had been exposed to a person that was positive for COVID-19.

On Aug. 18, the same employee produced a positive COVID-19 test.

A charge nurse was also interviewed by telephone by Maine DHHS and stated that she “did not notice a cough, but (the CNA) had that for some time.” The charge nurse also told DHHS that she does not look at the daily employee/visitor screening log as “everyone knows it’s their responsibility to let the Charge Nurse (know) if they are not feeling well,” and “as far as I know, there’s nobody looking at the screening tools. Nobody had ever checked it on my shift, and nobody has checked mine.”

In the statement of deficiencies provided by DHHS, the facility failed to implement recommendations and guidance provided by the U.S. CDC and Centers for Medicare and Medicaid Services regarding staff who presented with symptoms of COVID-19. Additionally, Maplecrest failed to have a system in place for the monitoring of systems during the screening process; these failures contributed to an outbreak.

Under the corrective plan Maplecrest must submit, the facility will need to answer how corrective action will be accomplished for those residents found to have been affected by the deficient practice; how the facility will identify other residents having the potential to be affected by the same deficient practice; what measures or systemic changes will be made to ensure that the deficient practice will not recur; how the facility will monitor its corrective actions to ensure that the deficient practice is being corrected and will not recur; and the date that each deficiency will be corrected.

Management at Maplecrest also has the opportunity to dispute the cited deficiencies through a written request that includes specifics on what is being disputed, an explanation and supporting documents.

 


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