The COVID-19 pandemic has affected many senior care facilities and nursing homes. But when news of the pandemic first started to reach the United States, administrators at the Maryland Baptist Aged Home, located in Baltimore, Maryland, took action. Those preventative measures have, thus far, prevented COVID-19 from entering the facility.
Early Preventative Measures
Reverend Dr. Derrick C. DeWitt, Sr., director and CFO, understood the potential gravity of the COVID-19 pandemic early on. “The news from around the world focused on how serious it was getting in other countries,” he explains.
“We hadn’t started taking it very seriously here. On the 26th of February, I heard the President say we have very few cases, and that by the end of the week it would be zero. It defied logic and common sense that it would disappear like that. So by the end of February and the first of March, we locked down the facility.”
That lockdown excluded all family visitation and prevented all workers who didn’t have direct contact with residents from entering the building. Outside contractors had limited exposure to the building. “We already had some pretty stringent safety measures in place,” he notes. “We’d had a full-time quality and infection control nurse, so she’d implemented a lot of stringent practices that helped us to be ahead of the curve.”
Employee involvement and investment in the nursing home’s prevention plan was also key to its success. “We did a lot of sit-downs with the staff to make sure that they understood the seriousness of what we were doing and why we were doing it,” notes DeWitt.
“The really important part was to explain why it was so important that they limit exposure to their family members and friends; we knew if the disease was going to hit the nursing home, it was going to be brought in from the outside. We asked them to really limit their contact with their own family members, which was a very hard thing to do, but we let them know it was necessary.”
The Maryland Baptist Aged Home has approximately 40 employees and 30 residents. “As a small facility, if the pandemic hit us it was going to be the end of our business,” says DeWitt.
Keeping the Faith
The fact that the facility is a faith-based institution meant that DeWitt faced lots of questions, especially when first putting preventative measures into place. Some employees and residents’ family members asked DeWitt why he was reacting as if he had no faith.
“Having faith is one thing, and then common sense is another thing,” DeWitt explains. “I have faith in God but I still wear my seat belt when I get in the car. Taking safety precautions is not an indication of a lack of faith. It’s an indication that you’re heeding wisdom as it relates to your faith.”
As it became apparent that the pandemic was much more of a threat than originally indicated, it became easier for others to understand the precautions behind DeWitt’s actions.
During the lockdown, DeWitt focused on ensuring that residents received the care that they needed – safely. The facility eliminated community meals, and residents ate in their rooms.
“This was a big deal for mental health and the community atmosphere, so we had to do a couple of things to enhance their experience,” he explains. Staff focused more on food presentations, including adding a fresh flower to the tray, to make meals more exciting, even though they were consumed alone.
The facility brought in extra activity staff to ensure that residents received daily visits, and helped to facilitate calls to their families. DeWitt solicited community help in purchasing TVs for every room and got a great response. Community members sent TVs through Amazon and Walmart, and the nursing home ended up with more TVs than were needed.
Extra cleaning staff also helped to keep the facility safe. Staff schedules were adjusted so that cleaning staff were present on every shift, instead of only during the day, as was standard. This change allowed staff to provide extra sanitation and to clean the entire facility at night while residents were sleeping.
Other changes included limiting the entrances and exits to one. Employees and visitors underwent temperature and interview screening. Those interview questions are highly detailed, asking staff to provide an hour-by-hour description of everything that they’ve done since they got off of their last shift. With such detailed screening, the facility will have thorough contact tracing in place if a staff member does test positive. Testing is performed weekly.
DeWitt is quick to credit others with the success of the facility’s plan. “I give a lot of credit, if not full credit, to our medical staff, our director, Josephine; administrator, Joanna; medical director, Leandra – they’ve been great in being proactive. All of our employees have made such a great sacrifice to make sure the residents have remained safe.”
Preparing for Challenges
DeWitt credits his early action to his awareness of what was going on elsewhere in the world. But prior preparation also played a role. “We’re a small facility, and I think we’re scrutinized a little more than some larger facilities,” says DeWitt.
“If a surveyor comes in and they do a random survey of a large facility of 300 people, they’ll look at a sample of 10% of the records. In our facility, with 30 residents, they have to look at everything. I think that forces us to maintain a high level of readiness. We already have extra water and extra PPE and supplies, and I think what we do is we go one step beyond what is required. If we’re required to have a two-week supply of water, then we have a three-week supply.
“One of the reasons I do that is because I understand, being a pastor in an underserved community, is that we are probably going to be the last to get whatever is needed.
“That’s been our history. We see that the pandemic is hitting Black and brown communities a lot harder that everywhere else; I think it’s because we’re already behind the eight ball when it comes to access and affordability of medical care in our community. Mentally, we prepare for that – if we get help, we’ll probably be the last to get help, so we need to help ourselves.”
Looking to the Future
As states start to loosen restrictions, the Maryland Baptist Aged Home is slowly and minimally making changes, too. The facility has started to allow family visitations on the porch by appointment and at a great distance. “I just think that we haven’t even scratched the surface of what this is going to be like because of our lack of national response,” says DeWitt. “We have to take care of ourselves. We’re not loosening restrictions at this point with the exception of that minor visitation.”