Watching television as the COVID-19 pandemic was unfolding across the nation in the spring on 2019, it struck Kent Emry as curious how long-term care facilities were locking down as soon as a person tested positive for the contagious disease.
The problem, he realized, was that once they were locked down, soon the entire population in a facility would come down with the disease — with sometimes up to half of them dying.
So Emry, who owns the company that runs Pacific Health & Rehabilitation in Tigard, told the Oregon Department of Human Services he'd be happy to make his facility ready for those who tested positive for COVID-19. From there, the plan was to triage those who arrived and determine whether they could be treated at the Tigard facility or if they needed to be sent to a hospital.
"It really was to save the lives of the people who are the other residents in nursing homes, by getting those COVID-19 positive patients out in the population as quickly as possible," said Emry. His company, Dakavian Management, runs Pacific Health & Rehabilitation and owns a total of eight nursing homes.
The state took Emry up on his offer, and in April 2020, Pacific Health & Rehabilitation became one of only a handful of dedicated facilities for COVID-19 patients in Oregon, with an initial contract from the state to have 50 beds available.
Recently, the Oregon Department of Human Services expanded its network of COVID-19 recovery units to include eight facilities, including the Tigard care facility, which now has a bed count that can handle as many as 70 patients — a valuable boost to bed capacity, at a time when the more contagious delta variant of the coronavirus has driven case counts and hospitalizations to record heights in Oregon. That's the largest number of available beds for a long-term COVID-19 recovery facility in the state.
The only other dedicated facility in the Portland metro area for the same type of patients is located at Avamere's The Pearl at Kruse Way in neighboring Lake Oswego. That location has 45 beds available for COVID-19 patients. It also offers monoclonal antibody therapy, which was developed last year to treat convalescent COVID-19 patients and was famously given to then-President Donald Trump after he was hospitalized with a serious case of the disease.
Pacific Health & Rehabilitation has been caring for COVID-19 patients nearly nonstop since the pandemic arrived in Oregon in late winter 2020.
"We have never not been doing this since the beginning," Emry said.
And the pandemic has taken a toll — not only in deaths, as COVID-19 has killed well over 3,000 Oregonians, but also on exhausted, burned-out healthcare workers.
Emry said his nursing home has the highest staff-to-patient ratios it has ever had.
"Staffing is tough right now, even in a facility where we're paying as much as we're paying," said Emry. "We have a very, very enhanced rate for employees working within the COVID recovery center, and it's still struggling to find staff."
Those direct care workers make $21 per hour over their normal pay, said Emry. Even kitchen workers make $15 per hour over and above their normal salary, he added.
In addition to having medical directors who are in the building several times per week, the Tigard facility offers occupational and physical therapy services for those recovering from COVID-19, allowing them to get their strength back before leaving.
When some of the other care facilities shut down during this summer, the Tigard facility was fielding up to 20 or more calls per day from as far away as Roseburg and Grants Pass to see if they could take some of their patients, according to Spencer Ross, nursing home administrator for Pacific Health & Rehabilitation.
"We're just trying to work as fast as we can to help everybody, as that's the whole reason we've been doing this … (to) help hospitals, health facilities. It's been a roller coaster here lately, but we're doing good. I think we're making a good, positive impact for everybody," said Ross. "Last month was our busiest month ever, for the last 16 to 17 months that we've been doing this."
"August was by far one of our most difficult, it was like relearning COVID-19 all over again. The patients are much sicker," Shannon Duff, a registered nurse and director of nursing at Pacific Health & Rehabilitation, wrote in an email. "It takes a physical and emotional toll on everyone, but we love what we do, and we support each other the best we can."
And there have been times when the care facility has been completely full — especially during a surge last winter.
While Pacific Health & Rehabilitation usually takes six to eight new patients in a day, it has taken as many as 13 — a large number for a nursing home, said Ross. While patients treated at the Tigard location are generally elderly, they did have one patient who was only 33 years old.
Ross said skilled nurses take care of everything from wound care to starting IVs. He noted that there have definitely been highs and lows along the way for staff and the nurses.
"We've had some stressful times, even just this past month, but we've got a good team," Ross said. "All the nurses, they know we're doing this for the patients and the community."
Morale is important.
"We try to have fun amongst ourselves while still dealing with a very stressful situation," Ross explained, adding, "They're doing pretty well overall."
Gretchen Kempfer, a registered nurse who is also the facility's resident care manager, agreed.
"It definitely helps when your team leaders are supportive and provide extra perks like coffee and tacos," she wrote. "We have a really strong team atmosphere that helps us all deal with the challenges of caring for very sick people."
Duff said the hardest part of the job is seeing patients who have to be isolated away from family and friends.
"We try to be pseudo-family to our patients and keep their families comforted in knowing their loved one is being cared for. It takes a lot out of us emotionally, because we care what happens to them," she said.
Kempfer said having to communicate with families and loved ones when the news isn't good is difficult.
"It's hard for the families to not know what's going on with their loved ones, it's hard to have to be the person to call someone and let them know their mom or dad didn't survive," she said. "It's especially hard being a care giver and not being able to actually help some of these patients because of the severity of their illness."
For the most part, Pacific Health & Rehabilitation has had the same group of nurses since the beginning of the pandemic, which has provided a sense of continuity, Ross said. That long-term help means they can often identify more quickly if a patient is deteriorating and get them more extensive help quickly.
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