COVID-19 fatalities at PBMC’s Skilled Nursing Facility attributed to hospital overflow, CEO says

As part of Peconic Bay Medical Center’s emergency plan to expand capacity during the onset of the coronavirus outbreak, the Skilled Nursing and Rehabilitation Center on the Riverhead campus was partly transformed into an overflow area for COVID-19 patients.

PBMC CEO and President Andy Mitchell said the short-term patients who were being treated at the facility, which is part of the hospital but has its own external access, were discharged. And the long-term patients were cordoned off to limit any contact with the new COVID-19 patients.

As a result, no long-term care patients have contracted the coronavirus and none have died, Mr. Mitchell said Tuesday afternoon. As the New York State Department of Health has begun releasing more data on nursing homes, PBMC’s Skilled Nursing Facility as of Tuesday has been listed with 15 fatalities attributed to COVID-19.

But Mr. Mitchell said those numbers are misleading since those deaths have been from hospital patients in the overflow section.

“We have a unique situation,” he said. “There’s only one other hospital on Long Island that has what we have, which is a hospital-based skilled nursing facility.”

Nursing homes and assisted living facilities have been breeding grounds for the virus as about 2,700 people confirmed with COVID-19 have died in New York and another 2,600 deaths are presumed to be due to COVID-19, according to the state DOH. In Suffolk County, there have been more than 700 deaths. Gov. Andrew Cuomo earlier this week announced additional precautions nursing homes and assisted living facilities must undergo, such as testing staff twice a week for COVID-19.

Mr. Mitchell said between 30 and 40 beds in the skilled nursing facility were used as the overflow area. The facility holds 60 beds.

“There’s a cordoned off section that remained for long-term patients and none of them were affected by COVID,” he said. “The overflow surge unit from the hospital, like every other hospital, we had a fair number of deaths. Those patients were counted because they were on the first floor.”

The second and third floors above the skilled nursing facility are medical surgical units.

Mr. Mitchell said given the current circumstances, it wasn’t worth trying to fight with state Department of Health over the classification of the fatalities.

“They key is that none of the long-term patients who are with us who are truly the skilled nursing facility patients got COVID,” he said.

There are between 15 and 20 long-term patients, he said.

Mr. Mitchell said there were never any issues with personal protective equipment for the skilled nursing facility staff since they are part of the hospital.

“We segregated the staff,” he said. “We were fortunate that we did not have a situation where COVID got into the unit.”

Part of the shift in policy announced by the governor is that a hospital cannot release a patient back into a nursing home until they test negative for COVID-19.

Mr. Mitchell said it’s too early to tell what effect that directive will have on PBMC. But he noted he’s seen patients who have not been hospitalized and needed six weeks before testing negative. So it could become an issue, he said.

As far as testing staff members twice a week, Mr. Mitchell said PBMC will follow those directives from the state and having a laboratory on site allows for quicker turnarounds on testing. Part of the challenge for testing is now around availability of the reagents — the chemicals used for the test — as demand increases nationwide.

As a result, some tests may be sent to Northwell Health’s core lab, which has an 18-24 hour turnaround, Mr. Mitchell said.

Mr. Mitchell said the hospital has plateaued with around 25 COVID patients at any given time since the crisis began. As of Tuesday afternoon there were about 95 total patients as more non-COVID patients begin to come into the hospital.

There’s been a concern that people have not sought care that they otherwise would have either out of fear of visiting the hospital or thinking there may be no room.

Mr. Mitchell said they’ve seen some patients in the emergency room in “dire condition” unrelated to COVID who should have sought care a week earlier.

“We’re seeing patients who have deferred their care for whatever reason now coming in much sicker,” he said.

The hospital recently had two patients suffering from heart attacks in the emergency room within minutes of each other. The hospital had room to treat them at the Kanas Regional Heart Center and both survived.