America's Best Nursing Homes Are Ready for What Happens Next With COVID

As the cold weather rolls in across the country, many people are bracing for a new surge in COVID-19.

Several states have already seen a spike in positive COVID-19 tests and COVID-19 hospitalizations over the past few weeks, according to maps published by the Centers for Disease Control and Prevention (CDC) and its data tracker.

On average, positivity rates were 10.1 percent, down 0.8 percent from the previous week ending on September 30. Colorado, Montana, North Dakota, South Dakota and Utah were some of the most affected states in the country, with Wyoming having the highest positivity rate in the nation at 13.4 percent.

There were 16,766 COVID-19 hospitalizations through the week of October 3, down 8.2 percent from the previous week, according to the CDC.

Several states, however, saw jumps in COVID-19 hospitalizations over the past week, including what the CDC calls "substantial" increases in New Hampshire (a 38.6 percent rise) and Rhode Island (a 28.6 percent increase).

During the height of the pandemic, staff and residents of nursing homes, assisted living and eldercare facilities were some of the hardest hit populations in the country.

In 2020, a report from the Henry J. Kaiser Foundation found that more than a quarter of the residents and staff in nursing homes and assisted living and long-term care facilities in 23 states had died from COVID-19. The report also found that at the time, 36 states reported nearly 51,000 new coronavirus cases in more than 4,000 of these facilities by the end of April 2020.

Mathew Levy, the CEO of NYC Health + Hospitals/Sea View, told Newsweek in an interview it was "heartbreaking" to see families separated and residents say goodbye to loved ones over FaceTime or through a glass window during the height of the COVID-19 outbreak.

But three years into the pandemic, Sea View has been able to ease some of the protocols and restrictions that were implemented to keep everyone safe early on. Visitors are no longer required to present a negative COVID-19 test, making the home feel less like entering a prison, Levy said.

"I'm glad that we've evolved, but we've learned a lot and I hope we never go back to that. I don't see our society surviving another shutdown, or I just don't know how it would work," he said. "I think we can treat this now. I think we know what we're doing and what's best for residents and nursing facilities and hospitals."

In 2021, the nonpartisan U.S. Government Accountability Office (GAO) found that more than 99 percent of nursing homes had COVID-19 outbreaks from May 2020 to January 2021.

The Sea View facility, which is part of NYC Health + Hospitals, began caring for elderly patients in the 1970s and offers several services, including short-term rehabilitation, long-term skilled nursing care and specialized care for serious injuries.

"This was a virus that came in, you had a plan, and it basically laughed in your face," Levy said.

Newsweek just ranked NYC Health + Hospitals/Sea View as the top nursing home in the state of New York for the second year in a row as part of its list of the best nursing homes in the country for 2024.

In addition to performance data and reputation, the ranking was also determined by a COVID-19 score. This score was calculated using data from Statista and was based on total confirmed resident COVID-19 cases, total resident COVID-19 deaths and vaccination rate for staff and residents.

Levy has worked at Sea View for five years but has been in the nursing home business for about two decades. He credits the facility's connection with the New York City public health system to providing the bandwidth and resources to manage the COVID-19 outbreak.

"While we were here 24/7 doing the best we can to navigate the challenges that COVID presented, we were able to do it in an easier fashion," he said. "When we needed help, we had buses of staff come in from all over the country, right, there was an open checkbook to say whatever is best for the residents, whatever is best for the patient, make sure it's done."

The facility was able to quarantine sick residents, get more nurses and physicians and hire a respiratory therapist. While there were COVID-19 deaths in the facility, Levy said the extra support allowed them to mitigate the impacts and treat residents and their families with dignity and respect.

He noted that everyone heard "horror stories" of mismanagement in nursing homes during the pandemic and said that the nursing home industry as a whole often doesn't do a great job of communicating internally or with the outside world.

"I find out what makes us successful at Health + Hospitals and definitely at Sea View is my communication and the team's communication with our families and our residents," he said. "We want them to know what's going on, we want to be transparent with them. We want them to understand that we're not impervious to COVID or other issues. I think people feel comfortable with [us] and we helped develop that sense of trust over the past three years [when] there's been questions in the nursing home industry as to can we be trusted."

At John Knox Village of Central Florida, early action and education for residents, nursing residents, staff, vendors and families were key to managing COVID-19 outbreaks.

"We provided the first education sessions to our entire campus as COVID was becoming an emerging illness in the U.S.," John Knox Village Director of Clinical Services Nicole Vega told Newsweek in an email.

From then, Vega said the facility treated COVID-19 like any other emergency: following protocols and recommendations from the CDC, tracing outbreaks and keeping lines of communication open.

She also noted that support from state resources dedicated to senior living was essential.

"Leading Age Florida and the Florida Health Care Association provided daily [and] weekly calls and made their teams available to assist with any needs we faced around the clock," she said. "Their teams provided a direct connection to regulators and helped decipher the enormous amount of information coming out daily."

These resources, along with establishing open and ongoing relationships with local health department partners, continued to provide support to the facility amid any updates or surges, Vega said.

"COVID has proven itself to be a formidable illness, and it's not likely going away," she added.

While both of these facilities relied heavily on local and state support to manage the pandemic, Levy recognized that those resources and services "are not commonplace in the industry."

"I think funding is something that's really lacking," he said. "Nursing homes really are significantly underfunded."

Facilities like Sea View in major cities were able to get extra supplies and money to help treat patients, but that is not always the case in more rural areas.

Levy proposed that officials at the state and federal level need to reassess how much money is allocated toward nursing homes and senior living facilities while finding ways to boost staff recruitment.

"How we can make nursing homes a more attractive place to be and for staff and potential nurses to see the mission and good work that we're doing here," he added.

Despite reports that COVID-19 cases and hospitalizations are on the rise across the country, Sea View has not experienced a spike, Levy said.

But he is still on alert, as he said the threat of a COVID-19 outbreak is still a real possibility. He said COVID-19 appears to be a virus that will peak and spike at certain times during the year and, therefore, his staff is ready for it.

"In my eyes, it never left," he said. "While we're not seeing the high level of mortality the way we were or increased sickness, I think we've become comfortable with the idea of how to treat this."