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Assisted living facilities, state officials striving for resident safety

Visitation restrictions a difficult aspect for residents, families

The Salem Mennonite Home in Freeman, an assisted living facility, is one of many such care providers that are dealing with the challenges of COVID-19 in 2020. (Erik Kaufman / Republic)

Assisted living centers and nursing homes in the area are striving to protect their residents, staff and communities from the threat of COVID-19, and it’s taking a little extra work and cooperation between facilities, each other and state health officials.

There are 162 assisted care living facilities and 104 nursing facilities licensed with the South Dakota Department of Health, and they are all currently facing various levels of challenges as they battle the infectious respiratory disease that has killed thousands in the United States and infected over a million people worldwide.

Chris Qualm, administrator for licensure and certification at the South Dakota Department of Health, said that while the front lines of the battle against the disease are in the facilities themselves, state experts are in regular consultation with those facilities to provide the latest information and help share effective methods and protocols.

“We’ve been working closely with the long-term care community since the beginning of the pandemic,” Qualm said.

There is a great deal of information to parse, he said. The state helps provide support in areas of Medicare and Medicaid guidance or Center for Disease Control recommendations, as well as working with long term care associations, he said. They also continue to beat the drum for best hygiene practices, such as regularly washing hands, social distancing and screening any visitors to the facility, if they are allowed in at all.


“We understand they have a lot on their plates, and our focus is on infection control,” Qualm said. “We reiterate the core infection prevention principles probably more frequently than anything we talk about. Getting down the basics - washing hands, wearing masks and monitoring and screening people as they come in. Testing is so vital.”

The state does not officially track which facilities are and are not allowing the public in for visitation, with Qualm saying it often depends on the particulars of each facility, it’s location and the overall state of the pandemic in its area.

Visitors currently are not allowed inside the Menno-Olivet Care Center, an assisted-living facility in Menno. The center, which consults regularly with the state department of health, has 35 residents in its care, with no reported cases of COVID-19 yet.

“We are very fortunate that in our facility we have not (had cases of COVID-19). I know other facilities that have, but we have been very fortunate,” said Kelsey Bertsch, administrator for the center.

She credits that to a dedicated, focused staff and a strong adherence to state recommendations on spread mitigation. It has not been an easy time since the arrival of the disease earlier this year, but sticking to those measures, including restricting visitors, seems to be having a positive effect.

“We’re following infection control practices, and we have an awesome staff here willing to do anything they can to keep the residents safe,” Bertsch said.

Qualm said closing a facility off from outside visitors can be a difficult choice, one that frustrates both residents and their loved ones who are forced to interact through other means other than in-person contact. Some larger facilities with more than one wing can isolate infections in those wings, whereas smaller facilities may find it more difficult to separate the infected from the non-infected.

“We know there are multiple facilities providing visitation, but it depends on the capabilities of the home, the experience of the nurses, availability of the staffing and how the building is set up,” Qualm said.


Bertsch said residents and the public are dealing with the circumstances as best they can, but there is some frustration when it comes to visitation. Often a publicly-welcoming and social community hub under normal circumstances, the center has had to find ways to substitute for that in-person interaction.

“Residents want to see their families, and families want to see the residents,” Bertsch said.

At the Salem Mennonite Home in Freeman, another assisted care facility with 36 residents in a small community, they have taken similar steps to keep COVID-19 at bay, and thus far those steps have been working. The home has yet to record a case of COVID-19, and Shirley Knodel, administrator for the facility, aims to do everything she can to ensure that remains the case.

“We haven’t had any here yet, and we’re praying it stays that way,” Knodel said.

The facility set up visitation between residents and family outdoors during the warm summer months, where it was easier to maintain social distancing practices, and have come up with a few other options for maintaining the connection between residents and the outside world. Video calls, which have replaced many workplace in-person meetings around the world since the start of the outbreak, are becoming more frequent in 2020, she said.

“We have video calls that help residents talk to their family, but it’s not the same. We had resident council yesterday, and they’re all fine with where they live, but they just want to be with their family. And we’re working on that,” Knodel said.

Knodel said Salem Mennonite Home officials keep in close contact with the state department of health and monitor local, county and state COVID-19 statistics to keep a finger on the pulse of the state of the disease outside their doors. They work closely with Freeman Regional Health Services, an Avera affiliate. They consult the state recommendations on reopening, but with 65 active cases in Hutchinson County, the home isn’t ready to take that step just yet.

“We’re watching Hutchinson County numbers and following the state plan for reopening, but (the numbers) haven’t gotten low enough yet,” Knodel said.


Qualm said long-term care facilities are put in the difficult spot of balancing the overall physical health of residents with their emotional and psychological needs.

“It is a balance. You want to have that infection prevention, you don’t want to transmit the virus, but you want to meet the psychological and emotional needs. It’s a definite challenge,” Qualm said.

Both Knodel and Bertsch said that separation is a necessary sacrifice at this stage, and the first priority is keeping residents and staff away from COVID-19. They both said they consult with the state department of health on a regular basis, and even consult with each other on best practices, with both facilities located in Hutchinson County.

Federal funds provided some assistance when it comes to testing, with Qualm saying the state department of health conducted 18,600 tests of long-term care residents and staff in the state in May, and have since continued with sentinel testing on a weekly basis.

“Testing is vital in order to identify a case and quickly make an intervention so you can isolate or quarantine for treatment. We’re talking about a very vulnerable population, (these residents) are in skilled facilities for a reason,” Qualm said.

The disease continues to disrupt virtually all aspects of assisted care in the state. For the Salem Home, it has even slowed the fundraising campaign that aims to build a new, expanded facility in town to replace the old one, parts of which date back to the mid-1900s. The economic instability caused by last year’s flooding, now coupled with the impact of COVID-19, has slowed donations, though Knodel said they are still moving forward with their plans.

Qualm said the cooperation between facilities and state officials is vital to keeping one of the more vulnerable populations safe and healthy, and it’s something that state will continue to provide as it can.

“The only way that we are going to be able to respond effectively is to have that partnership. We want to work with the providers and they want to work with us and the associations,” Qualm said. “We just want to support each other, and the only way we can do anything effectively is to continue with those strong connections.”

Erik Kaufman joined the Mitchell Republic in July of 2019 as an education and features reporter. He grew up in Freeman, S.D., graduating from Freeman High School. He graduated from the University of South Dakota in 1999 with a major in English and a minor in computer science. He can be reached at ekaufman@mitchellrepublic.com.
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