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Nebraska long-term care homes are in 'awful fight' with coronavirus; how awful is unclear

LINCOLN — The coronavirus pandemic has reached more than one in 10 Nebraska nursing homes and assisted living facilities, causing sickness and death among some of the state’s most vulnerable residents.

At least that’s the best estimate from an industry representative.

Official tallies are unavailable from the Nebraska Department of Health and Human Services, including the number of affected facilities, number of cases among residents and staff, and number of deaths. Unlike some states, Nebraska also does not make public the names of facilities with infections.

An HHS spokeswoman said officials are “currently compiling and analyzing data” and “hope to have that available in the future.”

But Heath Boddy, president and CEO of the Nebraska Health Care Association, which represents both nursing homes and assisted living facilities, said long-term care homes are struggling to control outbreaks, maintain staffing levels and find enough protective equipment for workers.

“It’s still an awful fight, a war of sorts with the virus,” he said. “I think we are north of 50 buildings that have been affected.”

Nationally, the coronavirus has killed more than 11,000 nursing home residents, according to various sources. That’s out of more than 50,000 deaths in the United States.

Among them were at least 37 people associated with the Life Care Center of Kirkland, Washington, a nursing home that gained infamy as an early virus hot spot. The home now faces sanctions from Medicare for failing to meet federal care standards.

No known Nebraska outbreak has reached that level. But Carter Place, an assisted living center in Blair, went into lockdown in mid-March and later temporarily closed after 13 residents and six staff members tested positive for the disease. One resident, Darrell Dibben, died of the disease at age 90.

At least 22 infections have been tied to the Gold Crest Retirement Center in Adams, Nebraska. The infections, identified in late March and early April, killed three residents.

News reports have identified some of the others. Among them are cases connected to the Central Nebraska Veterans Home in Kearney, Douglas County Health Center in Omaha and Callaway Good Life Center in Callaway, Nebraska.

Michelle Chaffee, who heads the Nebraska Office of Public Guardian, raised an alarm about the rates of infection and death in Nebraska long-term care facilities. In a letter to state policymakers, she called for testing all residents and staff of a facility once a case is confirmed in the facility.

Based on her office’s experience with wards in long-term care facilities, she said there has been confusion and inconsistency in how facilities are handling coronavirus cases.

In one example, she said the public guardian was told that a ward would not be tested unless the person showed symptoms. After symptoms appeared, the person was tested but was not sent to the hospital even after his fever rose to 103 degrees. The ward finally made it to the hospital after the guardian insisted.

In another facility, she said, X-rays showed that a ward’s lungs were affected and that he had a constant cough but no fever. The facility refused to test him, saying that it had only two tests available and that those were being saved for people with most symptoms.

“As long as you’re only testing people when they have symptoms, you’re simply treating the results, you’re not treating the spread,” Chaffee said.

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On Friday, Mark Parkinson, head of the American Health Care Association and National Center for Assisted Living, also called for more testing in long-term care homes, saying the true extent of infections cannot be known without adequate testing. He said facilities that have done expanded testing have found a high number of residents and staff who have the virus but show no symptoms.

“Lack of timely testing in long-term care has forced providers to rely on a symptoms-based approach, which ... will not prevent the spread of COVID-19,” he said.

In Nebraska, Boddy agreed, saying homes would appreciate being able to find out the full extent of infection.

Nebraska, however, does not have enough tests available to test all residents and staff at facilities with infections, according to Dr. Gary Anthone, the state’s chief medical officer and head of HHS’s public health division.

Health officials instead focus on testing residents and workers who show symptoms of coronavirus, such as a fever, dry cough and shortness of breath. Once someone tests positive, officials investigate to find out who might have been exposed to the person and may need testing.

“We do not test individuals without symptoms, as they could test negative one day and then contract the virus in the following days,” said HHS spokeswoman Leah Bucco-White, noting that the state is following current guidelines from the federal Centers for Disease Control and Prevention.

To help facilities, she said, state public health officials have been working closely with local health officials, long-term care facilities and others on strengthening infection control policies and practices. State officials have provided training for staff and administrators on such topics as the proper use of personal protective equipment.

If a facility has an outbreak, Bucco-White said an infection prevention expert from Nebraska Medicine’s infection control assessment program, along with one of the HHS physician epidemiologists and local health officials, will work with administrators on controlling spread and ensuring safety for residents and staff.

“Care for residents in long-term facilities is a top priority,” Bucco-White said.

But getting supplies of protective equipment, such as masks, gloves and gowns, for proper infection control has been a struggle for long-term care facilities. Parkison’s group reported recently that more than 70% of providers have been unable to get enough equipment.

Jenifer Acierno, CEO of LeadingAge Nebraska, a network of nonprofit long-term care facilities, said homes have been forced to reuse equipment if they did not have a big stockpile on hand or access to someone who could sew homemade masks and gowns.

She said federal and state guidance has recognized the realities facing long-term care homes. For example, guidelines put out by the state and the Nebraska Medicine infection control program allow employees who have been exposed to coronavirus to continue working as long as they wear masks and are actively monitored for symptoms.

Acierno said that provision helps facilities that could see severe staff shortages if all exposed workers were forced to quarantine themselves.

“I think our members are doing the best they can,” she said.

April photos: Nebraska faces coronavirus

Kara Eastman softens unapologetic edge as she eyes 2020 rematch with Rep. Bacon

Omaha Democrat Kara Eastman has sanded some of the edges off her rhetoric and approach in her second try for Congress after a close loss in 2018.

She’s running a favorite’s race in the 2020 Democratic primary, looking past May 12 to the general election. She has focused her fire on GOP Rep. Don Bacon and largely ignored the two Democratic candidates she must defeat to take him on — lawyer Ann Ashford and restaurateur Gladys Harrison.

She’s reaching out early and often to Omaha-area political independents.

And the way she talks about her progressive policies has changed since 2018. For example, she uses the term “Medicare for all” less often — even though she supports Congress’ most expansive version of the proposal.

Her primary opponents echo Bacon by saying that no matter how Eastman describes her positions, they remain too progressive to pass in Congress — and too liberal for her to win in November.

Eastman, 48, surprised many in 2018 when she ran for Congress, taking on former Rep. Brad Ashford, who served one term in Congress before being unseated by Bacon in 2016 and who was trying to regain his seat with help from the local and national Democratic establishment.

At the time, Eastman headed a nonprofit focused on helping Omaha children by addressing lead contamination in the city. She also served as a member of the Metropolitan Community College board.

Eastman won the nomination with a progressive-funded guerrilla campaign, outmaneuvering a better-known, better-connected foe by running to his left. She took a similar approach in the general election, which she narrowly lost.

Eastman said she still proudly backs progressive policies and says the political climate is changing.

“Since our last election, the policies I advocate — single-payer health care, debt-free college, etc. — have become much more popular and accepted with the American people,” she said.

When asked about health care at local events, she says that she backs H.R. 1384, a House health care bill put forward by Rep. Pramila Jayapal, D-Wash.

Building Trades union leaders pressed Eastman on Feb. 26 to explain what that means: Jayapal’s Medicare for all bill replaces all health insurance, including plans negotiated by unions.

Eastman describes the Jayapal plan as the most efficient way to get Americans the most health care for the lowest combined cost, estimated at $28 trillion to $32 trillion over 10 years.

The current system is more expensive, she says, citing projections that Americans, their employers and their governments would spend a combined $34 trillion to $54 trillion over the same 10 years under the insurance-based system.

On health care, Ashford and Harrison support adding a publicly funded insurance plan to the Affordable Care Act exchanges.

Both said they see no path to passage for Medicare for all. They call it a politician’s promise, easy to say, unlikely to deliver.

Bacon, seeking a third term, said voters in the Omaha area’s slightly right-leaning swing district don’t want a revolution.

“I don’t believe voters will elect someone who will strip 180 million people of their employer and union-provided health care plans,” he said.

Eastman laughs at those criticisms today, another difference from the 2018 race, when she sometimes lashed out. She said it shows that others see her as the candidate to beat.

Republicans, she said, are scared that she’s positioned to win in an environment where Democrats and left-leaning nonpartisans want a stronger check on President Donald Trump.

Bacon, she said, was the first member of Nebraska’s congressional delegation to endorse the president, and Trump backs him.

She dismisses Ashford’s criticism as bad blood from Eastman beating her husband, Brad Ashford, in the 2018 Democratic primary. He was the last Democrat to hold the Omaha seat.

Eastman, now a consultant for nonprofit organizations, bucked the Nebraska Democratic Party’s orthodoxy in 2018 that people in red states prefer their candidates “Republican lite.”

Her 2018 team’s political argument: Stop chasing Republican Party crossover voters, and instead motivate infrequent Democratic Party voters hungry for a bluer shade of Omaha liberal.

In that race, Eastman never secured the full financial backing of the Democratic Congressional Campaign Committee, or DCCC.

Eastman and her former campaign team angered the congressional committee’s leaders by telling the press that the group’s backing of Brad Ashford was evidence of its lack of effectiveness, those familiar with the conversations have said.

When Eastman announced weeks after losing that she would seek a rematch with Bacon in 2020, national Democrats tried to recruit an alternative candidate or candidates.

One of the people they approached was Harrison, people familiar with the discussions said. But recruiters never helped Harrison raise the funds to compete, and she has lagged.

This go-round, Eastman and her new campaign have made it clear that they want and need the support of the Democratic Party’s progressive and establishment wings to beat Bacon.

They’ve worked to repair ties with House Speaker Nancy Pelosi and the DCCC, her group that funds Democratic candidates. Their aim: Show national leaders that Nebraska’s 2nd Congressional District is winnable.

The DCCC stands ready to help whoever wins the Democratic primary throw Bacon a “retirement party,” spokeswoman Sarah Guggenheimer said. She described him as one of the most vulnerable House Republicans.

Eastman said she knows what’s waiting in the general election, a Republican incumbent who is a retired Air Force brigadier general and GOP-aligned groups that together will paint her as too radical for Nebraskans.

The National Republican Congressional Committee, along with the Douglas County and state Republican parties, call Eastman a socialist, dubbing her “Comrade Kara.”

Last time, Bacon let Eastman bank to the left, while he courted the middle’s nonpartisan voters, knowing that he could rely on GOP support in suburban Omaha and western Sarpy County.

This time, Eastman is trying to blunt that by raising more money and building a door-to-door effort that made a full pass through the district before coronavirus concerns shut down in-person campaigning. She got TV ads up a week earlier than her next closest primary competitor, Ashford.

She disagrees with criticism from Ashford and the state’s older Democratic establishment that her unapologetically liberal approach fueled her 2018 loss.

Eastman lost by 4,945 votes, or 1.9 percentage points, in a district that political observers say leans about 4 percentage points toward Republicans, based on voter registration and turnout data.

Record-high turnout is protected for the 2020 primary, with a potential crush of new and infrequent voters casting ballots by mail to avoid risking exposure to COVID-19. The impact of higher turnout on the race is unclear.

Eastman, an Illinois native who moved with her husband to Nebraska when he got a job at Creighton University, created the nonprofit Omaha Healthy Kids Alliance in 2007.

She helped steer federal and settlement money set aside to clear lead from the nation’s largest Superfund site in eastern Omaha to help replace the yards where children play.

Let Republicans call her Comrade Kara, she said. Let some of the Democrats she has beaten or outlasted call her arrogant for believing in herself, as several did privately.

Soon, if she and her team are right, they’ll call her something else: the party’s nominee.

Dakota County, pop. 20,000, now has more coronavirus cases than Douglas County

Dakota County, across the river from Sioux City, Iowa, and on the South Dakota border, has only about 20,000 people.

But it also has a massive Tyson Foods beef plant in Dakota City where 4,000-plus people work, a plant that locals suspect is the center of a major coronavirus outbreak there.

Dakota County reported 608 coronavirus cases as of Monday, and one death over the weekend, eclipsing the 489 known coronavirus cases in Douglas County, which is home to Omaha and about 571,000 people. Dakota County’s per capita rate of coronavirus cases is 40 times higher than Douglas County’s.

Dakota County now has one of the highest numbers of coronavirus cases in Nebraska, second only to Hall County, where the Grand Island area is battling its own wave of infections. It joins a number of other coronavirus hot spots in Nebraska and across the country, many of which are heavily connected to the food processing or production industries.

“There’s a lot of information that we don’t have ... but everybody here feels it’s coming from the meatpacking houses,” said South Sioux City Mayor Rod Koch. “We’re not very happy about it. We wish there could have been testing a lot earlier than what was done, and we want more transparency about cases coming out of those places.”

The hits kept coming Monday for Nebraska’s meatpacking plants, with more workers testing positive in Fremont and Crete, too, prompting one plant to temporarily halt its operations.

The Smithfield Foods pork plant in Crete appears to be the first major meatpacker in Nebraska to close because of the coronavirus.

Pat Lopez, the interim Lincoln-Lancaster County health director, said Monday afternoon that the plant is closing. Crete Mayor Dave Bauer said the plant, which employs about 2,000 people, will close Wednesday.

It’s “too bad that it had to come to this, but I do applaud them for what they are doing to keep the employees safe and to be able to get on top of it before it gets worse,” he said.

Smithfield Foods declined to directly address reports that the plant will close.

“The company will make an announcement if there are material changes to its operations,” a spokeswoman for Smithfield Foods said Monday afternoon.

Eric Reeder, president of United Food & Commercial Workers Local 293, which represents workers at the Crete plant, said it was his understanding that after the Nebraska National Guard ramped up testing in Crete last week, a large number of tests for plant workers came back positive this weekend.

“That had to have prompted their decision,” he said.

A total of 47 cases of COVID-19, the disease caused by the coronavirus, have been confirmed among Smithfield workers, according to Public Health Solutions, the local public health department that includes the Crete area.

Dr. Josue Gutierrez, whose clinic, Saline Medical Specialties, treats many of the employees and their families, said the closure was welcome.

What’s happening in Saline County is happening in other meatpacking communities, he said.

“If we’re not doing things quickly enough, we can get to this point,” he said. “It’s a good idea to stop production.”

Also important, he said, is for people to commit to social distancing, wearing face masks and staying home in the days ahead.

“Quite honestly, as a community, we’re in this together,” he said.

Smithfield Foods has closed plants in Illinois, Wisconsin and Missouri because of the virus.

Lincoln Premium Poultry, which runs the Costco chicken plant in Fremont, reported an additional nine coronavirus cases Monday. A total of 15 workers there have tested positive, while 26 have tested negative, a company spokeswoman said.

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In Dakota County, in northeast Nebraska, cases have exploded in a span of just two weeks — the county health agency didn’t report its first case until April 12.

What some call the tri-state area — the region that includes Sioux City, Iowa, North Sioux City, South Dakota, and South Sioux City, Nebraska — is home to more than 150,000 people and several large food processing and meatpacking plants.

That includes the Dakota City Tyson Fresh Meats plant, which employs an estimated 4,300 people, and the Seaboard Triumph Foods pork plant in Sioux City. It’s not uncommon for workers, many of whom are immigrants and refugees, to live in one community and work in another, or to hop around to different plants.

Working from home is not an option at these facilities, and the demands of the fast-moving production line make social distancing difficult, too. Hundreds, sometimes thousands, of workers in shifts slaughter animals and slice and package meat standing nearly elbow-to-elbow, work that was often grueling and dangerous even before the pandemic.

To be sure, people can catch the coronavirus from friends or family or out in public, not just their workplace. Coronavirus clusters are occurring at nursing homes and long-term care facilities, too. Gov. Pete Ricketts has said the outbreaks tied to Nebraska meatpacking facilities aren’t solely the responsibility of the plants but are also a “community issue.”

Still, it’s unknown how many cases are tied to the Tyson plant in Dakota City. The Sioux City Journal reported earlier this month that a 64-year-old Sioux City man who worked there died after contracting the virus.

A Tyson Fresh Meats executive previously confirmed cases at the Dakota City plant in an interview with a local TV station, but company representatives have repeatedly said they will not divulge the number of cases at individual plants to protect workers’ privacy.

Dakota County Health Director Natasha Ritchison has declined to comment on how many people who work at the plant have tested positive or on how many cases have been reported in each Dakota County town or city.

A Tyson spokeswoman said its facilities have put a number of safety measures in place, including monitoring workers for fever, relaxing attendance policies so workers stay home when they’re sick and providing masks that must be worn.

“We’re working hard to protect our team members during this ever-changing situation, while also ensuring we continue fulfilling our critical role of helping feed people across the country,” spokeswoman Liz Croston said.

Koch, the South Sioux City mayor, said plant managers seem to be addressing the situation now, but he worries that it’s too little, too late.

“I’ve heard rumors people are afraid to go to work. I’m hearing attendance is way down,” he said. “But the genie’s out of the bottle. This stuff should have been done earlier. This thing is running rampant.”

He understands the arguments about keeping packing plants open to avoid disruption to the supply chain that includes the farmers and ranchers who raise cattle, hogs and poultry and the customers looking for meat at their local grocery store.

“I know everybody’s ringing the bell of ‘the food chain, the food chain,’ but at the same time, where does people’s health come in?” he said. “I don’t think any of us in this country are going to starve.”

Koch and the mayors of Sioux City, North Sioux City, Dakota City and Sergeant Bluff, Iowa, released a joint statement Monday asking local and state health departments to release more data on the spiking cases in Dakota County, Woodbury County, Iowa, and Union County, South Dakota.

“Further, we are asking all businesses in our various communities to take responsibility for any outbreak or spread of COVID-19 in their facilities,” they wrote. “This includes providing accurate information to employees and the public about any confirmed cases in their facilities and the steps they are taking to protect their employees. ... If these steps cannot be taken, we would ask the business to close until such time a response plan is in place.”

They also cautioned Ricketts, Iowa Gov. Kim Reynolds and South Dakota Gov. Kristi Noem against lifting restrictions in their respective states too soon.

Testing in Dakota County is becoming more widespread, with people heading to the volunteer fire station in Dakota City to get their noses swabbed.

“They’re testing a lot of people, so hopefully that will help, one, identify everybody, and two, help us get our hands around this thing,” said Dakota City Mayor Jerry Yacevich, a volunteer firefighter and emergency medical technician who’s been putting on gloves, a gown and mask to respond to 911 calls.

He said area hospitals don’t seem to be stressed or overtaxed with COVID-19 patients.

But people in his small city of about 2,000 seem to have been a little slower to take the virus seriously, he said. He doesn’t always see people wearing masks or staying 6 feet apart when grocery shopping or getting gas, though more seem to be following those guidelines in recent days after cases surged.

“People may have thought ‘Shoot, it’s not going to get here,’ and kaboom!” he said. “Guess what? It’s real and it’s here.”

World-Herald staff writer Henry J. Cordes contributed to this report.

Photos: Nebraska's coronavirus helpers


With city parks open again, Andrew Bodlak and his dog, Nyla, were able to enjoy a beautiful spring day at Elmwood Park. Social distancing guidelines are still in place in Omaha parks, which closed April 8 because of the pandemic. The state will allow Douglas County and 58 other counties to ease some restrictions next week. Find a rundown on Page 6A.

Former OPS principal sentenced for failing to report child-molesting teacher

Former Fontenelle Elementary Principal Eric Nelson had already pleaded no contest to a misdemeanor over his failure to report abuse by a teacher at the Omaha school.

But that didn’t stop attorneys from feuding during a sentencing hearing Monday over the validity of the charge.

In fact, the hearing took on the tenor of a trial — albeit a trial conducted via videoconferencing software, with Nelson and his attorney, Steve Lefler, appearing behind surgical masks.

Before Nelson was sentenced to two weeks in jail and one year of probation, Lefler rattled off several defenses of his client’s failure to go to authorities once two staffers raised alarms about first grade teacher Greg Sedlacek’s behavior with little girls. Under state law, adults, especially school and medical officials, are required to report if they have reasonable suspicions that a child has been abused.

“It’s all nonsense,” prosecutor Molly Keane said of Lefler’s defenses. “Excuse after excuse after excuse. If Mr. Nelson wanted a trial on this matter, he should have had a trial.”

It was a bit of a trial by broadband Monday. What no one disputed: that Sedlacek was the predator, having admitted to molesting six first graders in his short stint at Fontenelle. Sedlacek is serving 40 to 65 years in prison.

But when it came to Nelson’s handling of the matter, the two sides squared off over several matters, including:

OPS’s hiring practices

Lefler blasted the Omaha Public Schools for hiring Sedlacek in the first place. Sedlacek had a history of inappropriate behavior that led to his removal from an assistant teaching job at the Red Cloud Indian School on South Dakota’s Pine Ridge Indian Reservation.

He also was dismissed from a Catholic seminary in 2014 after an official from the Red Cloud school contacted the Archdiocese of Omaha about Sedlacek’s problems with observing boundaries with children.

Lefler noted that Nelson had no role in vetting Sedlacek. OPS’s central office should have, he said.

“All they had to do was check his records,” Lefler said.

Keane said such backgrounding has nothing to do with why Nelson failed to contact authorities about Sedlacek in November 2018. Two staffers had reported that they saw Sedlacek sitting on the end of a slide with a girl in his lap and his hand under her dress. They went to Nelson.

She noted that Nelson not only didn’t act, he also resisted and resented an assistant principal’s concerns about Sedlacek.

After not addressing the matter that November 2018 day, Nelson went to a doctor’s appointment the next morning. When the staffers returned to school that morning, they were shocked to find Sedlacek in his classroom before school, tutoring first grade students. An assistant principal, Cheryl Prine, contacted authorities.

When Nelson arrived, he ordered Prine into his office. She said Nelson was upset and angry and told her that it wasn’t her school and that “a man’s career was on the line.”

The filing of charges

in this case

Lefler said former Assistant U.S. Attorney Mike Wellman, a prosecutor, had reviewed Nelson’s actions and concluded that the case “never would have seen the light of day” in his time.

Keane’s response: Wellman is Nelson’s godfather so his opinion is biased. Keane said she filed based on Nelson’s lack of action in the face of obvious abuse.

The lack of charges

in other cases

Lefler pointed out that this newspaper has detailed the inaction of school administrators in several cases. Of note, Lefler pointed out that former Davis Middle School Principal Dan Bartels was not prosecuted for his handling of teacher Brian Robeson, who is serving 20 years in prison for repeatedly sexually assaulting a 14-year-old student. Lefler also noted that no Marian High School administrators were prosecuted for failing to report behavior by former assistant basketball coach Andrea Lightfoot.

Keane didn’t address Davis’ case, although a federal judge threw out a civil lawsuit against Bartels and OPS in that case. The prosecutor did address the Marian case, noting that the statute of limitations had passed because Lightfoot’s victim did not report the matter for seven years. Lightfoot, now known by her married name of Knecht, is serving 10 to 15 years in prison for abusing a 14-year-old girl.

“It’s slightly confusing to me who gets prosecuted in these cases and who doesn’t,” Lefler said. “It’s not even some get prosecuted and some don’t. Eric Nelson is the only (administrator) who got prosecuted.”

Reporting policy

Lefler said three retired OPS principals told him that OPS’s reporting policy left them confused. The previous policy, since abandoned, required the principal or an administrator to do some investigating before contacting either police or Child Protective Services.

Lefler argued that Nelson had two strange but not clearly criminal photos that had been brought to him by the teachers and was trying to line up the photos with surveillance video of the playground. He had yet to get through that surveillance video. Not even 24 hours had passed since the initial report.

Keane said the reporting law is clear.

“His focus was on protecting himself and Gregory Sedlacek, not this little girl,” Keane said. “He had every opportunity to get that man out of the classroom, to review that video. He didn’t think it was worth his time.”

Nelson’s reputation

Lefler said Nelson had 20 letters of support, including from former OPS Superintendent John Mackiel. Mackiel described Nelson — the son of one of his top assistants — as an “inspirational principal.”

Lefler also noted that more than 500 people had signed an online petition to reinstate Nelson as principal.

Now, Nelson is a woodworker.

“OPS is the loser that he is no longer an educator,” Lefler said.

Nelson didn’t address the judge.

He “struggles with the fairness of it all,” a probation officer wrote, after interviewing him. “Nor will he ever truly accept that his actions were criminal.”

The mother of one of Sedlacek’s victims summed up the matter best, Keane said.

Nelson “took what was already an unimaginably bad situation and made it worse,” the mother wrote. “He chose to protect a pedophile over my 7-year-old daughter.”

Notable crime news of 2020