'Devastating beyond words': Inside Prairie Crossing's COVID-19 outbreak in rural Shabbona

SHABBONA – After her long-term facility reported it was 100% free of COVID-19 on July 9, Dana Payton said she was excited.

But as time wore on, COVID-19 ended up finding its way into Prairie Crossing Living and Rehabilitation in Shabbona, which to date has seen 74 cases and three deaths, the second-largest in DeKalb County.

Even when it was in outbreak mode, things were mostly contained for a month. After three initial cases on Sept. 29, two in staff and one in a resident, there still were only five cases on Nov. 20. Ten days later, they were up to 27 cases.

The facility in Shabbona, a village in rural southern DeKalb County, is licensed for 91 beds. There have been 54 residents and 80 staff members at the facility, according to an email to the health department. With 24 cases in staff and 50 in residents, that means 55% of the residents and staff have been infected.

Payton, who is the regional director of operations for five Prairie Crossing facilities in Franklin Grove, Oregon and Shabbona, declined an interview with the Daily Chronicle, although in response to a request for comment issued a statement.

“The results are sombering particularly because so many were asymptomatic at the time of testing,” the statement read in part. “Despite taking every precaution and following all guidance, COVID-19 is ravaging skilled nursing facilities throughout the country and county. For everyone lost to this deadly virus and everyone still fighting it every day, this pandemic is simply devastating beyond words.”

The outbreak is the largest currently in the county among eight long-term care facilities, and second overall. Earlier this year, Pine Acres Rehabilitation and Living Center in DeKalb battled an outbreak that ended with 82 cases and 12 deaths. The number of cases at Prairie Crossing recently surpassed Willow Crest Nursing Pavilion in Sandwich, which had 68 cases and 15 deaths during its first outbreak.

The past month has seen exponential growth in COVID-19 outbreaks and deaths in long-term care facilities. Throughout DeKalb County, eight facilities currently are battling COVID-19, with seven out of 10 deaths since Dec. 5 linked to residents of four facilities.

Currently, Lincolnshire Place in Sycamore reports 46 cases and three deaths, Oak Crest-DeKalb Area Retirement Center in DeKalb reports 51 cases and a death, and Bethany Rehabilitation and Health Care Center reports 70 cases and one death.

“Like nursing homes around the country who have been impacted particularly hard in this pandemic, the Prairie Crossing Living family mourns the loss of those taken by COVID-19 and those fighting the virus,” Payton wrote in the statement. “Our condolences and sympathy go out to their families and friends. Our appreciation and admiration goes out to our heroic staff who courageously work on the front lines every day to care for the most vulnerable of our society.”

Inside Prairie Crossing

Emails obtained by the Daily Chronicle through the Freedom of Information Act show the facility’s correspondence with the DeKalb County Health Department throughout the pandemic.

In a June 17 email, Payton reached out to Stacia Runge, health department coordinator of communicable disease, to find out about COVID-19 testing frequency as baseline testing was set to begin.

On July 9, she shared the news with Runge about the 100% negative tests.

“I know some of the other facilities in the county have struggled, but I am excited by our results,” Payton said in an email to Runge.

Fighting outbreak

Kristen Etchison, Prairie Crossing facility administrator, sent a number of emails in late October asking about leaving outbreak mode.

On Oct. 29, when there still was a single-digit number of cases at Prairie Crossing, Etchison asked Kathryn Kovac, clinical team leader at the county health department, why they were listed as having a resident case, implying that they had no resident cases at that point. Kovac answered that the number of staff and residents reported continues throughout the outbreak, regardless of currently ill cases or recoveries.

Local health departments are required by the Illinois State Department of Health to report all COVID-19 activity within long-term care facilities.

On Oct. 28, Kovac sent Etchison an email reviewing a contact trace of someone at the facility – the name was redacted – and said the symptom onset was Oct. 16, within 28 days of the last onset. That meant outbreak mode was to continue.

In the email, Kovac added the new positive test also starts the testing of all negative staff and residents every three to seven days until no positives are identified for 14 days.

Managing earlier cases

A facility does not enter outbreak mode until there is one confirmed case and one probable case, per the Illinois Department of Public Health.

On June 4, Brooke Fruit, registered nurse and director of nursing at Prairie Crossing, emailed Runge to inform the county about a positive test in an employee. That employee, a resident of La Salle County, had last worked on May 23 and had been off since May 24 unrelated to being ill, Fruit wrote in the email. The positive test came on May 31.

It was the first positive test in the facility.

Case totals for long-term care reporting are published in specific ways.

Health departments are required to report cases and deaths linked to the facility regardless of residency (much like Northern Illinois University's elected reporting), but the DeKalb County Health Department only includes deaths and cases in local totals if the person infected lives inside county limits.

Runge, in her response, talked about what outbreak mode would entail, including daily submission of lists of staff and residents, a symptom monitoring log and test results among other things.

Fruit indicated the staff member from La Salle returned to work on June 20.

In a July 10 email Payton wrote to Kovac, she mentioned a staff member that also worked at Pine Acres.

“I do recall mentioning one staff member that we were going to watch because she worked at Pine Acres,” Payton wrote. “She was off at least 3-4 weeks before picking up shifts at our facility. She resigned and left the state for awhile and no longer works for us.”

Testing and response plan

On June 23, Etchison sent the county the facility’s resting and response plan. The 10-page document laid out various procedures in detail.

The plan said test results would be given both written and verbally to residents, families, legally authorized representatives and health care providers.

During outbreak conditions, the facility will test asymptomatic residents who are at elevated risk for transmission based on exposure outside of the facility, which includes those who make trips for dialysis, cancer treatments or other such services.

There was also a plan for staffing shortages, which included transfers from sister facilities, if available. Another plan was to offer retention and overtime incentives for staff members.

Supply requests

On April 6, Payton made what appeared to be the first personal protective equipment supply request, for 50 N95 masks and 350 surgical gowns.

On April 28, Melissa Edwards, emergency preparedness coordinator with the county health department, informed the facility that the state would be sending 200 N95 masks, 2,000 surgical masks, 2,000 gloves, 100 face shield sets, two boxes of hand sanitizers and 200 shoe covers.

On May 19, Payton indicated the facility needed 100 more surgical masks, 20 coveralls, 12 boxes each cavi wipes (germicidal cleaner) and 80% antiseptic, and the one pair of infrared goggles allowed per facility.

A June 12 order was for 2,000 large gloves, 2,000 extra large gloves, 500 face shields, 500 N95 masks, 1,000 surgical masks and two boxes each of hand sanitizer and cleaner.

Surge in Shabbona

Throughout the pandemic locally, Shabbona has always recorded one of the lowest overall positivity rates in the county. As late as Sept. 9, even into the start of in-person schools at Indian Creek school district, Shabbona reported only six COVID-19 cases and a positivity rate of 1.1%.

Numbers indicate virus surge within the village has correlated directly with the outbreak at Prairie Crossing within the past two months.

“The IDPH website updates the number of confirmed cases and the number of deaths per facility on a weekly basis,” Payton said. “In an effort to protect our residents and staff, we initiated testing of all our residents and staff and increased testing as the community numbers rose.”

On Sept. 29, the first case was reported at Prairie Crossing. That day, Shabbona had 14 cases and was still at a 2.3% overall positivity rate.

As late as Nov. 20, Shabbona had just 33 total cases as there were still just five reported at Prairie Crossing, and the overall positivity rate was 4.5% for Shabbona.

But 10 days later, Prairie Crossing reported 27 cases at the facility. And on Dec. 4, the village of Shabbona was up to 74 cases during the pandemic, and an overall positivity rate of 8.3%.

On Tuesday, Shabbona had 94 cases and 943 tests as it approached a 10% positivity rate for the first time.

“The health and safety of our residents and staff is our solitary focus at this challenging time,” Payton said. “We are doing everything we can to stop the spread of COVID-19 within our facility, including testing as directed by the department of health strictly adhering to all guidance from the CDC, and staying in close communication with local and state health officials to ensure we are taking all the appropriate steps.”