PITTSBURG, Kan. — In its latest reporting on COVID-19 outbreaks, the Kansas Department of Health and Environment (KDHE) identified active clusters of positive cases in the past two weeks at two local long-term care facilities.


According to KDHE, Pittsburg Care and Rehab Center had six positive cases and Via Christi Village of Pittsburg had five cases within the past 14 days as of Wednesday.


Despite these newly reported clusters, and most of the coronavirus-related deaths in Crawford county being related to long-term care facilities, county health officials told the Crawford County Commission on Friday that they are impressed with how these facilities are handling them.


"They are being appropriately aggressive," Crawford County Public Health Officer Dr. Tim Stebbins said. "They are doing a great job."


Differences between local health department data and the state’s numbers have previously raised questions about the reliability of KDHE’s cluster reporting.


Stebbins said that long-term care facilities are testing regularly, sometimes twice a week. Because of the high concentration of testing, the county had elected to keep their data separate from the rest of the it’s numbers.


"It’s not truly reflective of what we are trying to evaluate for positivity in the community," Stebbins said. "Those are isolated areas."


Because nursing home residents are being tested so often and mostly coming back negative, including those numbers in the county’s total testing data "could actually dilute our community numbers to the point where you almost get a false sense of security," Deputy Crawford County Public Health Officer Dr. Linda Bean said.


Stebbins said that as those in long-term care facilities are the most at-risk population, health officials will continue to monitor them carefully.


In late August, all long-term care facilities in the county were directed by the health department to return to "phase red," or the most restrictive phase in their reopening plan.


Last week, however, county officials were discussing the possibility of increasingly allowing limited visitation at area nursing homes.


"I’ve had several calls pertaining to people wanting to see their loved ones in the nursing homes," Crawford County Commissioner Tom Moody said at the commission’s Sept. 25 meeting.


Stebbins said at the time that the Centers for Medicare & Medicaid Services (CMS) had recently released guidance on nursing home visitation, which were based on community impact. In Crawford County, Stebbins said, the community impact of COVID-19 was judged to be moderate.


"We are, by that guideline, working to open up visitation, at least on the outside visits with barrier mitigation to allow for family interaction," he said. "We know it’s important. As medical professionals we know it’s important, it’s needed, but we need to do it safely. The inside visits we can’t really safely open up yet, and that also follows the CMS guidelines."


Stebbins also discussed some of the bureaucratic challenges of managing the response to the pandemic.


"We do have a challenge with the CMS visitation policy because KDADS — the Kansas Department for Aging and Disability [Services] — they have a set of criteria," he said. "CMS says ‘We’re in charge,’ KDADS says ‘We’re in charge,’ and in the background we have KDHE that’s also playing in the picture, and then us, locally."


All long-term care facilities in the county, however, have been included in calls with the local health department several times a week, Stebbins said, and some were beginning to reopen for admissions and outside visits, while all of them were in the process of submitting plans last week for how they would handle visitation moving forward.


"Right now we have four facilities that have positive either residents or staff. And the number’s not big, but it's there, and so we have to protect the residents, because that population is the single highest rate of injury and death, right, and accounts for half of our deaths," Stebbins said. "So we want to do the right thing there. But we want to do the right thing also with visitation and allowing them to open, because they’re dwindling, because they can’t see their family."