In Baltimore, a struggling, black-owned nursing home keeps covid-19 at bay

By Rebecca Tan July 24, 2020 at 7:00 a.m. EDT

BALTIMORE — Some call the nondescript building in West Baltimore a miracle. Because amid a raging pandemic that has infected nearly 10,000 people in the city, including 338 in its Zip code, the nursing home has remained free of covid-19.

Tucked between run-down townhouses and a drug rehabilitation facility, the Maryland Baptist Aged Home is the oldest black-owned nursing home in the state. It serves predominantly low-income, older black and Latino adults who have proved to be the demographic most vulnerable to the novel coronavirus. Most of the 40 employees are people of color, and many live in the same Zip code as the nursing home, where the median household income is less than $40,000 a year.

To outsiders, it may seem as if the 100-year-old facility has kept the virus at bay only by the grace of God, said the Rev. Derrick DeWitt, who serves as its director. But there have been other, man-wrought blessings, too: a relatively small population of 29 residents, a strong history of infection control, a dedicated staff and — this has been key — the cynicism that comes with residing in an underserved community.

“We’re used to being the last to get help if and when it comes,” said DeWitt, 53, who grew up nearby and serves as pastor of a Baptist church in the same neighborhood. “We knew that when the virus came we had to take care of ourselves, because no one else would.”

For DeWitt, alarm bells started ringing when President Trump said on Feb. 28 that the novel coronavirus was a “hoax” spread by Democrats. It seemed like a sign that things were about to deteriorate, DeWitt said, so he directed the nursing home to enter “full lockdown.”

Too few masks, tests and workers: How covid-19 spread through Maryland nursing homes

The facility barred all visitors, stopped communal meals and ordered protective equipment two weeks before the first infections were reported in Baltimore. In the following months, as the virus tore through hundreds of long-term-care facilities in Maryland, infecting more than 13,000 residents and employees, Maryland Baptist was spared.AD

Faced now with a resurgence of the virus in Baltimore, administrator Johana Walburn said the facility has been staying extra vigilant and testing all residents regularly.

Her approach to the crisis can be easily summarized: “Cleaning, cleaning, cleaning,” she said. “Every surface, every day.”

A sign at the Maryland Baptist Aged Home this month.
A sign at the Maryland Baptist Aged Home this month. (Marvin Joseph/The Washington Post)

DeWitt had invited her to work at the nursing home three years ago, drawn by her decades of experience and her natural empathy — “her fit,” he said — for low-income, elderly residents.

Walburn, however, was initially ambivalent. The Jamaica native had spent her career working in large nursing homes, including “fancy” ones in Montgomery County, where she lives. The drive to West Baltimore would be an hour each way. And like some patient families, she had reservations about the neighborhood, known to be dangerous in a city that has the highest homicide rate in the country.

When DeWitt invited Walburn to tour the facility, however, she liked what she saw — and smelled. “No odor,” she remembered. “Everything was nice and clean.”

Ten years ago, Maryland Baptist hired a full-time infection-control nurse who instituted a rigorous cleaning regimen. At the time, DeWitt said, people complained that the position was unnecessary — even wasteful — for such a small facility that was already struggling to make ends meet.

Most residents at Maryland Baptist rely on Medicaid, which pays far less for nursing home patients than Medicare or private sources. For years, the nursing home operated with a deficit, DeWitt said, getting by only with donations from nearby churches.

But even when DeWitt started personally doing the grocery shopping to cut costs, he insisted on keeping the infection-control specialist. Maryland Baptist, he reasoned, does not have “the aesthetics or curb appeal” of more well-funded facilities, so its basic services had to be top-notch.AD

A recent federal report found that infection-control lapses were the most common type of deficiency faced by nursing homes pre-pandemic. From 2013 to 2017, 82 percent of all surveyed facilities were cited for not having adequate hand hygiene or properly isolating patients with infectious diseases.

According to federal inspection reports, however, Maryland Baptist has not been cited for a single infection-control deficiency in the past four years.

Hundreds of nursing homes with cases of coronavirus have violated federal infection-control rules in recent years

Roxane Prettyman cooks and prepares meals for nursing home residents at First Mount Calvary Baptist Church in Baltimore.
Roxane Prettyman cooks and prepares meals for nursing home residents at First Mount Calvary Baptist Church in Baltimore. (Marvin Joseph/The Washington Post)

“They are on point,” said Carolyn Lark, whose brother William Martin is a resident at Maryland Baptist. When she heard that the coronavirus was in Baltimore, she wasn’t worried, she said, because the facility had already notified family members about what it was doing to keep the virus out. And, besides, she trusted the staff.

With such a small resident population, employees get to know each patient fairly well. Martin’s nurses, for example, know Lark and all of her sisters by name, she said. This is a perk of having employees who come from the same community as residents and who identify with the mission of the nursing home, DeWitt said. “It starts to feel like family.”

When the paint on the nursing home’s wheelchair ramp faded, one longtime nurse came on her day off with her son and husband to repaint it.

To help residents cope with isolation during the pandemic, staff members took it upon themselves to solicit old televisions to put in their rooms.

And when the facility recently started getting fresh produce from food banks, DeWitt made sure that each employee went home with a box.

“We’ve put them through a lot,” he said one recent afternoon, standing outside the nursing home. Since March, staff members have been told to stay home except for work and keep their distance from others, including their own families if necessary.

“They’re front-line workers, and at the end of the day, they go home and watch the protests, listen to the divisiveness of the current administration,” DeWitt said. “It’s a lot. It’s too much.”

Since the lockdown began, DeWitt has stayed out of the nursing home, worried that his other duties, such as overseeing food giveaways at the church or checking in on needy congregants, might expose him to the virus and place the facility’s residents at risk.

Every Wednesday, however, he calls Walburn, who places her cellphone against the speaker of the building’s public address system. Residents wheel themselves out to their doorways and employees stop their work briefly to listen. DeWitt tries to make people laugh, encourages them, then ends with a prayer.

“Even for myself, sometimes I’m up here,” Walburn said, putting her hand above her head. “And by the end of his call, I’m down here, I’m okay.”

Overwhelmed nursing homes kept taking patients. Some got sick and died.

Johana Walburn is the administrator at the Maryland Baptist Aged Home in Baltimore.
Johana Walburn is the administrator at the Maryland Baptist Aged Home in Baltimore. (Marvin Joseph/The Washington Post)

On a recent afternoon, DeWitt was talking to Walburn outside the nursing home when a delivery truck arrived with crates of fresh vegetables. Huffing through his black face mask, DeWitt lifted boxes onto carts wheeled out by nurses in scrubs. When the activity director came out the front door, DeWitt and Walburn asked at nearly the same time whether she needed a bag of produce for her family.AD

The two leaders are friends and switch easily from talking about nursing home supplies to joking about DeWitt’s thinning hair. For three years, they have also shared the dream of expanding Maryland Baptist into a larger continuing-care retirement home where more low-income elderly residents could stay. Their underlying belief, DeWitt said, is that Baltimore residents should not have to leave their communities to age with dignity.

Ever since word got out that the facility has had no coronavirus cases, the phone has just kept ringing, Walburn said. Hundreds want to move in, including some from out of state. But the nursing home has no available beds.

The United Baptist Missionary Convention, which owns the nursing home, also owns a plot of unused land next door. Standing in a field overgrown with weeds and littered with debris, DeWitt spread out his arms and said: “See all of this? We want to transform it.”

“Over there, you see?” he pointed to the row of townhouses on the other end of the street, some occupied, others vacant and dilapidated. “That’ll be our independent-living section.”

The pastor grinned, his mind mapping out a new, distant future for this oldest of nursing homes.

In due time, he thought to himself, his neighborhood would get the care it deserves. – Washington Post