This article has been updated.

Some staff members at the San Antonio nursing home where a cluster of coronavirus cases occurred also work at seven other local care facilities, San Antonio Fire Department Chief Charles Hood said Friday.

Citing a need to prevent additional nursing home outbreaks, Mayor Ron Nirenberg on Friday said people who work at a nursing home in San Antonio can no longer also work at other facilities.

Sixty-seven of the 84 residents and eight of the 60 staff members at the Southeast Nursing and Rehabilitation Center tested positive for COVID-19 this week. One Southeast resident died from the virus, and the City of San Antonio and Bexar County are still trying to contact 28 additional employees of the nursing home to get them tested, Nirenberg said.

“In case anyone in San Antonio needed a wake up call about the seriousness of COVID-19 to our community, this is it,” he said. “COVID-19 is alarmingly contagious and very insidious.”

Contacting the Southeast employees and testing symptomatic residents in other nursing homes is the top priority, Hood said. SAFD officials will focus on the seven facilities where the employees also work, but will contact each assisted living, nursing home, and intermediate care facilities – more than 200 – in the Bexar County area.

Those seven facilities include , The Village at Incarnate WordThe Rio at Mission Trails, Buena Vida Nursing and Rehab-San Antonio, Floresville Residence and Rehabilitation Center, and Advanced Rehabilitation and Healthcare of Live Oak. The latter of which is managed by the same company, Advanced Healthcare Solutions, as Southeast Nursing and Rehabilitation Center.

Baptist Emergency Hospital – Overlook and Methodist Specialty and Transplant Center were previously identified as hospitals that had overlapping staff with Southeast. After those facilities investigated, that was found to be false.

“Investigations like this create an evolving understanding of the situation,” said Dr. Dawn Emerick, director of San Antonio Metro Health, in a press release Friday afternoon. “It’s important that we communicate not only when potential exposures are believed to have occurred, but also when they haven’t. In this case, patients and staff at Methodist and Baptist need not be concerned, as the initial information provided by the nursing home has proven to be inaccurate.”

SAFD and Emergency Service District staff will be hand-delivering notices to those facilities, including an order to contact a division within the Southwest Texas Regional Advisory Council for approval of all patient movements to hospitals or other locations, Hood said.

The order does not prevent residents from leaving a care facility, he added. “That’s up to the family. If you have a loved one, we’re not going to prevent you from taking a patient – but you could be taking a positive patient home with you.”

All residents and staff should be tested at Southeast, but only people with symptoms will be tested at other facilities throughout San Antonio, Hood said. “[At this time] we are saving those tests for the people who are showing signs.”

However, Emerick later clarified, “any nursing home employee who worked in close contact with an employee who also worked at the Southeast Nursing and Rehabilitation Center will be provided access to testing.”

It’s possible to have and spread the virus without showing any symptoms, she said. “So even if you do not have any symptoms, behave as if you do.”

“There should not be any sick personnel at nursing facilities” or anywhere out in public, Emerick said. “Just stay home.”

The outbreak at the Southeast facility is not the peak of the virus’ spread in San Antonio, she added.

Councilwoman Rebecca Viagran (D3), whose district includes the facility, told residents who live near it to remain calm and continue to practice social distancing.

“Don’t panic,” Viagran said, noting there is no increased risk to residents in the immediate area surrounding the facility.

Of 84 residents at the home, 11 tested negative for the virus and six tests are still pending or inconclusive as of 11 a.m. Friday. The eight staff members who tested positive are self-isolating. Another seven were tested on Thursday and 17 will be tested on Friday, Nirenberg said.

“A localized outbreak requires a localized response, and that’s what you’re seeing,” he said. “So if you are a staff member of this facility, you must respond to the notice to be tested. We need your cooperation to stop the spread of COVID-19.”

Nirenberg said he will update the Stay Home, Work Safe order today with the new nursing home directive.

An 11-page report on the Southeast Nursing and Rehabilitation Center by the Department of Health and Human Services in late October 2019 detailed various violations, including a lack of proper sanitary measures, food safety issues, mechanical and electrical failures, pest control issues, and an overall lack of professional standards and adequate training. Southeast was given a one-star rating from medicare.gov and cited for abuse.

Nursing home officials have not responded to requests for comment. There are more than 30 zero- or one-star facilities in the San Antonio area.

To comply with the Stay Home, Work Safe orders issued by Nirenberg and Bexar County Judge Wolff, senior living facilities should have already prohibited nonessential visitors, group activities, and communal meals, and gatherings of residents.

The 11 Southeast residents whose tests came back negative are being kept in a separate part of the building and staff is not shared between that part and where positive patients live, Hood said.

Iris Dimmick

Senior Reporter Iris Dimmick covers public policy pertaining to social issues, ranging from affordable housing and economic disparity to policing reform and workforce development. Contact her at iris@sareport.org