Nine residents have died of coronavirus at Opis Coquina Center, a nursing home in Ormond Beach with a history of infection control problems, according to inspection reports.


Opis Coquina Center is tied for having the fifth highest number of coronavirus deaths in a Florida long-term care facility, according to new data provided by the Florida Department of Health Friday.


Deltona Health Care, which has reported one death, is the only other facility in Volusia County with a coronavirus-related death.


Since December 2016, Opis Coquina Center has received federal citations on three separate occasions for breaking infection control protocols, according to inspection reports by the Agency for Health Care Administration. The most recent citation was issued in July 2019 in regard to multiple sanitary issues when changing a resident’s bandage.


As of Thursday, Opis Coquina Center had 45 residents and nine staff members currently infected with coronavirus, according to the Florida Department of Health.


[READ MORE: Coronavirus outbreak, death revealed at Ormond Beach nursing home as state releases data]


[READ MORE: CORONAVIRUS: 6 deaths at Ormond Beach nursing home with outbreak; 1 death at Deltona nursing home; state now releasing number of cases at each long-term care facility]


Multiple messages left at the facility and with its legal representation went unanswered by the time of publication. Emails to the local and state FDOH asking how the outbreak started at the nursing home provided no answers.


The citations for failing to follow proper infection control procedures could be part of the reason the nursing home is seeing such a widespread outbreak of coronavirus, according to Brian Lee, executive director for the nonprofit citizen advocacy group Families for Better Care.


“With their problems with infection prevention and management and implementing control programs ... it’s sadly not surprising that this outbreak occurred,” Lee said. “I’m surprised it’s not worse.”


The most recent federal citation the nursing home received was in July 2019, after a trail of blood and a bloody washcloth was found in a resident’s room, according to the reports. Staff could not identify where the blood came from. The resident had a cut on their foot but there was no fresh blood on the cut or bandage. A staff member then, without washing their hands and without re-cleaning the cut, changed the bandages on the resident’s foot.


The nursing home was also cited in November 2018 for not cleaning blood pressure cuffs between patients and in December 2016 after an employee failed to wash their hands after leaving one resident’s room and entering another resident’s room, according to AHCA inspection reports.


“On the surface it’s a four-star nursing home with no fines, no penalties, staffing levels are average and health inspections are above average even though they’ve been repeatedly cited for infection control,” Lee said. “On the surface this place looks pretty OK. When you dig deeper, it’s unsurprising you’ve seen this outbreak.”


Lee said the recurrence of citations could be a training issue or the nursing home’s inability to follow the Centers for Disease Control and Prevention guidelines.


When asked how the outbreak started at Opis Coquina Center and why it continued to escalate, Holly Smith, spokeswoman for the FDOH - Volusia, did not provide any answers.


“Though we appreciate the desire to understand which Floridians have been tested, received a negative test or are under public health monitoring as a result of suspicion they may have COVID-19 or has been in contact with someone who have COVID-19, balancing the privacy of the individuals being tested and monitored and the confidentiality of the epidemiological investigations with the responsibility to Floridians to disclose information to protect the public is a vital role of the Florida Department of Health,” Smith said in an email. “The department strives to protect the identity of individuals tested or affected by COVID-19, while also ensuring information necessary for the public health is available.”


Smith went on to say the FDOH is unable to provide certain details regarding coronavirus case information.


AHCA didn’t provide any answers, either, and referred The News-Journal to the FDOH. A public records request to AHCA for all emails, notes and inspections regarding Opis Coquina Center revealed a total of 1,493 emails since March 1. The News-Journal was not able to obtain the emails by the time of publication.


City of Ormond Beach public information officer Jenn Elston didn’t have any answers, either.


“As a municipality, we really do not have the authority to speculate on health care matters,” she said. “We have worked closely with the Florida Department of Health as well as other partner agencies to closely monitor the COVID-19 health crisis. That is all the information I have at this time.”


In most cases, nursing home residents are not known to spread the virus; it’s usually the staff, according to Lee.


“We’ve seen they are working really hard to keep loved ones safe and alive, but unbeknownst to them, they can be asymptomatic and spread it around,” Lee said. “Some of them work at multiple facilities, trying to make ends meet.”


Issues with obtaining personal protective equipment at nursing homes and assisted living facilities have also contributed to the problem, according to Lee.


“That’s what we’ve been seeing across the country — the staff not having the equipment needed,” Lee said. “There is also a lack of testing of residents and staff. We would like to see universal testing of staff and residents.”


Lee said the answer is rapid testing at each facility that can detect the virus in five minutes or less.


“Unless you test everyone periodically, there’s no way to stop the virus,” he said. “It’s tough to slow this thing. If you are not doing the testing, more people are going to get sick and more people are going to die.”