A Dubuque nursing home that experienced a deadly outbreak of COVID-19 has resolved violations that prompted the state to cite the facility, according to records recently obtained by the Telegraph Herald.

The rapid spread of the novel coronavirus through Dubuque Specialty Care prompted in May an investigation from the Iowa Department of Inspections and Appeals.

IDIA ultimately fined the facility $10,000 for permitting three employees to continue to work after they displayed symptoms of COVID-19 and for five staff neglecting to don personal protective equipment, placing “residents’ health and safety in immediate jeopardy.”

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Care Initiatives, the Des Moines-based company that owns Dubuque Specialty Care, did not respond to a request for comment.

Data reported to the U.S. Centers for Medicare and Medicaid Services for the week ending Sept. 6 indicate that seven staff and 45 residents at the facility had tested positive for COVID-19. Thirteen residents have died.

The most recent confirmed positive case or death of a resident occurred in mid-June, while the last staff member to test positive did so in mid-July, according to CMS.

IDIA attributed the outbreak and deaths to the facility’s failure “to have a thorough process in place for screening people for illness before entering the building.”

In a response to the department, facility Administrator Brook Benes denied the facility was noncompliant by the time the facility received the citation but submitted a plan of correction as required by state and federal law.

Under the plan, those who display symptoms now cannot enter the facility unless authorized by two managers. Benes and the director of nursing also must authorize the decision of a staff person to return to work after being diagnosed with or showing symptoms of COVID-19.

Surveyors later inspected Dubuque Specialty Care from July 6 to 9 and determined the facility was operating in compliance with COVID-19 infection-control regulations.

IDIA spokesperson Stefanie Bond said the state fine is being held in suspension until CMS regulators determine whether the agency will assess a federal penalty.

“If CMS decides not to collect the fine, the facility will be required to pay the state fine,” she said.

Neither Bond nor a CMS spokesperson would confirm whether the fine has been collected.

Another major outbreak that occurred in the spring at a different nursing home also has largely subsided.

Grant County’s Orchard Manor has confirmed 30 COVID-19 cases among residents, with the most recent case this month. Fourteen residents have died since the pandemic’s onset.

Meanwhile, 14 staff have been diagnosed, the most recent of which occurred in late August.

Because the facility reported at least one confirmed case within the past 28 days, it is under an active public-health investigation. However, most infections occurred before May.

Administrator Carol Schwartz attributed the easing of viral spread to staff members’ universal adoption of masks and isolation of sick patients in a negative-pressure wing.

“If you have an outbreak, you have to step it up,” she said. “It’s a whole learning curve. Obviously, none of us have ever been through this before.”

The Wisconsin Department of Health Services conducted an infection-control survey of the facility from April through June and determined the facility was in compliance with regulations, according to state records.

As viral activity heightens in the county with the start of school, Schwartz is confident that Orchard Manor will not see another wave of infections.

“The staff handled it well,” she said. “(They) learned a lot from it.”