The town has seen the first COVID-19 deaths from Golden Pond assisted living facility, where 37 residents had tested positive earlier this month.

According to Shaun McAuliffe, the town’s Health Department director, four Golden Pond residents have died after contracting the disease, including three who were in Alzheimer’s hospice care, where the majority of the facility’s COVID-19 cases reside.

McAuliffe said his department has been working with Golden Pond on an almost daily basis, and while the facility is doing what it can, state regulations are making it impossible to be able to provide the proper care needed.

“The main issue is assisted living facilities are not created to provide medical care,” McAuliffe said. “We had to get permission from every health care proxy and related physician to be able to get their temperatures. Golden Pond has implemented the programs that the CDC and the state recommended, and they’ve been bolstering processes to meet all of the standards — the new medical standards that just came out within the last two days. They’re rising to the challenges. It’s not an issue that they’re not providing care or they’re providing less care than any other assisted living facility. It’s that assisted living facilities just aren’t designed to provide the type of care that’s needed to take care of COVID patients.”

McAuliffe noted that assisted living facilities are not managed and overseen by the Department of Public Health like nursing homes are. Assisted living facilities are managed under the Executive Office of Elder Affairs.

“[Golden Pond staff] collect the temperatures every day, and that’s how we gauge someone might have an infection and might have COVID,” McAuliffe said. “But if they register a temperature, the staff aren’t able to act on the temperature. To prescribe a Tylenol or any fever medication they’ve got to get permission from the health care proxy. They’re not equipped and not able by license to respond to that. Their response is to call the Fire Department, have the Fire Department pick them up and transport them to Milford [Regional Medical Center] or UMass Memorial [in Worcester] and have them assessed there. And then the physician at the hospital, sometimes in consult with the health care proxy, will put together a plan and add that medication regimen or whatever. But they don’t have intubators and all this other equipment at their facility.

“It’s really just for comfort, to make sure that they’re being fed and changed. And especially at the hospice and dementia units. So, how do you provide COVID care in an environment like that? That’s been the battle I’ve been having with the state over the last month, that the current situation is just not tenable. You’ve got people who need to be monitored, who need to have care plans, who need to have people who can respond to the changing conditions without having to call the Fire Department to have them transported.”

Moving all patients out of the facilities is not a viable solution either, McAuliffe said.

“Say Framingham and Hopkinton, if we decided not to allow our assisted living facilities to provide care or to take patients on site, we’d flood any nursing facilities and likely the hospitals, then no other communities would have bed space for patients,” he said. “There’s no good solution at this moment.”

McAuliffe said he and other health officials have been pushing the state for more action, and it finally appears to be making a difference.

“I’ve been on the phone with the DPH and the Executive Office of Elder Affairs 2-4 times a week crying out for assistance,” he said. “Then I had a discussion with some of the aides to the state representatives this week also. As we started getting a little more vocal and some other newspapers started really reporting on this, the governor has stood up an infection control group and a nursing assistance group. I think yesterday they were at the Soldiers’ Home out in Holyoke [where 82 residents have passed away in the past five weeks] working with their staff to educate them on infection control, proper PPE use, donning and doffing the PPE, how to improve their hygienic practices, how to better monitor and how to put together plans for patient care. Those units are supposed to be cycling through the commonwealth to help stand up other assisted living facilities throughout the state.”

In the meantime, McAuliffe and Hopkinton’s public health nurse, Kasey Mauro, are providing Golden Pond with advice and assistance as needed.

“Your gut is telling you there’s so much more that can be done, but you’re running into this bureaucracy,” McAuliffe said. “It’s just a terrible situation.”