Lessons From Canterbury Rehab

By Peter Galuszka

For weeks, the Life Care Center in Kirkland, Wash., has been seen as the epicenter of the threat of COVID-19 at tightly packed health care facilities. So far, 37 patients have died of the virus.

It hardly gets the national media attention, but a suburban Richmond facility, the Canterbury Rehabilitation & Healthcare Center, maybe surpassing Life Care with 35 deaths of the virus as of April 8.

Why so many deaths?

That’s an important question. There have already been signs of mismanagement there. Henrico County Manager John Vithoulkas has been unusually scathing in his criticism of Canterbury. He has said that the deaths could have been avoided and administrators at the facility rejected offers of help from the county.

To be sure, early on Canterbury officials had asked for emergency supplies of medical equipment, such as face masks. They asked for state help and the state asked the federal government to let it have supplies from a stockpile it keeps for just such occurrences.

It will be a while before what happened at Canterbury is sorted out.

There are a few takeaways right now.

One is that President Donald Trump’s pathetically incompetent handling of the pandemic crisis is killing people. Trump has claimed that equipment is available when it isn’t. In his confused babbling, he says that states are on their own to get life-saving gear like ventilators, setting off drastic competition to secure gear..

Another takeaway is that Canterbury is a privately-owned facility. It is owned by Marquis Health Services that is based in Moorestown, N.J. The company operates more than 30 acute care facilities in Virginia, Maryland, Pennsylvania, New Jersey and Massachusetts.

This is important to note because on this blog, some contributors have pretended that there is no failure in the private sector regarding the pandemic. They instead beat up on Gov. Ralph Northam, a Democrat, for his alleged failings at fighting the virus. They claim that Northam simply can’t handle a big health crisis. This is an odd complaint since Northam is a physician who served as an Army doctor in the Gulf Wars.

A bipartisan group of Members of Congress from Virginia are trying to get federal help. Democrats Abigail Spanberger and Jennifer Wexton along with Republicans Denver Riggleman and Morgan Griffith have urged Health and Human Services Secretary Alex Azar for extra funding to help critical care facilities get more protective gear.

This is the real battle zone, not anti-government witch hunts by the conservatives at Bacon’s Rebellion.

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30 responses to “Lessons From Canterbury Rehab

  1. following……….

  2. The situation at Canterbury Rehab is a debacle, and Peter is right to focus on it. Someone needs to get to the bottom of the situation and ensure that whatever failures occurred there are not replicated elsewhere. Unfortunately, he mars his commentary with totally unsubstantiated statements.

    In his confused babbling, [Trump] says that states are on their own to get life-saving gear like ventilators, setting off drastic competition to secure gear.

    I’ll leave others to render their own judgments as to whether Trump “babbles” — I’m certainly not impressed with his command of the spoken word. But if Peter wants to quote him in order to criticize him, he needs to get the quote right.

    From the New York Times: “President Trump told a group of governors on Monday morning that they should not wait for the federal government to fill the growing demand for respirators needed to treat people with coronavirus.”

    “’Respirators, ventilators, all of the equipment — try getting it yourselves,’” Mr. Trump told the governors during the conference call, a recording of which was shared with The New York Times. “’We will be backing you, but try getting it yourselves. Point of sales, much better, much more direct if you can get it yourself.’”

    “Last Wednesday, Mr. Trump directed his labor secretary to increase the availability of respirators, and he has generally played down fears of shortages.”

    “Some contributors have pretended that there is no failure in the private sector regarding the pandemic. They instead beat up on Gov. Ralph Northam, a Democrat, for his alleged failings at fighting the virus. They claim that Northam simply can’t handle a big health crisis.”

    I don’t recall reading anyone implying (“pretending” or otherwise) that there is “no failure in the private sector.” Peter is making that up out of whole cloth. It’s true enough that some of us have criticized Northam for aspects of his management of the crisis, particularly his track record in communicating with the public and his ineffectual efforts at increasing testing. Those commentators (including me) have backed their criticism with abundant evidence, which Peter could rebut if he chooses to. But he didn’t even try to rebut the evidence presented. It’s so much easier to assail the critics.

    Sounds like the same tactic used by someone else I can think of… last name beginning with a “T” and ending in “rump.”

    • If as Peter says the company owns multiple locations, it seems only this one has been so stricken. That would point to specific failures at that location.

      • Nursing homes have been problematical for a LONG TIME. There are good ones and there are bad ones and there are mediocre ones and the two things that really are issues are:

        1. – professional management – not every manager is a highly qualified professional but in the nursing home world – the demand for them far outstrips the supply and they do what they can and sometimes is goes sideways.

        2. – the workers. This is one of the more difficult and arduous jobs in the economy and people leave as soon as they can find a better situation and what’s left are many who have no other options or are totally dedicated to their mission.

        ANYONE who has been to two or more nursing homes – knows what they look like on the inside. It’s a terrible place but a necessary one. This
        is little hope for most – and for workers it’s an endless day of cleaning up the inevitable messes that happen – 24/7 – as well as trying to keep people alive – for a little longer.

        At most nursing homes, every day or every week, folks expire and get wheeled out – and a new person comes in to repeat the cycle.

  3. So it’s okay to bring Trump back into commenting here?

    All I can say is that for all of Northams flaws – real and imagined, he does NOT get up at his Press Conferences and proceed to engage in personal attacks against anyone he perceives as a political opponent or telling the counties in Virginia that they are “on their own”, or any of dozens of other truly idiotic behaviors that I would find reprehensible in ANY elected leader no matter what their name is.

    • PETER started in on Trump, as if bad orange man had come to western Henrico and spread the pest in person. For weeks, I stayed out of these debates. No more. (But no question the daily briefings have put Trump’s flaws on display once again. I watch sometimes to hear the docs.)

  4. It would be really interesting to know what the death rate at this facility has been pre-Covid 19 crisis. Obviously folks don’t go there because they are in top health. I’m not trying to defend these folks necessarily, but am trying to get this in context.

    • Silly rabbit. Now is not the time for data and discussion and patiently waiting to learn the truth! Attaaaaaacccckkkk!

    • Exactly. Prior to COVID-19, it was fairly routine that some nursing homes would be in trouble with the regulators.. There collected metrics that tell the tale at poorly operated facilities.

      It is no surprise at all that for some facilities that were already not well regarded that more stress on them would result in even more problems.

      Anyone who has actually visited these facilities can see the problems they deal with. Some of them do their best – and you can see it but even under the best of conditions – the problems they have to deal with are just horrendous.

  5. My Dear Mr. Bacon,
    YOU are my source. You commented on April 4″Peter, please enlighten us. How has the private sector failed us in the COVID-19 crisis?”

  6. A lot of deaths at a nursing home in Henrico somehow absolves Ralph Northam of his administration’s inept response in Virginia. Just out of curiosity – America is full of nursing homes. Two have become fiascos. One in Washington state and one in Henrico County. And Northam was a doctor in the GulfWar. So, Northam must be doing well in this crisis. Even by the pretzel logic of modern liberalism that argument doesn’t hold up.

    • So nursing homes are private sector, right? Should government be regulating them and if there are “failures”, it’s the government’s fault?

      I’m curious what that has to do with “liberalism”?

      Is speaking of issues in common sense terms such a partisan thing?

      I cannot believe some of the stuff folks are writing here.

    • johnrandolphofroanoke

      It took only 4 days for Ralph to call for a special session of the GA in the wake of the Va. Beach shooting last year.

  7. Thankfully Peter is pointing out how the federal government, and President Trump specifically are responsible for a tragedy at a single nursing home in VA. Because the federal government is monitoring every nursing home in the country and directly responsible for any happenings. I’m tired of hearing people heap all the blame on the federal government, as if individuals, localities, regional groups, and states have no responsibility nor culpability in these times. The federal stockpile was not sufficient, and hasn’t been for years. That was pointed out to multiple administrations. That doesn’t mean Virginia couldn’t have taken steps to prepare itself in case of a pandemic. What we’ve seen here is a failure from the local level to the federal, no one group is solely responsible, nor one political party.

    • Pretty much agree Atlas – with one exception. It’s one thing to do planning studies for a generic pandemic, it’s quite another to execute such plans in the face of a pandemic the likes of which we have never seen.

      Is this a “failure”? I guess one can make that argument but when it’s occurring
      across the board – at all levels of govt and we got everybody and their dog blaming their favorite opponents… we look like a bunch of ASSHATS!

  8. How can we reasonably expect for any level of government to keep us safe? We have a preponderance of evidence in the shortcomings of government at all levels, and a dearth of evidence demonstrating competency.

    • because “protecting us” is not a black/white, yes/no thing and never has been just like stopping crime or fixing traffic congestion or educating kids.

      It’s never going to be “fixed” – but that’s NOT a “fail” unless one is of that mindset in general and then pretty much anything about govt is that its bad.

  9. I think this issue is resolving itself…

    Coronavirus-wracked nursing home evacuated after most of staff failed to show for two days
    By Allyson Chiu closeAllyson ChiuReporter with the Morning Mix teamEmailEmailBioBioFollowFollow

    A California nursing home where dozens have tested positive for the novel coronavirus was forced to evacuate Wednesday after a majority of its staff failed to show up to work for the second consecutive day, according to public health officials.

    https://www.washingtonpost.com/nation/2020/04/09/california-nursing-home-coronavirus/

  10. johnrandolphofroanoke

    What is happening at Canterbury is a very important story. Perhaps our governor can call for a special session of the General Assembly to consider reforms to make nursing homes a haven of hope?

    • That is bloody unlikely although, speaking from personal experience, damn overdue with respect to Canterbury. My father was there for physical therapy in the relatively recent past. The facility is understaffed and, at least in my view, at the time, undersanitized. Visitor check in was a joke and it was often impossible to find a nurse or an aide. I have held the belief that the ineptitude and lack of proper sanitary measures of that facility as well as Henrico Doctors Hospital are directly responsible for the not one but two infections that ultimately killed my father who despite being 95 at the time was still sharp as a tack and living on his own. The State has failed miserably when it comes to regulation of those facilities (I had similar issues with an Alzheimers unit which will go unnamed that cared for my mother until the end). Infrequent inspections, little to no follow up and a lassiez faire attitude at all levels of State oversight.

      • Nursing homes are private sector businesses. Do we expect the govt to impose stricter regulations on them every time something is wrong – and to lay sanctions and fines on them or put them out of business if they cannot meet govt rules?

        One more thing. Many folks who are in nursing homes – the ones we are talking about – are there with government entitlements – correct?

        The folks who are wealthy – do very much get high quality nursing homes and if they don’t they switch to ones that are better. Free market, right?

        • “Do we expect the govt to impose stricter regulations on them every time something is wrong – and to lay sanctions and fines on them or put them out of business if they cannot meet govt rules?”

          That certainly seems to be case when it comes to restaurant health inspections, sooooo, are you suggesting situational oversight and regulation depending who is paying the freight. BTW, in the case of both of parents who were relatively wealthy (were being the operative word as my mother’s care was by no means inexpensive), they largely paid their own way. You are ignoring that there is simply a limit on the number of facilities, beds and caregivers, particularly when it comes to Alzheimers units.

          You really are a piece of work, pick a side of the aisle and quit jumping from one side of the fence to the other. I would give you some benefit of the doubt if I believed you were playing Devil’s advocate but I sense that you are simply a bored asshole who has little else to do in life but antagonize people here.

          • “bored asshole”? is that you? is that why you comment here?

            NO.. I DO play both sides – ON PURPOSE and especially so when we talk about the role of government and regulation. It’s not boredom, it’s very much something that does affect all of our lives and is the subject of more and more politics. Assholes all around if that’s your view.

            And NO, I’m NOT ignoring the “limit” of facilities but once again, would ask you – fellow asshole that you are – WHY is that?

            why does the free market not meet that demand?

          • Why does the free market not meet the demand, simple, unlike mom and pop operations that fill niche or local needs in the restaurant industry, constructing, equipping, staffing, administering, and maintaining rehab and elder care facilities is extraordinarily expensive and not easy to get off the ground, starting with finding a parcel that is appropriately zoned in an area with a density high enough to support it. Then there is the real problem, lack of qualified personnel available of willing to staff those facilities given the relatively low rate of return and thus relatively low wages vis a vis the rest of the healthcare industry. Been to one of those facilities recently, good luck finding one that is not largely staffed by those from other countries who are largely the only ones the facilities can afford to hire. Even then, the staff turnover is extraordinarily high.

            Could you deem that last comment zenophobic or racist, sure you could, however, that would ignore the economic and employment realities present. It is what it is and patients and their families have damn few options. How’s that for an answer.

          • re: ” Why does the free market not meet the demand, simple, unlike mom and pop operations that fill niche or local needs in the restaurant industry, constructing, equipping, staffing, administering, and maintaining rehab and elder care facilities is extraordinarily expensive and not easy to get off the ground, starting with finding a parcel that is appropriately zoned in an area with a density high enough to support it. Then there is the real problem, lack of qualified personnel available of willing to staff those facilities given the relatively low rate of return and thus relatively low wages vis a vis the rest of the healthcare industry.
            so this is due to government failings?

            re: ” Been to one of those facilities recently, good luck finding one that is not largely staffed by those from other countries who are largely the only ones the facilities can afford to hire. Even then, the staff turnover is extraordinarily high.”

            “Could you deem that last comment zenophobic or racist, sure you could, however, that would ignore the economic and employment realities present. It is what it is and patients and their families have damn few options. How’s that for an answer.”

            Everything you say is TRUE. What is government proper role if this is primarily a private-sector industry?

            Do you think the govt should, for instance, try to do something about the “other countries help”?

            When you say that families have “few options” – what do you mean? What options do they have and whose responsibility is it?

          • Sorry, this subject hits just a little too close to home, I’m not going to play your stupid game today.

      • johnrandolphofroanoke

        I know exactly how you feel about this. I have been through this myself over and over. It leaves you wondering everyday until the end of days if you did all that could be done. Thinking on this subject just rips my guts out some times.

  11. Mom,
    I am sorry to hear about your Dad. I can empathize. After my Dad died in 2004, I had to move my Mom from North Carolina to Chesterfield County. She went to Brandermill Woods, a continuum of care facility. She was there five years and we had a good experience. Well maintained and no infections. The problem I had was at a nearby hospital, Bon Secours St. Francis. She had Alzheimers and was in a memory unit. During her last months, she would have to go to the ER at St. Francis which was a five minute ambulance ride away. I’d drop everything and go there. She could not remember her medications although Brandermill had included a packet with that info. Hospital staff kept loosing it and she would stay in an ER room for hours untreated. I onc got into a screaming match with a doctor over it.

    • Been down that road, ER visits, lost files, lost medications, conflicting prescriptions, unexplained bruises, etc., etc., etc. Our situation was complicated by mother’s extraordinary good physical health, leading her to being a wheelchair bound, breathing potted plant for five years. Don’t know how my Dad maintained his sanity, my sister couldn’t deal with it. As I suspect you know, the issue isn’t local. I have two aunts in Chicago with similar memory care unit issues in Chicago and a cousin in Atlanta experiencing the same. I won’t pretend to have a solution.

  12. @Mom – you seem to think you’re the only one who has been through this. I can assure you that you are not. And in my own experience, I have questions also about how things work and why. And I have opinions also.

    I also wonder how any of us end up in a nursing home where we do not have enough money for a “good” one… these are realities … that more than you have run into.

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