Nursing Home Horror

by Kerry Dougherty

One of the saddest aspects of what’s being called the “new normal” is that nursing homes are closed to visitors. It’s necessary, of course, to keep COVID-19 away from the elderly. But it is wrenching for families.

I have a friend whose mother is on the first floor of a local nursing home. He visits by standing outside her window while they chat on the phone.

He says they joke that it’s “like jail visitation.”

This lady knows she’s loved and gets to see her son often. But how many other folks — especially those with dementia — are simply alone during this pandemic?

Heartbreaking.

Making matters worse, one of Virginia’s publicly funded nursing homes is now the nation’s number one hotbed of death.

Nearly one quarter of Virginia’s 208 COVID-19 deaths have come from a single place: The Canterbury Rehabilitation & Healthcare Center outside of Richmond.

Nursing home officials just confirmed a 46th death yesterday. That grim number surpassed the 43 fatalities at the Life Care Center near Seattle, where the first U. S. nursing home outbreak occurred.

The New York Times, which is studying Covid-19 clusters in nursing homes around the country, says Canterbury leads the nation in nursing home deaths, noting that some of these Medicaid residents are living three-to-a-room.

That would be a recipe for disaster during the regular flu season.

New management took over the center in January and claim they’ve made improvements. Still, this is how the Associated Press describes the nursing home:

Even in normal times, Canterbury merited just one out of five stars in Medicare’s rating system, with inspection records showing the facility had such poor staffing levels that it impacted patient care.

One nurse told an inspector last year “residents would stay in bed because it is almost impossible for two people to assist 62 or 63 residents.” Previous inspections also found infection-control problems and failure to report an attempted rape of a patient.

The Richmond Times-Dispatch reports that Canterbury Rehabilitation and other Virginia nursing homes are driving up the numbers of COVID-19 cases in the commonwealth. So far, 45 facilities are in the midst of outbreaks.

“A publicly funded nursing home like this is a virus’s dream,” said Dr. James Wright, medical director at Canterbury and two other Richmond-area long-term facilities that don’t rely on Medicaid funding by the federal and state governments.

Wright said publicly funded nursing homes lack money to adequately pay staff, occupy buildings with smaller rooms and living space, and house people who in many instances have “had a lifetime of poverty” that has undermined their health.

“We were simply ripe for a spread like this, like any publicly funded nursing home is,” Wright said.

Any time you have people living in close quarters — be it a barracks, aircraft carrier or college dorm — contagious diseases spread quickly.

When that confined population is older and in poor health it can become the stuff of nightmares.

And that’s what the situation at Canterbury is — a nightmare — where Virginia’s fragile and poverty stricken seniors are being picked off by this virus.

As James Sherlockreports, the conditions inside this facility are subject to oversight by the commonwealth, which has failed miserably.

In several states the National Guard has been called in to evacuate residents from nursing homes. In Virginia, however, they languish.

Here’s a thought: Instead of worrying about whether healthy Virginians are sitting on the beach or getting their hair cut, perhaps the governor should turn his full attention to the most vulnerable among us.

The low-income residents sardined into Medicaid-funded nursing homes.

Sadly, it’s too late for 46 of them.

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13 responses to “Nursing Home Horror

  1. The most important passage of this story appears near the end:

    “Here’s a thought: Instead of worrying about whether healthy Virginians are sitting on the beach or getting their hair cut, perhaps the governor should turn his full attention to the most vulnerable among us.”

    I’ve had the very same thought. Kerry beat me to the punch in putting in written words.

    • Isn’t the Governor’s job right now a bit more complex that picking and choosing between the two? He should make the best decisions possible, based on the most relevant data, to keep healthy Virginians healthy, isolate Virginian’s infected with covid-19 in a manner to give them the best opportunities for full recovery, and protect the most vulnerable among us.

      Public leadership doesn’t provide the option of cherry-picking situations or to pat people on the head. Fortunately those particular healthy Virginians sitting on the beach are apparently still healthy. If they were not, I imagine a story with a different ending. And perhaps a few other Virginians continue to be healthy because of actions taken by the Governor. Or perhaps fewer have died.

  2. Did anyone read this:

    ” The day after Canterbury Rehabilitation & Healthcare Center announced the first two deaths from COVID-19 at the skilled nursing facility in western Henrico County, Henrico emergency management officials said they offered kits to test all residents and staff.

    But the biggest obstacle wasn’t test kits.

    Canterbury already had secured rapid testing technology from the same Innsbrook-based company used by the county, but the push to test everyone in the stricken rehabilitation facility was stymied by then-current guidance from national and state public health officials to reserve tests for those showing symptoms of the disease.

    “I don’t think we understood at that point how much spread could be by asymptomatic individuals,” said Dr. Danny Avula, director of the state health department’s Henrico and Richmond districts, who has worked closely with the center’s medical staff since the first confirmed COVID-19 case there on March 18.

    Canterbury and health department officials realized the magnitude of the policy miscalculation after testing everyone at the center a week later and discovering that more than half of the residents infected with COVID-19 — 54 out of 92 confirmed cases — showed no symptoms of the coronavirus.

    “This is a disease that spreads when nobody knows it’s there,” Avula said in a conference call interview with Henrico officials on Wednesday. “It’s a grim situation for nursing homes.”

    • I did read that article and thought the argument plausible. However, other nursing homes and rehabilitative centers were faced with the same conditions and guidance. Many of those, including Beth Sholom, the Virginia Home, and Westminister Canterbury, have reported positive cases, and at least one, Beth Sholom, has reported deaths. But none have experienced the extensive outbreak that Canterbury has. The question then remains: Why was it so much worse at Canterbury?

      • May not be level of care. Could be the dose. How sick was the vector? Could be the strain of COV2, S or L, L is highly aggressive.

        Somebody just had an equation, no_data + ignorance = ? Can’t remember but the RHS wasn’t good.

      • I think it is pretty clear that particular nursing home had problems and at a one star rating , probably on their way to being de-listed by CMS but in these times where a lot of the residents came down with COV18 – no other nursing homes would want them transferred to their facilities so it was literally between a rock and a hard place.

        As said before there are over 280 nursing homes in Virginia – all of them also under the regulatory rules of VDH and perhaps 5 of them have problems.

        The fact that the rules for testing at that time – both National and State, ruled out tests for anyone not showing symptoms, combined with the fact that many who are already infected, show no sysmptoms – was a recipe for disaster not only at Cantebury but most every nursing home – across the state – and across the country as major news media is now reporting.

        We’re not blaming Cuoma or the GOv of Washington for their accelerating nursing home infections … perhaps at some point, when we look back, we can see where there was failures – and learn from it but my suspects are that the majority of ordinary people are not going to blame the Governors for this. just my 2 cents.

  3. Just go to the beach already!

  4. ” … but the push to test everyone in the stricken rehabilitation facility was stymied by then-current guidance from national and state public health officials to reserve tests for those showing symptoms of the disease.”

    Another day, another (American) government failure.

    I talked to a friend of mine in eastern Europe today. He told me that his company bought 4,000 testing kits so that anybody working for the company who wanted to get tested could get tested.

    BTW Larry … the article I read yesterday said that the full testing of Canterbury residents happened three weeks after the first case was detected not one week later. Not sure whose source is right.

    Here’s the question for Northam – Has Virginia now tested every resident at every long term care facility in the state? And somebody please remind King Ralph that the only acceptable answers to the question are “yes” or “no”.

  5. johnrandolphofroanoke

    Sometimes it takes a personal tragedy to shake up a political figure. I seem to remember a flurry of activity in the area of mental health following the tragic story of Creigh Deeds.

    • “Sometimes it takes a personal tragedy to shake up a political figure.”

      Rarely, I’s say.

      Far more typically it takes poll numbers, political contributions of money, a steam rolling meme, or wedge issue, or some combination thereof, to lie about and demagogue that shakes up politician.

      • johnrandolphofroanoke

        I seem to remember a great deal of good will between Bob McDonnell and Creigh Deeds to get something done on mental health. It would serve the interests of the people well to hammer out some common sense no arguments reforms for nursing homes. I suppose must of us will end up here unless your name is Enoch or Elijah.

        • Yes, but problem is it has to happen to the politician, not the citizens he or she is elected to serve. So as powerful as that incident was, and deservedly so, it pointed up the corruption of our government today across the board.

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