Jean LeBouttier, 94 years old and unable to walk on her own, wants to buy a car — maybe that Chrysler she saw in the parking lot — and then get fish and chips, and then go swim in the ocean.
“When can we go?” she asks her daughter. “Can we go now?”
“Soon, mom,” Laurie Callahan says to her mother. With her mother’s dementia, it’s easier to let her dream. “We’ll go soon, when this is all over and goes away.”
Sitting 6 feet from her daughter and son-in-law, LeBouttier’s attention shifts, and she looks up at the tall trees that line the sidewalk outside Life Care Center of Kirkland. She hasn’t been outside with her loved ones in months.
“It looks different now,” she says, wringing her hands, one of them bandaged though she doesn’t remember why, as she tries to articulate what’s different about now versus before.
Laurie and Kevin Callahan wait for her to speak, though they know everything is different now at Life Care, the site of the first COVID-19 outbreak in the United States.
They have no complaints, but with six months of context, those who were connected to the nursing home in March are polarized in their views of what happened, so much so it can sound like they are talking about two separate facilities.
For some, it is a loving place that just happened to be the first out of thousands eventually taken over by COVID-19. For others, it is a death trap with top-to-bottom failures.
Back in March, media swarmed on the sidewalk under the trees, trying to get footage of a building that was synonymous with the outbreak of COVID-19. Bouquets were left on the Life Care sign for the patients who had died and the employees working 14-hour days to care for those remaining. Masks weren’t yet ubiquitous — health officials called them unnecessary unless you had symptoms.
The media swarm is gone. Within two weeks, the national correspondents moved on to cover outbreaks elsewhere, some even getting the virus themselves. Orange flowers have bloomed in front of the Life Care sign. Everyone going in and out wears a mask, per state requirements.
“It looks different,” LeBouttier says again. “Now, there are clouds.”
Before COVID-19 spread through the United States, killing more than 184,000 people, sickening more than 6 million people and effectively shutting down the country, there was Life Care Center, the first virus epicenter, where more than a fourth of the facility’s 120 residents died.
The first deaths that were reported in late February — six months ago this week — signaled not just that the virus had reached the U.S., but that it spread quietly, before anyone realized what it had done.
Life Care Center of Kirkland is a now a blip on the list of 15,000 long-term care facilities nationwide where COVID-19 has infiltrated. But it was the first to show how lethal the virus would be in a particularly vulnerable population.
“With Kirkland being the first facility, it taught our country what [COVID-19] looked like, and we started learning how to manage it through Kirkland,” said Nancy Butner, vice president of Life Care Centers of America’s Northwest Division, at its corporate offices in Federal Way. “Any facility would have faced significant challenges.”
Life Care faces wrongful death lawsuits over its handling of the outbreak, but staunchly defends its response, pointing to the ever-changing regulations on personal protective equipment and testing, and initial confusion about how the virus spreads. More than 50 care facilities across the U.S. have surpassed Life Care’s death toll — and Life Care officials note that those places had warning and better guidance than they did.
Life Care now has 67 residents, slightly more than half the count in late February. At its lowest point, the facility was down to 32 people when it was restricted from admitting anyone because of deficiencies cited by the state’s Department of Social and Health Services. That restriction was lifted July 1. In-person visits resumed in mid-August.
On Friday, the facility unveiled a plaque for its residents who died that will remain on the property. The ceremony, livestreamed on the company’s website, included remarks from Life Care President Beecher Hunter in Tennessee and the lighting of 39 candles, one for each COVID-19 victim.
Loyalty to Life Care, and lawsuits
Some families are resolute in saying the facility did the best it could under circumstances no one could have predicted; Kevin Callahan calls Life Care Center “like a Hilton hotel for Social Security.”
Yet other families, both of residents who survived COVID-19 and who didn’t, say Life Care bears responsibility for their loved ones’ suffering. Among their accusations: The facility continued admitting patients even when it was aware of a respiratory outbreak, it waited too long to report an outbreak, and those inside the building received inadequate care while they were sick.
The facility also faces continued scrutiny from state and federal agencies. In April, the federal Centers for Medicare and Medicaid Services fined Life Care $611,325 for deficiencies that federal inspectors said caused a “system failure” in the facility; Life Care disputes the findings and is appealing.
The federal case represents the first long-term care facility appeal of CMS enforcement alleging health and safety violations related to the COVID-19 pandemic, according to the federal Department of Health and Human Services, potentially setting a precedent.
When Chuck Sedlacek, 87, spent roughly two months at Life Care during the pandemic rehabilitating from a bad fall, nurses would rarely respond to his call button, so “he had to scream bloody murder” to get help, according to his son Scott Sedlacek.
Now, at the facility where he lived before Life Care, Emerald Heights in Redmond, when he needs something, he refuses to use his call button, and just yells.
While at Life Care, Chuck tested positive for COVID-19 on March 8, though he never had many of the symptoms now associated with the virus. For weeks, family members searched for another place for him to go, but no facility was taking in new patients, especially ones who had been at Life Care and tested positive.
Scott Sedlacek says his family never received adequate updates from Life Care about Chuck’s health — he lost 30 pounds and became immobile after missing six weeks of physical therapy — or how dire the situation had become. Life Care acknowledges there were communication lapses, overwhelmed by requests for information from relatives, media and facilities across the nation.
The company, which has more than 200 facilities in 28 states, now has a system that sends out links to videos, information and updates related to COVID-19, and automatic messages sent out if a facility confirms a virus case.
“That was probably one of the hardest things for us to manage through, with staff shortages and an onslaught of having people call, but we have made a lot of strides,” Butner said. “It helps our families feel much calmer about the unknown.”
Two lawsuits have been filed in King County Superior Court by relatives of Kirkland residents who died that accuse Life Care of fraud and wrongful death. The daughter of Twilla Morin, an 85-year-old Kennewick native who died on March 4, filed a lawsuit in April. Karen Lambrecht, the wife of Doug Lambrecht, a 71-year-old longtime emergency room doctor who died March 1, filed a lawsuit in late July. Both lawsuits have trial dates set for next year.
The Sedlacek family considered pursuing legal action but opted to focus on their dad’s health.
“He is going to be in skilled nursing for the rest of his life because of the muscle memory he lost and just some of that will to survive,” Scott Sedlacek said. “The emotional toll of being alone and not being able to get help.”
Other residents remain loyal to Life Care. Douglas Smith also went weeks without physical therapy, though occasionally someone would come in and walk with him. At 69, he’s one of the youngest Life Care residents, and has no health issues that make him particularly vulnerable to the virus, which he tested positive for but never showed symptoms.
As a stroke survivor, he says that there’s no other place he would rather be to receive the skilled nursing he requires and understood that physical therapy could be considered risky.
“You have to think of the health and safety of the whole staff,” said his wife, Deborah Triguerio, who was one of the last visitors to the facility before it went into lockdown. Smith’s roommate, a man in his 80s, died of the virus, as did several other people he considered friends.
Visitors return to Kirkland
Back at Life Care, chairs are placed outside many windows for visitors to sit for meetings. The facility recently started coordinating short outdoor visits, like LeBouttier’s, that require visitors to go through a checklist and sit at tables 6 feet apart. No hugs or touching, but they’re closer than they’ve been.
On a patio, around the corner from a door where cleaners once entered in hazmat suits, Smith and Triguerio met for the second time in two weeks. Triguerio says that she was so ecstatic to see her husband that, as the months went on, it didn’t feel like much time had passed.
“Really?” he asks. “It feels like forever to me.” He used to joke that he would die of boredom before he died of COVID-19.
At the table by the facility’s putting green, LeBouttier is getting tired, so the Callahans get ready to say goodbye, but first, she wants to sing one of her favorite tunes: the fishy song. She brings her palms together and wiggles them like a fish as they sing. One more time, she asks when they can leave and go to the beach.
“Soon, Mom,” Laurie Callahan says. “Soon.”