For nearly a week, the eyes of the nation have been on a nursing home in Kirkland, ground zero of the coronavirus outbreak in the U.S.
Families with loved ones at Life Care Center of Kirkland demanded more information, growing more concerned as the number of deaths from the nursing home rose to at least 10. Even as their roommates were taken to the hospital, residents at the nursing home were not tested for COVID-19, the disease caused by the virus, according to their family members. And as staff got sick, workers said they needed reinforcements.
It appears a fuller response is finally coming. A federal disaster response team was called in, and Life Care said it has smoothed the flow of information to residents’ families. Officials are now saying all residents will be tested on-site.
The nursing home is coming under even more scrutiny as the Centers for Medicare & Medicaid Services announced it would send inspectors, and Vice President Mike Pence, speaking in Washington state on Thursday, said “a very fulsome investigation” was underway.
Life Care Center did not respond to questions submitted late Thursday. In a statement, administrators said it was working with officials to monitor residents and prevent the spread of the disease.
It is unclear why it took until now for the broader response to arrive, but Life Care offers a test case as this coronavirus, also known as SARS-CoV-2, continues to spread nationwide.
Dr. Jeff Duchin, health officer for Public Health — Seattle & King County, acknowledged at a news conference this week that communication with families was inadequate, as the nursing home struggled to contact them.
Although Life Care said Wednesday that each family was assigned a clinical representative who would provide daily updates, some residents’ relatives said those representatives gave incorrect information.
For example, a nurse called Pat Herrick early Thursday morning with the news that her mother, a resident of seven years, had died. But hours later, Herrick said a clinical representative called and said her mother was alive and doing well.
“Apparently the nurse that had called me — she was swamped,” Herrick said at a news conference held by residents’ families. “She was giving meds, she was doing temperatures, she was trying to deal with the coroner and everybody else to help get my mom out and she somehow neglected to get all the information into the chart.”
Despite the glitch, Herrick, who has worked in health care herself, said she doesn’t blame Life Care employees for the error or the spread of the disease. She is hoping her mother, who hadn’t previously shown any symptoms, will be now be tested for the virus to determine if it had a role in her death.
Family concerns mount
Life Care in Kirkland is Washington state’s fifth-largest nursing home by licensed beds — with 190 — and the largest private for-profit facility of its kind, according to state data. It is operated by Life Care Centers of America, a closely held company based in Tennessee that manages 14 other nursing and senior-care facilities in Washington and more than 200 nationally.
The Kirkland facility has the highest possible overall rating from the Centers for Medicare and Medicaid Services, a score that combines data on health inspections, staffing and quality-of-care metrics. When health inspectors have identified violations at Life Care in Kirkland in recent years, most have been relatively minor, federal data shows. Still, there were some lapses in infection control found last year, The Seattle Times has reported.
At least three employees at the nursing home, who spoke to The Times on condition of anonymity out of concern for their employment, said staffing was a challenge in the aftermath of the first confirmed cases, reported on Saturday.
One worker said that early this week, there were only two certified nursing assistants working their section, which usually has six nursing assistants. Reinforcement in recent days has helped, workers say.
The son of one resident, who requested anonymity to protect his mother’s privacy, found out she had pneumonia when he got a call from the facility last week, informing him that she was on her way to the hospital. She tested positive for COVID-19 a week later, he said.
Now, he wonders if more could have been done to help her and to prevent the disease from spreading.
The man’s mother had been sick with a respiratory illness and received breathing treatments in the nursing home for weeks, but she was never isolated from her two roommates, he said. The daughter of one of the roommates told The Seattle Times the same. She said her mother, who is still in the nursing home, is now being treated in isolation for respiratory symptoms.
Kevin Connolly, whose father-in-law, Jerry Wall, 81, is a Life Care resident, said he grew concerned about what he called the facility’s “inept” communication after he called the facility Saturday to check on Wall’s condition. He found the center’s bookkeeper triaging phone calls.
Staff also say communication had been sparse. A nursing assistant, who spoke on the condition of anonymity, she said was concerned about co-workers who told her they felt feverish and faced obstacles in getting tested for the virus.
Testing has been a central issue for many of the residents’ families, who said they had been told that only those exhibiting both fevers and respiratory issues would be considered for testing at the hospital.
Despite their frustration, many of the residents’ family members who have spoken out said they don’t blame the nursing home or its workers.
“While we believe that the Life Care Center has been ineffective, we do not believe that they are to blame,” Connolly said at the families’ news conference. “They should never have been left to deal with this outbreak unsupported,” particularly by the federal government.
“I’ve never seen anything like it”
Robin Dale, chief executive of the Washington Health Care Association, which includes nursing homes, said he is in touch with a regional Life Care representative and has been working on ensuring the Kirkland facility has adequate personal protective equipment. Beyond Life Care, Dale said he and his staff have been fielding calls from directors of nursing seeking guidance on the outbreak, particularly how to deal with visitors and staff with symptoms of respiratory illness.
“I’ve never seen anything like it,” he said of the general anxiety about the virus. While Dale wasn’t aware of any other nursing homes where a resident has contracted COVID-19, he said, “I worry that another call will come in.”
Public Health — Seattle & King County has increased its involvement at Life Care this week, sending in two epidemiologists to help respond and identify patients who need to be hospitalized.
The Centers for Disease Control and Prevention had a handful of personnel on site within a day of the first announced cases Saturday, before sending a team of about 20 people to the facility this week, according to Washington state Gov. Jay Inslee.
A team of 28 clinicians from the U.S. Department of Health and Human Services’ national disaster medical system have also been called to the nursing home, where they will assess the situation, provide clinical support and monitor for proper use of protective equipment such as masks and gloves. The team of physicians and nurses should all arrive by Friday.
At a Thursday news conference, Inslee said he was aware of the concerns about the facility and that if necessary, the state could assume control.
“That is only a possibility at the moment, but I want you to know we do have significant concerns there and we know these families are really worried about their loved ones and we share that view,” Inslee said.
Staff reporter Elise Takahama contributed to this report.