 |
| Scott Morrow visits his mother, Claudette Stasik, at the Bria of Geneva nursing home in the western suburbs of Chicago. Since mid-April, 75 of the nursing home’s 91 residents and 37 of its 120 workers have tested positive for the coronavirus. (Anjali Pinto for ProPublica) |
by Jodi S. Cohen and Haru Coryne
ProPublica Illinois is a nonprofit newsroom that investigates abuses of power. Sign up to get weekly updates about our work.
Standing
outside a window at the Bria of Geneva nursing home one morning last
week, 2-year-old Rosa Morrow tried to get her grandmother’s attention.
She held her palm to the screen. She blew kisses. She counted slowly, “1
… 2 … 3 …”
On
the other side, 71-year-old Claudette Stasik, who has tested positive
for COVID-19, sat in her reclining wheelchair, her eyes closed and her
arms crossed against her chest, her gray hair braided to one side. A
nurse, wearing gloves, gently rubbed her hand.
“Can you say hi? Wake up, honey. You have visitors.”
Separated
by the glass — and by a devastating outbreak of the coronavirus at this
facility in the western suburbs of Chicago — Stasik’s son Scott and his
family can only attempt to communicate with her through a FaceTime
call.
“Hi, Mom. We’re over here. Can you look over this way?” her son said. Stasik opened her eyes, but only for a moment.
It’s
been a brutal few weeks at Bria of Geneva, which has experienced one of
the largest and deadliest outbreaks of the coronavirus in the state,
according to a ProPublica Illinois analysis of Illinois Department of
Public Health data.
Since
mid-April, 75 of the nursing home’s 91 residents and 37 of its 120
workers have tested positive for the virus. Twenty-four residents have
died from COVID-19, the most recent on Monday, according to Bria of
Geneva and the coroner’s office in Kane County, where the facility is
located.
While
other Illinois nursing homes may have seen larger overall numbers of
cases and deaths, almost none have experienced an outbreak on the scale
of the one here, with more than two-thirds of the residents infected
with the virus and one-fourth killed by it. The situation at Bria of
Geneva illustrates the price of insufficient and delayed testing and how
a lag in public reporting of cases and deaths in nursing homes obscured
the breadth of a crisis that has disproportionately hit the state’s
vulnerable elderly population.
The
first resident at Bria of Geneva tested positive April 17. At the time,
Illinois public health officials had instructed nursing homes that they
did not need to test everyone when there were positive cases. That
guidance changed soon after, when state officials acknowledged that more
testing was needed in nursing homes to identify asymptomatic residents
and staff members and prevent large outbreaks. Still, it took another
week for Bria to obtain enough supplies to do widespread testing.
State public health officials first released coronavirus case data on nursing homes
April 19. It showed no cases at Bria of Geneva, even though the
outbreak was underway. In some of the Public Health Department’s weekly
updates since, the number of deaths has been undercounted or becomes
outdated almost as soon as it’s released, according to a comparison of
state data with a tally from the Kane County coroner’s office.
Some
family members have blamed Bria officials for being unprepared for the
virus and for failing to communicate with them about their family
members. The county coroner, who has been performing posthumous COVID-19
tests, also has expressed frustration with the handling of the
outbreak.
“I
don’t feel that it should be my responsibility at this point running
around testing [dead] people that should have already been tested,”
Coroner Rob Russell said.
Philip
Branshaw, the medical director at Bria of Geneva, said that the last
few weeks have been “trying” and “heartbreaking” for the medical staff,
family members and residents, but that he is confident that patients are
well cared for. As of this week, 43 residents and staff members have
either recovered from the virus or are asymptomatic, according to the
nursing home.
“I
likened it to following all the rules, and when you get ready to cross
the street and look at the lights and you step out and get run over by a
truck,” Branshaw said.
At
least 1,500 residents of Illinois nursing homes or other long-term care
facilities have died from the virus — roughly half of all COVID-19
deaths in the state, although residents of such facilities make up less
than 1% of Illinois’ population. The crisis is most apparent outside
Cook County. In these areas, long-term care centers account for
two-thirds of all deaths, according to a ProPublica Illinois analysis of
data from the state Department of Public Health.
Across
the state, more than 400 out of about 1,700 facilities have reported at
least one positive case among residents and staff, and about 20
facilities have had 100 or more positive cases.
The
75 cases among residents at Bria of Geneva, located about an hour west
of Chicago, include Claudette Stasik, who has Parkinson’s disease and
dementia, her family said. Although she hasn’t displayed a high fever,
cough or other symptoms of the virus, her health has declined in recent
weeks as she has been confined to her room.
Patricia
Yanni, 78, had lived at Bria of Geneva for eight years. “The doctor
called me and said, ‘I’m not sure she will make it out of this,’” said
her daughter, Kristin Davison. Yanni died several days later, on May 1.
Susan
Borowiak knew her mother, Lucille James, had been tested for the virus,
but nobody from the nursing home told her the results, she said. James
died May 1, hours before Yanni. The death certificate listed the cause
of death as COVID-19 and noted she was last seen alive in the late hours
of April 30. “The hardest part is knowing there was nobody there with
her,” Borowiak said.
“Somehow the virus got in there and went like wildfire,” Borowiak said. “You scratch your head over the whole thing.”
A Dire Situation
When
Branshaw discusses the timeline of the outbreak at Bria of Geneva, he
starts with the morning of April 17. That’s when the first resident,
sent to Northwestern Medicine Delnor Hospital in Geneva a day earlier,
tested positive for the virus.
“We
did not have any testing available to us, which unfortunately is pretty
common,” Branshaw said. “Once we got our first patient, it was a
landslide.”
Three
more Bria of Geneva residents were admitted to Delnor that day. Others
have been admitted since. Some of the first residents to test positive
were transferred to a facility in Palos Hills that Bria of Geneva’s
parent company, BRIA Health Services, operates. At the time, staff
members thought they could contain the virus by transferring them to a
coronavirus-designated wing at the Palos home.
“We were still trying to figure out the scope of the issue,” Branshaw said.
He
was hamstrung, he said, because he couldn’t get testing supplies. At
the direction of the Kane County Health Department, Bria of Geneva
eventually obtained 10 tests from a state lab, the amount supplied to
facilities at the time, county health officials said. Branshaw secured
an additional 60 tests after asking, in a group chat with medical
professionals, if anyone could help; top health officials from
Northwestern’s Central DuPage and Delnor hospitals supplied them.
On
April 23 and 24, Branshaw and a nurse practitioner went from room to
room at the nursing home. “We swabbed everyone we could,” he said.
Russell,
the coroner, said he was frustrated by the difficulty nursing homes had
in obtaining tests. “The biggest disappointment to me is why aren’t
long-term facilities testing folks? There are things they could do to
mitigate the spread,” he said last month, as the outbreak was just
beginning. He tested some nursing home residents after they died, both
to provide answers to family members and to build a more accurate public
accounting of the disease.
Only
four nursing homes in Illinois had more deaths than Bria of Geneva when
the state updated its count last Friday. All of them are larger
facilities, with more beds and a higher average number of residents.
Meadowbrook Manor of Bolingbrook has had at least 26 deaths, the most in
the state, but it has three times the capacity of Bria of Geneva.
Symphony of Joliet, with twice the capacity of Bria of Geneva, has had
24 deaths.
Pat
Comstock, the COVID-19 response director for the Health Care Council of
Illinois, an industry group that represents about 300 nursing homes,
criticized state public health officials for not providing nursing homes
with personal protective equipment early enough. Hospitals obtained
gear directly from the state, but nursing homes initially had to go
through county health departments or secure it on their own, she said.
“Not
prioritizing nursing homes early enough created some challenges across
the board,” she said. “At the beginning, even if facilities went out and
tried to find their own test kits, the supply just wasn’t available.
Help was needed from the state.”
Gov.
J.B. Pritzker has said that the state provided protective gear to all
county health departments and made clear that the long-term care
facilities are “priority recipients” for distribution. Kane County
health officials provided masks, gloves, gowns and other gear to Bria of
Geneva, a spokeswoman said.
On
April 20, state officials said they would send teams to nursing homes
to test residents and staff — including at facilities with no confirmed
cases to try to isolate cases and avoid major outbreaks. It’s unclear
how many sites they’ve visited, and the Illinois Department of Public
Health did not respond to a request for that number.
“We
are working to test all residents and all staff at those homes,”
Pritzker said in April, adding that the state would prioritize homes
serving minority populations. State officials also said staff members
should be tested more regularly instead of relying on “wellness checks”
that don’t detect asymptomatic carriers.
In
response to questions from ProPublica Illinois, an Illinois Department
of Public Health spokeswoman said the agency has sent 30,396 test kits
to 129 long-term care facilities and Quest Diagnostics, a private
company, has sent at least an additional 2,653 test kits to eight
facilities.
“This
effort continues daily,” IDPH spokeswoman Melaney Arnold said. “Early
in the pandemic when testing capacity and PPE were limited, and
asymptomatic transmission was thought not to occur, isolating residents
and restricting staff could be done with symptoms alone.”
Arnold
said the state releases data on nursing home cases and deaths only once
a week because public health officials are currently “stretched” and
their focus is on responding to outbreaks to limit the spread and
protect residents and workers.
“Without
widespread testing and without frequent release of the data, there are
undoubtedly buildings across the state that have outbreaks that we don’t
even know about or don’t know as much about as others,” Comstock said.
Troubling Reports
At
the front door of Bria of Geneva, it’s as if time stopped before the
coronavirus arrived. A sign at the front door still reads: “Visiting
hours are only a suggestion. Visitors are welcome any time.”
But
no visitors have been allowed inside since mid-March. Messages in the
windows signal the fight that’s going on inside: “#WeGotThis.”
“#BriaStrong.” “#AllforOne.” “GenevaProud.”
BRIA
Health Services operates nine facilities in Illinois, all in the
Chicago area and near St. Louis. Five of them have had deaths from
COVID-19.
The Centers for Medicare and Medicaid Services, which inspects and regulates nursing homes, gives Bria of Geneva
an overall rating of four stars, which is above average, and its top
rating, five stars, for the care of long-term residents. But in its most recent health inspection report,
in July 2019, the federal agency cited the facility for having
insufficient staff to meet residents’ needs and for some workers not
using proper hygiene, among other concerns, and gave it just two stars
in that report.
The
report described residents waiting so long for workers to respond to
them that they soiled their clothes or were essentially confined to
their rooms. “We just don’t have enough staff,” one resident told
inspectors last year, according to the report. “I have waited up to 2
hours to get my call light answered.”
Inspectors
also watched a nursing assistant change a resident’s soiled underwear
without changing her gloves. The same worker, 45 minutes later, changed
another resident’s soiled underwear and then, still wearing the same
pair of contaminated gloves, transferred him back to his wheelchair,
wiped his face with a wet washcloth and combed his hair.
“Staff
should wash their hands and change their gloves after caring for
residents to prevent the spread of infection,” the report states.
Inspectors concluded residents did not face immediate harm but there was
potential for it. Bria of Geneva was not fined.
Some
family members whose relatives died from the virus told ProPublica
Illinois they were left in the dark as COVID-19 spread through the home.
Kristin
Davison’s mother returned to Bria of Geneva after being treated at a
hospital for COVID-19 symptoms around April 25. Davison said she spent
hours repeatedly calling the nursing home to get updates, but nobody
answered the phone. She FaceTimed with her mother on Wednesday, April
29. The next day, she couldn’t reach anyone at the facility.
“They
either didn’t pick it up, I was hung up on, I was transferred. It took
forever for someone to call me and most people would not return your
calls,” Davison said. “I had to hound them. It was ridiculous. You
shouldn’t have to do that.”
On
Friday evening, May 1, she got a phone call that her mother had died.
“The director said, ‘We did our rounds and when we came around she was
gone,’” Davison said. She called the nursing station to ask what had
happened and why she wasn’t contacted. She said a nurse replied: “We are
very busy here. I didn’t know she was going to pass, so I didn’t know
to contact you.”
“What
hurts me the most is my mother was alone,” Davison said. “I would have
loved to have been able to FaceTime her one more time to say goodbye,
and I didn’t have that option.”
Susan
Borowiak said she’s also concerned about the care that her mother,
Lucille James, received in the weeks before she died. When Borowiak last
saw her mother through a window, she “looked really rough,” she said.
Her hair was long and unkempt. Food was stuck on her shirt.
“The
nurses we did know there, we liked. They were very caring. Once the
staff all got sick, it was a rolling boil there,” she said. “I don’t
think they were as prepared as they should have been and didn’t have the
proper protective equipment.”
She
also expressed frustration at not getting updates about her mother’s
declining health after learning through a mass email from Bria of Geneva
on April 24 that residents and staff had tested positive. The next
evening, she emailed the nursing home with a plea for an update on her
mother’s health, saying she had been trying to reach someone there for
two days. “I understand it’s insane there. I’ll even take a text or
email,” she wrote. “Thank you for being there and taking care of my
mom.”
Administrators
allowed Borowiak’s sister, Donna James, to visit her mother the night
before she died, and she held her hand for the last time. As she walked
into the home, James said, a resident was wheeled out on a stretcher and
into an ambulance. The nursing home workers did not have face shields
or medical-grade masks as they went from room to room, James said.
Lucille
James died on her husband’s birthday. They had been married for 59
years. Borowiak, who had said goodbye to her mother on FaceTime, went to
Bria of Geneva one last time and watched as the funeral home arrived to
pick up her mother’s body, draped in purple velvet, her favorite color.
When
Stasik’s family visited last week, the nurse by her bedside wore a face
shield, gown, mask and gloves. But during visits before that and since,
the family said, workers didn’t wear gloves and one nurse assistant
wore his mask below his mouth.
“He was touching her and everything,” said Stasik’s daughter-in-law, Maria. “No wonder it is spreading so fast.”
Branshaw
said that Bria of Geneva has been “more than adequately staffed” by
nurses working longer shifts or through pulling in employees from other
BRIA homes. He said the nursing staff has been “heroic” and that it has
had sufficient protective gear.
Bria
of Geneva resident Debbie Jacobs, who tested positive for the virus but
is asymptomatic, has lost many of her friends in the past few weeks.
She learns the disease has taken another life when the nursing home
plays the hymn “How Great Thou Art” over the intercom to mark each
death.
She
said the outbreak was “like a bomb went off.” Two days after residents
met with the Bria of Geneva administrator to discuss preemptive lockdown
procedures, the first resident tested positive, Jacobs said. “Nobody
expected it,” she said. She said workers have been supportive during the
crisis and have kept residents informed through flyers and one-on-one
meetings.
“I have never met a [nursing home] administrator that cares so much for her building,” Jacobs said.
Other
families, including whose loved ones died, have sent letters, emails
and food to thank the nurses and other workers for their courage to keep
coming to work. Community members provided lunch from Panera Bread Co.
and the Geneva library staff sent a letter of thanks.
Difficult Visits
During
the 90 minutes that Stasik’s family visited her last week, at least two
other residents had windowside visits from their families.
Mary
Niceley dropped off homemade fudge and pumpkin-date bread for her
95-year-old mother, who has also tested positive for the virus but is
doing well, she said.
“I
love you mom,” Nicely said, during a brief windowside visit. She cried
as she walked away, waving her hands in front of her eyes to try to stop
the tears.
Noel
Corral saw his 89-year-old father, Alfredo, who had tested positive for
COVID-19 a week earlier and was moved to a room on the first floor so
his family could visit. Corral tapped on the window and told his father
he wasn’t alone. He told him not to worry anymore.
“Every
day he is getting weaker and weaker,” Corral said, choking up. His
father died the day after that visit. Nursing home workers escorted
Alfredo’s body outside when the funeral home came to pick him up. “The
staff did everything possible to make us feel like we were there with
our dad,” he said.
During
last week’s visit, Stasik’s son shared small talk and asked questions
he knew his mother, who can no longer speak or feed herself, would not
answer. “I haven’t seen you in a few days? Anything new and exciting?”
“You have to eat a little more, OK?” Morrow said. “It will make you feel better.”
Stasik
occasionally opened her eyes. Once, she wiggled her fingers, as if she
were waving. “Grandma’s ’wake!” shouted her 2-year-old granddaughter.
The end of the visits are always the hardest. “We all love you,” Morrow said through the window.
As he drove off in his minivan, he had the same thought he has every time. “Will she be OK the next time I see her?”
Full Article & Source:
A Quarter of the Residents at This Nursing Home Died From COVID-19. Families Want Answers.
No comments:
Post a Comment