It is unknown how many of our vulnerable elderly fall victim to neglect or abuse each year since such actions are easily hidden from view and underreported. In fact, according to the National Center for Elder Abuse (NCEA), 84 percent of abusive situations involving older adults go unreported or unrecognized.
In early March, Coronavirus spread undetected through an assisted living facility named the Life Care Center in Kirkland, Washington. It’s a situation so horrific, it’s been nicknamed the Kirkland Disaster. By March 21, 2020, three weeks after one resident and a staff member tested positive for the virus, thirty-five people connected to the facility were dead. That’s twelve percent of all residents and staff—an astounding number, even for a novel virus known to have a 4 to 8 percent fatality rate in the elderly.
How Did the Kirkland Disaster Happen?
Chelsey Earnest, a registered nurse with 20 years’ experience, rushed to help the staff at the Life Care Center when she heard they needed emergency staff. In an interview with CNN, Earnest called COVID-19, “an invisible invader.” Elderly patients who seemed fine by day and had strong vital signs suddenly struggled to breathe at night.
One of the major signs of serious illness in the residents was red, irritated-looking eyes, Earnest said. From there, many of the residents’ condition began to deteriorate rapidly. In her interview with CNN, Earnest recalled an elderly male patient who became deathly ill over the course of a few hours.
Despite the heroic efforts of the nursing staff, investigators say the facility, along with local health agencies, failed to take action at several critical points in the week that followed the first positive test.
On February 27th, the public health department in Seattle & King County received a notice from Life Care Center that they had patients with severe respiratory illness. According to KUOW public radio in Seattle, the health department regarded it as “a usual wintertime message.” The next day, two Seattle residents with connections to Life Care Center tested positive for Coronavirus, prompting local health officials to alert the Centers for Disease Control and the Department of Health. The CDC sent an emergency response team to Kirkland on February 29th, but swabs for COVID-19 testing didn’t arrive until March 4th.
At that point, it was too late for many of the patients and staff at the facility. By mid-March, 29 of Life Care Center’s 120 residents had died, along with eight staff members. Many other staff members tested positive for Coronavirus and were ordered to stay in quarantine for two weeks at home.
Who is At Fault for the Spread of COVID-19 in this Kirkland Nursing Home?
The Centers for Medicare and Medicaid Services (CMS) released a detailed report that found the Life Care Center in Kirkland committed “serious infractions” during the Coronavirus crisis.
When inspecting this Kirkland nursing home, the CMS and the Washington Department of Social & Health services found three “Immediate Jeopardy” situations, which are circumstances where a patient’s safety is placed in imminent danger. Specifically, the facility’s failure to rapidly identify and manage ill residents and to notify the Washington Department of Health about the increasing rate of respiratory infection could have led to this horrific event. Additionally, the Life Care Center did not have a sufficient backup plan once its primary physician fell ill.
The Life Care Center of Kirkland may now face serious penalties for putting the lives of residents in immediate danger. CMS has now classified the facility as “in immediate jeopardy.” On March 18, CMS gave the facility 23 days to make major improvements. It will be subjected to unannounced checks, and if it fails to meet CMS’ benchmarks for improvement, it could become ineligible for federal funding.
Steps the CMS is Taking to Prevent the Virus from Spreading in Other Nursing Homes
The Life Care Center in Kirkland is far from the only nursing home or assisted living facility severely affected by Coronavirus. According to information that CMS obtained from the Centers for Disease Control, 147 nursing homes in 27 states have at least one patient with Coronavirus. Because not every facility has access to Coronavirus testing, the real number could be much higher.
Using this information, the CMS and the CDC are working together to identify areas where the virus may spread next and take action before another tragedy happens.
CMS said it is postponing routine inspections of nursing homes to focus on the immediate threat of Coronavirus outbreaks. Under its new protocol, CMS will only conduct three types of federal inspections: complaint inspections, targeted infection control inspections, and self-assessments.
During these more targeted inspections, the CMS is giving guidance to these nursing homes about how to control and prevent the transmission of the virus. CMS will conduct only the immediate jeopardy inspections and provide additional training related to infection control.
CMS also will provide nursing homes, assisted living centers, and other long-term care facilities with a self-assessment tool. The self-assessment will help care facilities determine whether they are taking the proper steps to prevent a Coronavirus outbreak—before the federal government gets involved. Verma, the CMS administrator, said she is making the self-assessments available because many state health inspectors have their hands full, assisting with other aspects of the Coronavirus response.
How Families Can Protect Their Loved Ones in Nursing Homes
In this time of national emergency due to the growing threat of Coronavirus, what can family members do to protect a loved one who resides in a nursing home or long-term care facility? Ironically, one of the most important things you can do is avoid visiting them. This is because elderly people and individuals with underlying health conditions are more susceptible to Coronavirus. In fact, many nursing homes have banned visits from family members and friends as instructed by the CDC.
However, this does not mean you can’t stay in touch with your loved one. Communicate frequently—via e-mail, letters, or video conferencing programs like Skype. You should also ask the facility what their plan is to stop the spread of Coronavirus. CMS also encourages family members to ask the facility for the results of their CMS self-assessment.
As tempting as it is to protect loved ones by moving them home during the Coronavirus emergency, experts say it’s a bad idea. Although the Coronavirus outbreaks at nursing home facilities have been frightening, the elderly and medically vulnerable are more likely to be exposed to germs outside of these facilities than in them.
One piece of advice nearly all experts have for concerned family members is to speak up and use your voice to advocate for your loved one. You are well within your rights to remind staff to practice proper hygiene, like frequent hand-washing and sterilization. It is also important to understand their plan to control contagious diseases. If you believe a long-term care facility is putting its residents at risk, report it to the local health department.