Washington state nursing home’s response to coronavirus placed some patients’ safety in ‘immediate jeopardy,’ federal agency finds

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By Madeline Holcombe and Sara Sidner, CNN March 25 2020

(CNN)An inspection of the Life Care Center of Kirkland nursing home earlier this month found the facility had at times put patients’ safety in imminent danger during the coronavirus outbreak there, the Centers for Medicare and Medicaid Services (CMS) said.

Thirty-five coronavirus deaths are associated with the Washington state facility, which was once the epicenter of the US coronavirus outbreak.

The virus infected two-thirds of residents and dozens of staff members. After visitors were banned, some loved ones resorted to yelling at windows and holding signs outside to get information and connect with residents.

The inspection by CMS and state regulators concluded March 16, when there were 29 deaths connected to the facility. It found three “Immediate Jeopardy” situations in which a patient’s safety is in imminent danger, according to a CMS release Monday.

It was performed by two federal surveyors who performed an on-site inspection, including observations of patient care, and Washington state staff who reviewed documents off-site. The inspection was not intended to be punitive but to ensure federal health and safety standards compliance, CMS said.

The statement said preliminary results from the inspection found that the facility:

  • Failed to rapidly identify and manage ill residents;
  • Failed to tell the Washington Department of Health about the increasing rate of respiratory infection among residents; and
  • Failed to have a sufficient backup plan after the facility’s primary clinician fell ill.

CMS did not specify in its release what recommendations the facility should have followed instead. CNN has reached out to CMS for further comment.

Nursing home says it had ‘inadequate guidance’ from health officials

Life Care Center spokesman Tim Killian agreed that patients were in jeopardy — but only because of an extraordinary pandemic that he says government officials did not prepare the nursing home for.

“Of course, patients were put in immediate jeopardy. We were experiencing a pandemic in which we had inadequate guidance from the CDC as (to) the rate and spread of the infection,” Killian said Tuesday.”

We had inadequate guidance from government agencies.”

CNN has reached out to the CDC for comment.

Killian said Life Care Center intends to seek an independent review of the CMS’ findings. He disputes the claim that the nursing home did not tell the state health department about an increase in respiratory illnesses.

“We believe we did report known influenzas and pneumonia in our facility (to the) Department of Health,” Killian said.

“The real question relative to this report is what help we received from the Department of Health in (the) immediate response to our reporting of the respiratory issues we were seeing,” he said.

“In reality, we received next to no immediate support from our local and federal government agencies that would have helped us deal with a Covid-19 outbreak within our facility.”

CNN has reached out to the Washington State Department of Health for comment.

‘These nurses are heroes’

Killian said the facility did the best it could after its medical director contracted coronavirus and many other employees fell ill.

“In the first few days of this (coronavirus) outbreak, we lost 55 of 180 employees,” including the medical director, Killian said.

Despite the director’s illness, “he continued to work from home using a phone to consult and guide our nursing staff. There is no nursing staff in the country who would be able to manage this crisis in which one-third of the staff almost immediately was lost to the Covid-19 outbreak.”

Cheryl Strange, secretary for the state’s Department of Social and Health Services, said the coronavirus outbreak at Life Care Center “was an unprecedented situation for the state of Washington,” according to the CMS news release.

A nurse at the facility said battling the virus in the nursing home was like nothing she had seen before in her 20 years of experience.

“How I describe it is, you’re going off to war and you’re in a battlefield where supplies are limited. The help’s slow to get to you and there’s lots of casualties and … you can’t see the enemy,” Chelsey Earnest said.

“We would hope that CMS would judge us in light of an unprecedented global pandemic that happened to us, not because of us,” Killian said.

“These nurses are heroes. And the suggestion that they are responsible for the spread of a largely unknown virus is unfair and diminishes the heroic effort they continue to make every day to treat their patients.”

Elderly are most vulnerable to virus

The information gained from the inspection will be applied to ensure other long-term care facilities in the state are prepared for a possible coronavirus outbreak, the CMS statement said.

While more evidence shows young adults can become seriously ill from coronavirus, the elderly and those with underlying conditions are the most vulnerable to dying from the virus.

And across the country, more nursing homes are grappling with coronavirus outbreaks. According to CDC data shared with CMS, 147 nursing homes across 27 states have at least one resident with coronavirus.

Seven nursing homes across Arkansas have reported cases, state Department of Health Secretary Dr. Nate Smith said. One facility has been linked to 41 cases of coronavirus.

Everyone at a nursing home in West Virginia will be tested after a woman there tested positive, Gov. Jim Justice said. He did not identify the nursing home.

In New Orleans, seven deaths and 24 confirmed cases are linked to the one retirement community, said Dr. Alexander Billioux, Louisiana’s assistant secretary of health. He said seven other facilities in Louisiana have reported cases.

CNN’s Holly Yan and Joe Sutton contributed to this report.