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Nursing homes need answers, more protection

At The Gardens at Stevens, a skilled nursing and rehabilitation facility in Denver, Pennsylvania, 39 residents had died of COVID-19 as of the publication of LancasterOnline journalist Nicole C. Brambila’s investigative article published in the Jan. 17 edition.

“The Gardens at Stevens is a troubling outlier in Pennsylvania,” Brambila reported. “The death toll is second only in Lancaster County to the 446-bed Conestoga View Nursing and Rehabilitation in Lancaster Township, which is five times larger. Statewide, only about 20 of Pennsylvania’s nearly 700 nursing homes have had more deaths.”

So, what went wrong? Brambila asks that question early in her article detailing the devastating, outsize loss that has occurred at the small Denver facility.

We’d like the answer to that, too.

The surrounding issues are complex and we’ve seen little meaningful response.

No explanation was forthcoming from the owners of The Gardens at Stevens, who did not respond to Brambila’s multiple requests via email and phone for an interview with LNP.

We find that shameful. Families who have lost loved ones and current residents of the facility deserve answers.

They are the human faces of all this unimaginable heartbreak.

Brambila talked to the family of 73-year-old Charles Christian Groff. They were given short notice that the man they lovingly called “Pop” didn’t have long to live, so they made the long drive from central Florida for the opportunity to goodbye.

“Groff had fallen at his East Earl Township home, fracturing several ribs and two vertebrae,” Brambila explained. “Following a hospital stay, he was sent to The Gardens at Stevens to recover. Less than three weeks later, Groff had COVID-19.”

Brambila also talked to Don Eshelman, whose 69-year-old wife, Sue, had gone to The Gardens at Stevens to recover from an ankle injury. She was diagnosed with COVID-19 five weeks after arriving and died shortly after Thanksgiving.

Don Eshelman never had a chance to cook the turkey he had waiting in the freezer — he had promised his wife they’d celebrate Thanksgiving together.

“I still feel if she would have stayed home and I’d taken care of her, she’d still be alive,” he said.

Long before COVID-19, myriad issues have dogged the nursing home industry and impacted the quality of care some provide.

Staffing shortages have been a persistent nationwide problem. Quality of care is strongly tied to staff size, “but staffing is expensive and is sometimes kept artificially low to maximize profits,” Brambila wrote.

In this pandemic, insufficient staffing can be a prime contributor to the rapid spread of the novel coronavirus.

But weak Pennsylvania guidelines have also played a role.

Federal research states that average direct-care staffing of 4.1 hours per resident per day is needed at nursing homes, given the age and morbidity of residents.

Pennsylvania, however, requires a state minimum of just 2.7 hours per resident per day. That figure hasn’t changed in more than two decades.

Looking at The Gardens at Stevens, Brambila found that, on average, it provided 3.34 hours of direct care per resident per day in the third quarter of 2020. That surpasses the state minimum, but falls short of the federal number.

Richard J. Mollot, executive director of the Long Term Care Community Coalition, a New York-based nonprofit organization focused on improving the quality of nursing home care, called Pennsylvania’s minimum “woefully inadequate.”

Brambila also detailed the “perfect storm” of staffing issues that hit The Gardens at Stevens during its deadliest month.

Last autumn, many state nursing facilities had difficulty finding the workers they needed to fill gaps left by sick staff members. That shortage dovetailed with the worst of the health crisis at the Denver facility.

“Once the first residents were infected in mid-November … the virus tore unimpeded through the facility, sickening all 67,” Brambila reported. “Within three weeks of the first reported COVID-19 fatality, 36 residents were dead.”

Where was the state Department of Health during this time? The pandemic had been underway for more than half a year at that point.

Nate Wardle, a state health department spokesman, could not tell LNP anything specific that had been done for the Denver facility.

“As we continue to combat this public health and economic crisis, accountability and oversight are just as important as ensuring that facilities have the resources they need — like PPE, testing and vaccinations — to combat the virus and protect residents and workers,” Democratic U.S. Sen. Bob Casey told LNP. “We must conduct ongoing reviews of what is going wrong and what can be improved.”

Casey has the right idea.

But is the Wolf administration listening?

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