BOSTON — As COVID-19 cases began surging in Massachusetts this spring, state health officials devised a plan to help protect capacity at area hospitals.
Part of the plan included sending recovering coronavirus patients into nursing homes, potentially putting a vulnerable population at risk.
But, as 25 Investigates found, some of those homes were understaffed, poorly rated and were already battling a COVID-19 outbreak.
25 Investigates spoke to families and advocates who say the move was an unnecessary risk and are demanding the state stop using nursing home as part of its line of defense in the fight against COVID-19, especially if there is a second surge in the state.
Ruby M. Kinney was a resident at one of the homes tapped by the state. She was just shy of her 87th birthday when she died in April of COVID-19 complications at the Benjamin Healthcare Center in Boston’s Mission Hill neighborhood.
Her daughter Priscilla Flint-Banks and her husband, Brother Lo, say that as the novel coronavirus was surging in early April, they called the home to make sure Ruby was safe.
“I said, ‘Do you have COVID, [does] anybody you know been tested or have it?' and they’re like, ‘No, no, no, there’s no COVID here,’” said Priscilla. “I know I took them at their word.”
On April 20th, Priscilla says she got a call informing her that her mom wasn’t doing well. She wasn’t eating and would be tested for COVID-19. And just two days later, she got a call from the home’s on-duty nurse telling her Ruby was “non-responsive.”
“We thought she was gonna be safe and taken care of and apparently that didn’t happen,” said Brother Lo.
Ruby died April 22nd before her family even knew there was a single COVID-19 case at the home.
According to data from the Massachusetts’s Department of Public Health (DPH), Ruby was one of 20 residents to die of COVID-19 at the Benjamin Healthcare Center.
At the end of March, state health officials needed a plan to preserve capacity levels at hospitals. That’s when they turned to nursing homes.
“They were part of the backup plan,” said Arlene Germain, Policy Director with the Massachusetts Advocates for Nursing Home Reform. “But I don’t know why they were part of the backup plan. It’s just common sense that you don’t commingle COVID patients with such vulnerable nursing homes residents.”
For months, Germain’s group has been questioning the state’s plan to put coronavirus positive patients in facilities with “most vulnerable to this deadly disease.”
25 Investigates has learned pretty much any nursing home was eligible and they received financial incentives.
Facilities only needed to fill out an attestation form, stating they have a COVID-19 isolation space - either a floor, wing or room - and that they had the capacity to accept new residents. In exchange, the state freed up millions in additional funding for homes.
“So the question is, what kind of vetting really did happen?” added Germain.
The state’s COVID-19 response command center said the state made sure to work with nursing homes.
In a statement they told 25 Investigates:
“COVID-19 dedicated facilities helped create additional capacity in the system as the Commonwealth prepared for anticipated need during the surge, and dedicated care and isolation spaces in facilities helped nursing homes successfully mitigate outbreaks within their facilities. The Administration worked closely with long term care providers to ensure they had the necessary resources to keep residents and staff safe, including swiftly implementing an accountability and support initiative that included unprecedented levels of funding, free in-house mobile testing, staffing assistance, PPE, and strong infection control standards.”
We also found some homes on the state’s list had been flagged by federal auditors for a variety of issues including poor staffing, poor plans for controlling the spread of infectious disease and some even had a history of abuse.
"Bringing in even more patients was just creating an additional burden [for nursing homes] that wasn't necessary," said Germain.
When the state audited the Benjamin Healthcare Center after the surge began here in Massachusetts, it found the facility followed federal and state guidelines for infection control. Therefore, it was eligible for additional funding.
But earlier in the spring when the state was first sending COVID-19 patients, the facility scored a two our of five star rating on the Medicare.gov website for poor performance after a federal audit. The facility paid $49, 069 in federal fine in the last three years.
25 Investigates also learned there were other options beside nursing homes.
The state designated seven individual facilities across the state just for COVID-19 patients. They were located in Worcester, East Longmeadow, New Bedford, Great Barrington, Falmouth, Brewster and Wilmington. We learned none of them was ever at capacity and some were never used at all.
Additionally, five field hospitals were also set up for post-acute care for patients with COVID-19. According to the state, only 100 of the 500 beds at Boston Hope were used at it’s peak. About 30 of the 250 beds at the DCU center in Worcester were used at peak. The field hospitals in Lowell, Dartmouth and Cape Cod never saw a single patient.
The state says field hospitals were meant to be an extension of hospitals and without them the demand on nursing homes would’ve been even higher.
“We should really take a hard look at these isolation units and not keep perpetuating them,” said Germain. “It’s not worth the risk. It’s not worth their lives. It’s not worth the lives of their health care workers.”
Priscilla and her husband don’t know how Ruby got COVID-19 but say they want to see change.
“Not being to able to see her in her last days, not even be able to go up to the window and wave to her,” said Brother Lo through tears.
“This insanity if you ask me,” said Priscilla. “I would like to see probably a totally new policy around nursing homes.”
25 Investigates contacted the Benjamin Healthcare Center on several occasions but requests for a comment went unanswered.
It’s also important to note that Massachusetts hospitals discharged infected patients to some of the lowest rated homes, as well as some of the highest performing facilities. There were outbreaks and deaths at both.
To date, 5,312 people have died after contracting COVID-19 at long term care facilities. That’s more than 60% of all deaths in the state.
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