The Washigtnon Post - 03.04.2020

(Joyce) #1

friday, april 3 , 2020. the washington post eZ re A


the coronavirus pandemic


BY MARIA SACCHETTI
AND JON SWAINE

A Washington state nursing
home tied to 40 covid- 19 deaths
faces a fine of more than
$611,000, federal inspectors said,
and could also lose Medicare and
Medicaid funding if it does not
correct a slew of deficiencies that
led to the country’s first major
outbreak of the novel coronavi-
rus.
In a letter Wednesday to Life
Care Center of Kirkland, the Cen-
ters for Medicare and Medicaid
Services wrote that the nursing
home failed to report an outbreak
of respiratory illness to local au-
thorities for two weeks as re-
quired by law, gave inadequate
care to its residents during the
outbreak and failed to provide
24-hour emergency doctor servic-
es.
The inspectors said that if the
nursing home northeast of Seat-
tle “does not correct all deficien-
cies and return to full compliance
by September 16, 2020, then CMS
will terminate your facility from
participating in the Medicare/
Medicaid program.”
In a statement on Thursday,
Life Care said it would “continue
to work with CMS to find solu-
tions” to problems raised in the
inspection report.
“We are working hard to ad-
dress their current concerns in a
timely and respectful manner so
as to provide our residents the
best care,” the statement said.
The company noted that the Kirk-
land home had received a five-
star CMS rating before the pan-
demic.
Inspectors levied a per-day civ-
il penalty of $13,585 for the al-
leged deficiencies, dating to Feb.
12, around the time the outbreak
is thought to have taken hold, and
continuing through March 27.
They s aid the fine could be raised,
or lowered, depending on the
facility’s compliance with its cor-
rection plan. The company has a
right to appeal.
In addition to losing its federal
payments under the Medicare
and Medicaid programs, the facil-
ity also could lose its Nurse Aide
Training and Competency Evalu-
ation Program and forfeit federal


payment for the patients it admit-
ted from March 21 to March 27.
Officials said 129 residents,
staff and visitors were infected
with the coronavirus. Forty peo-
ple associated with Life Care have
died because of covid-19, which
includes residents and visitors,
according to a tally Thursday
from a spokesman for King Coun-
ty, which encompasses Kirkland.
In figures updated April 1, the
county said 2,496 people had
tested positive for covid- 19 in
total and that 164 people had died
from the disease.
In a summary of its findings
issued last month, CMS said in-
spectors had found that Life Care
failed to swiftly notify regional
authorities that it had a surge in
respiratory infections, and con-
tinued to admit new patients and
hold events such as a Mardi Gras
party for dozens of residents and
guests.
The Washington Post found
that Life Care did not file a report
with authorities for more than
two weeks after it began discour-
aging visitors on Feb. 10 because
of the illness among residents,
which it assumed to be seasonal
influenza.
King County said it received
notification of an increase in re-
spiratory illnesses at the nursing
home late on Feb. 27. Life Care has
said it also left a voice message
with county officials the day be-
fore. State law and county regula-
tions required Life Care to report
any suspected flu outbreak with-
in 24 hours.
The Seattle region was the site
of the first confirmed coronavirus
case in the United States. Author-
ities said on Jan. 21 that a 35-year-
old man in Snohomish County,
which is adjacent to King County,
had tested positive after traveling
from the Wuhan region of China,
where the virus is thought to have
originated. The man has since
recovered.
Some relatives of residents
who were at Life Care during the
outbreak said they were shocked
by the inspectors’ findings.
To dd Campbell, 59, said he was
surprised that Life Care contin-
ued accepting patients such as his
father, Gene, and that the facility
did not have an adequate plan to

deal with infection. Campbell’s
father, 89, was admitted to Life
Care on Feb. 21 after a brief
hospital stay for a stroke, and
later tested positive for covid-19.
He is now recovering, Campbell
said.
“It’s surprising that they have
until September to fix things,”
To dd Campbell said. “Nobody’s
going to want to go there.... I

wouldn’t want my dad to go back
there.”
Federal records on the inspec-
tion requested by The Post con-
tained new details of the pande-
monium as the virus descended
on Life Care. The facility had
failed to follow basic protocols
required to prevent infection, in-
spectors said, and instead created
conditions that could have al-

lowed it to spread.
The report showed that Life
Care in 2019 failed to hold “con-
sistent or effective” quality assur-
ance and performance improve-
ment (QAPI) meetings, which are
intended to flag infection control
and other issues.
Managers at the facility held
quality assurance meetings on
Jan. 27 and Feb. 19, after the virus
already had been detected in a
neighboring county.
The home’s director, who
joined the facility in January, told
CMS inspectors: “Normally if
there are concerns in infection
control it would have been dis-
cussed in the QAPI meeting.”
CMS said infection concerns
did not come up at either meet-
ing, including the one in Febru-
ary, which was held days after
Life Care said it posted signs
warning visitors about the respi-
ratory outbreak that staff thought
was the flu. “Further review of the
02/19/2020 monthly QAPI meet-
ing minutes under the nursing
section revealed: no reports of
infection concerns at the facility,”
the CMS report said.

The nursing home’s medical
director, who was not identified,
did not attend either of those
meetings, the report states. Life
Care’s “infection preventionist”
nurse attended the January meet-
ing, but did not attend the Feb. 19
meeting.
The executive director and two
unidentified administrative staff
members said “it was very chaot-
ic” inside Life Care, as patients
and dozens of staff members fell
ill in February and March. Patient
records were incomplete. Staff
members were sick and unable to
tend to the residents, they told
inspectors.
“We were triaging residents as
the residents were crashing, so
there wasn’t going to be a lot of
documentation,” one nursing
home official, who was not identi-
fied in the report, told CMS in-
spectors.
CMS said the facility “did not
have effective systems in place” t o
prevent the infection or respond
to it. Life Care officials did not
notify health-care authorities of
the outbreak until Feb. 26 and did
not have a 24-hour emergency
physician or adequate staff to
respond to the outbreak.
The facility lacked a “clear
medical plan of action,” inspec-
tors said, leading to a “systemic
failure.”
On March 7 — nearly a month
into the outbreak — inspectors
said two certified nursing assis-
tants, a man who had worked at
Life Care for 15 years and a
woman who had been there for
four years, said they had not been
trained to properly sanitize items
with bleach wipes.
Also that day, inspectors spot-
ted a laundry staff member who
delivered clothing to residents in
multiple rooms without changing
her gown, gloves and other pro-
tective gear despite warning
signs that patients might have
been contagious.
Bridget Parkhill, a 54-year-old
medical assistant whose mother,
Susan Hailey, 76, remains at Life
Care after testing positive for
covid-19, said the fine imposed by
CMS was “ not even close” t o large
enough to make a difference.
maria.sacchetti@washpost.com
jon.swaine@washpost.com

Wash. nursing home faces $611,000 fine over lapses during fatal outbreak


Brian snyder/reuters
ABOVE: Flowers and ribbons are tied to trees outside the Life Care Center of Kirkland, Wash., in mid-
March. BELOW: On March 13, a nurse walks past the room of a center resident who tested positive for
covid-19. The facility has been tied to 40 deaths from covid-19.  See more at wapo.st/VirusLifeCare

ted s. Warren/associated press

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