The Washigtnon Post - 03.04.2020

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.

[email protected]

[email protected]

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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