Bloomberg Businessweek - USA (2020-11-09)

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BloombergBusinessweek November 9, 2020

care,profitwouldfollow,”thisperson

says.Whitcomb,whousuallyturneda

modestprofitatthehomes,decidedto

sellthemtoCareRitein 2017 amidthe

chain’sstatewideexpansion.

CareRite wasfoundedin 2011 by

entrepreneursMarkFriedmanandNeal

Einhorn,whohadbiggerambitions.

StartingwithhomesinNewYork,they

builta nationalnetworkthatreliedon

polishedmarketing—earlybrochures

promoteda “dynamicfusionofluxury

andservice”—and,atleastinTennessee,

cost­cutting,accordingtointerviews

with 29 currentandformeremploy­

eesattheCareRitehomesinthestate.

AfterthecompanyboughtWhitcomb’s

homes,it eliminatedyearendbonuses

ofa fewhundreddollarsperemployee.

Ordersfor supplieswere trimmed,

sometimesleavingthebuildingsshort

onglovesandgowns.Nurseswereocca­

sionallytoldtotapetogetherresidents’

colostomybags so they didn’t leak

becausetheydidn’thavetherightsizes

instock,saysAmandaShannon,a sup­

plymanagerwhoworkedatTrevecca

forfouryearsbeforequittingin2019.

“Wewentfromhavingeverythingwe

neededtohavingnotenough,”shesays.

AsCareRitehasexpandeditsbusi­

nesstoinclude 29 homesinFlorida,

NewJersey,NewYork,andTennessee,

someattorneysspecializingincases

ofallegednursinghomeneglecthave

become familiarwiththecompany.

“Whatweseeoverandoveragainis

thelackofstaffingandthelackofsup­

plies,”saysCameronJehl,anattorney

inMemphis,who’sfiledatleastfive

lawsuitsagainstCareRiteinTennessee,

allegingthatcutbackscontributedto

residents’healthproblems.Oneofhis

suitswasfiledonbehalfofa womanat

BethanyCenterwhodevelopedbed­

soresandalsofracturedherhipina

falllastyear.Inlegalfilings,CareRite’s

lawyershavedeniedallegationsofsub­

standardcare.

AfterCareRiteacquiredTrevecca,

employeessayitslashedthebudget

to keepthefacilityclean,reducing

spendingonlinens,towels,andblan­

ketsbymorethan50%.Nurse’saides

sometimeshadtocutoldsheetsinto

piecestousethemaswashclothsfor

residents.Meanwhile,severalhouse­

keeperswerelaidoff,oftenleavingone

persontoclean 30 roomsona floor

duringaneight­hourshift,whenbefore

there’dbeentwo.Workerssaythebuild­

ingfellintodisrepair.Blanketsworeso

thinthata staffmemberrecallshold­

ingoneupandreadingthetimeoffa

clockthroughit.Thelobbywasadorned

withbigpottedplantsandplushuphol­

steredchairs,butthecream­colored

carpetaccumulatedanever­expanding

collectionofstains.

Few departments were asbadly

depleted as housekeeping. When

residentsaremovedwithina facility,a

standardpracticeamongnursinghomes

istodisinfecttheroomsthoroughly,

conductingwhatisknownasa “ter­

minalcleaning.”Thisincludesspray­

ingdownthemattress,scrubbingthe

surfaces, and swapping out the privacy

curtain.AfterTreveccastartedturning

uppositivecasesinlateApril,thehome

hadtomovedozens of residents around

to create isolation units. Employees say

that some of these moves happened

without the disinfection process, poten­

tially exposing healthy residents to the

virus. “We didn’t have enough people to

do it,” says Daisy Shipp, who worked as

a housekeeper at Trevecca for 12 years

before leaving in May. “Sometimes the

mattresses wouldn’t get cleaned.”

Even though we now know the virus

is spread mostly through the air rather

thanonsurfaces,thefailuretodisinfect

roomsis a majormisstep,accordingto

infection­control experts. “It’s a very big

deal,” says Dolly Greene, chief executive

officer of Infection Prevention & Control

Resources, which trains nursing home

workers. “The environment can be a

sourceoftransmission.”

TenmilesawayatBethanyCenter,

a two­story brick building capable of

housing 180  people, supplies were

stretched so thin that nurse’s aides

would scramble at the beginning of

each shift to gather up the few clean

towels they could find. Workers, such as

Woldemariam Fersha,

a nurse’s aide who

started there in 2005,

would come home

and complain about

it. “He was frustrated,”

says Yerom Eshete, his

wife. “They don’t pro­

vide workers every­

thing they need to

take care of patients.”

Another Bethany

Center aide, April

Avery, was assigned to

work the home’s isola­

tion unit. But the bins

that were supposed to

contain gowns, gloves,

and other protective

equipment were fre­

quently empty, she

says. Patients in the

rooms still needed

help, so aides would

simply go in and out

“They were putting me in danger, and I was

putting the residents in danger”

April Avery