Nursing home workers warned the government of security breaches prior to the outbreaks and deaths of Covid-19

Like hospitals, nursing homes have faced severe supply shortages during the pandemic and have urgently sought government assistance. The workers’ complaints concern dangerous conditions in which staff members are deprived of basic protective equipment and have been told to use coffee filters as masks and to wear garbage bags or rain ponchos as medical clothes. Employees say they have been kept in the dark about epidemics in their facilities while caring for elderly and frail residents who are particularly sensitive to the disease.

Some of the employee complaints, according to CNN, were made a few days or weeks before the outbreaks and deaths of Covid-19 were announced in the same facilities. Other complaints were made after management was presumably aware that the virus was spreading across all its facilities.

In New Jersey, for example, the 10 facilities where CNN identified OSHA complaints all had coronavirus deaths. In total, these locations reported around 500 cases and nearly 150 deaths.

However, records show that OSHA closed many complaints after operators denied the complaints or promised to address alleged problems. On-site inspections, which the agency claims to launch to investigate the most serious allegations, were rare.

In the worst examples, employees reported that managers were hiding positive cases from staff, which means that caregivers had no way of knowing for sure if they were treating a patient with the disease. They expressed concern about the lack of preparation, training and supplies to prevent them from contracting and spreading the virus. Employees also reported that staff were forced to work while symptomatic of Covid-19.

“Management is not telling staff what is really going on, nor is it taking the correct measures to prevent disease,” an employee at a Michigan facility said in March, who declined to comment on the complaint. Even though the residents were “coughing uninterruptedly” and “very sick with temperature and upper respiratory problems” – and some had died – the complaint said that the staff had been told that they could not wear masks and that the hand sanitizer was hidden from the employees .

Government warnings

Under federal regulations, employers should protect workers from dangerous conditions. During the pandemic, this includes the need to use gloves and respiratory protection “when the risks at work justify it” and to ensure that workplaces are “free of recognized hazards that can cause or that could cause death or serious physical injury”, according to the OSHA website.

The over 500 complaints identified by CNN come from employees who work for long-term care facilities, such as nursing homes and assisted living centers, as well as from nursing homes and home care companies. They have been filed with OSHA as well as have been with OSHA approved worker safety programs and date from early March to early May.

OSHA continued to investigate over 300 open complaints, according to the most recent data published on the agency’s website. More than 200 long-term care complaints had already been closed, which means that OSHA has reviewed employers’ responses and determined that further action was not warranted. OSHA officials can close complaints if there is “information indicating that the employer is aware of the danger and is correcting it,” according to the directions on its website, which means that just because a complaint has been closed does not mean that it was deemed invalid.

Nursing home officials accused of not reporting a worker’s death, for example, stated in their written response to OSHA that they had not reported an employee’s death because only later had they learned that it could be related to Covid -19 and that the autopsy results were still pending. Representatives of facilities where employees complained of wearing rain ponchos, being told to work while they were sick, or that a flu shot would protect Covid-19 workers, denied the allegations in CNN statements.

Deborah Berkowitz, director of the National Employment Law Project’s worker health and safety program, criticized OSHA’s lack of complete supervision in relation to Covid-19.

“All the employer has to say to OSHA is that we are trying,” said Berkowitz, who previously served as chief of staff and then senior political consultant for OSHA.

OSHA provided data to CNN demonstrating that it had opened more than 40 Covid-19-related inspections in nursing facilities. Most of these were caused by employee deaths or hospitalizations, and only two were opened at facilities where workers’ complaints were recorded, according to available data. Only three states with their OSHA-approved worker safety programs have opened inspections of nursing facilities related to complaints, according to OSHA.

While details of open complaints and inspections are not publicly available, the allegations made by workers in the closed complaints provide a window into the type of concerns that nursing home workers are expressing to the government.

At Opis Coquina Center, a nursing home in Florida where the state says 16 residents died and at least 11 workers contracted the virus, an employee told OSHA in early April that leaders would wait days to tell the staff of a resident who tested positive for Covid -19. The owner of the center’s company said he could not comment on the specific information in the complaint, but noted that it had been closed without any action against the facility.

Also last month, a worker from the Cardigan Nursing & Rehabilitation Center in Massachusetts reported that residents had not been tested for Covid-19 and that the facility was declaring them negative when there was evidence that they were positive. Not even the local health department had been informed of the “supposedly positive” cases, the complaint said.

The state has not released information on where more than 3,000 long-term care deaths have occurred in Massachusetts, but publishes a list of all facilities with two or more cases. A Cardigan administrator, who isn’t on that list, declined to say if there had been any deaths – only stating that Cardigan doesn’t fall into the category of two or more positive cases of Covid-19. He denied the allegations in the complaint and noted that it had been closed.

The most common problem that threatened long-term care workers was the lack of personal protective equipment, or PPE, which includes face masks, gloves and clothing. Some workers said they did not have protective equipment due to the shortage of structures, while others said that their structures did not allow them to wear masks even if they had them.

“Long-term care providers are facing an unprecedented situation that has led them to ask for tests, personal protective equipment (PPE) and staff resources,” said Mark Parkinson, president of the American Health Care Association. and National Center for Assisted Living, a trade organization representing long-term care facilities. “Just like in hospitals, we asked for help. In our case, nobody listened.”

Many employees reported not receiving masks while working with residents who had tested positive for Covid-19 or who were symptomatic. In some cases, facilities accused of inadequate security measures subsequently reported that coronavirus had infiltrated their facilities.

This is the case of the Cedar Mountain Post Acute Rehabilitation in California. Five days after an employee filed a mask shortage there, county officials learned there was Covid-19 in the facility. Cedar Mountain has now reported that 77 residents tested positive, as did 36 staff members. There were 21 resident deaths – the highest number of Covid-19 deaths at any facility in San Bernardino County, according to state data.

A facility spokesman told CNN that Cedar Mountain “has never been short of PPE” and that the proper use and inventory of the facility’s PPE has been verified by county and state health departments, as well as by centers. scientists for disease control and prevention.

The first positive coronavirus case in Stafford Hill Assisted Living, Massachusetts was reported to the city almost two weeks after a complaint was filed with OSHA. The employee said the facility had not developed or communicated a plan to reduce the risk of Covid-19 employees and that supervisors did not allow staff to wear masks, even when they had brought their own.

A facility spokesman acknowledged that an employee was told not to wear a homemade mask to work even though medical grade masks were unavailable and said the facility was following CDC guidelines at the time. He said that when the complaint was filed, Stafford Hill was within days of insuring the medical masks and stressed that when the clerk asked to wear the homemade mask, there had been no positive cases. Since then, however, 14 staff members have tested positive and 20 residents, according to the structure. There were three deaths: all the residents.

Four days after Avista Healthcare in New Jersey reported an outbreak of Covid-19 in the county, a worker worried that the virus would spread to staff. The worker told OSHA that employees dealing with a suspect residing in Covid-19 had not received adequate PPE and that the resident himself was authorized in the common areas. State data show that there were 60 positive cases in the facility and 18 deaths. The property did not respond to a request for comment.

In a May letter reviewed by CNN, a Camden County official told the state health department that the county “was diligently evaluating facilities and instructing staff on infection control measures” and had “very serious concerns” about Avista and other facilities. He asked the state health department, which said the letter is under review, to immediately install a state monitor to keep an eye on the facility – an action generally only taken when there is a situation that endangers the health and safety of residents.

“These are healthcare professionals asking for help”

Nursing home employees also turned to elected officials seeking help – desperate for someone to intervene and echoing many of the detailed concerns in OSHA’s complaints about other facilities.

“For many weeks we worked with extremely small staff!” an employee of the Nashoba Valley Life Care Center wrote to officers in Littleton, Massachusetts, according to documents obtained from CNN. “Instead of managers who come forward and help us fight to protect the patients they are in [their] offices. On Friday, our first patient proved positive that we wore masks and they told us we couldn’t do it because (we were) contaminating the floor. ”

Littleton’s documents show that city officials received at least 12 calls and messages from employees as deaths increased there in April, eventually becoming the site of 14 deaths and over 80 positive cases among residents and staff. An employee said he tested positive for the virus but received no response after calling the facility in an attempt to let management know. A spokesman acknowledged that the calls may not have been answered because family members, city officials and the media had overwhelmed the telephone lines and the staff was “giving priority to patient care.”

Another staff member was one of the first employees sent home with a fever, according to a message sent to city officials, but had not been informed of any cases at the facility, so it was not tested. Then the clerk learned that a colleague was in the hospital.

“My dear friend and nurse is struggling for her life in ICU sedated on a ventilator,” the worker told city officials, according to records containing summaries and in some cases the full text of the calls and messages they have. received by family and workers. “I never knew what was going on in the facility.”

The nurse that this employee was worried about later died and, after her death, a caller told the city that there were two other nurses in ICU.

A spokesman for the Life Care Centers of America, the owner of the Nashoba Valley, told CNN that the management immediately informed all staff of the first positive case in late March and that “it is simply not true that we knew about the outbreak and did not communicate this to our staff. ” He said a survey by the state’s health department found that the facility was compliant with infection control and preparation for Covid-19 regulations, including the proper use of protective equipment. As for the two additional nurses that an employee claimed to have gone to ICU, he said that one recovered and the other was a certified nursing assistant who went to the hospital but “as far as we know it has never been in intensive care “.

As of April 13, the most recent data provided by Life Care, more than 30 employees have proven positive for the virus or are assumed to have contracted the virus because they have shown symptoms.

Even more recently, a Pennsylvania state senator, Katie Muth, has been inundated with text messages and calls from employees of a state-run veteran home where her office has stated that there have been around 50 deaths since April 1 – although not all of them had been permanently linked to Covid-19. The state did not provide data for the Southeast Veterans Center, but claimed that its system of six veteran homes had reported 101 confirmed, probable Covid-19 deaths, 47 staff and 39 deaths.

Muth said workers at the Center for Southeast Veterans reported that supervisors were putting pressure on them to clear the signs of the disease from medical records and medical records and to get to work even after they tested positive for COVID-19.

“These are healthcare professionals asking for help,” Muth said in a statement. The senator, along with the county coroner, asked for an investigation into the facility’s management of the outbreak.

A spokesman for the Pennsylvania Department of Military and Veterans, who runs the facility, said he takes all of his staff’s concerns very seriously and followed the CDC’s guidelines on when employees should be brought back to work. He said the department has an officer who is responsible for “ensuring that all employee requests are properly addressed and resolved” – noting that home veterans have recently passed state and regional inspections and that they have found that structure used the correct protocols.

A veteran house employee, who asked to remain anonymous for fear of losing his job, told CNN that what became a desperate situation began when the facility banned staff from wearing PPE until the first week of April. . The management complained that wearing masks could “scare or insult” residents. A colleague was also disciplined for wearing his mask to work, he said.

He said that employees undoubtedly spread the virus throughout the facility during meal delivery and that although some residents were clearly showing the symptoms of Covid-19, they heard supervisors tell staff that they were not sick. Supervisors also called and “abused” workers who proved positive, he said, telling them to come to work or not get paid. The state said it could not comment on employee issues.

Although control over the veterans’ home has intensified, he said his bosses were pressuring employees to keep quiet about how much the situation got worse.

He would have left by now, but sees the facility’s veterans as his “adoptive family”. Every morning, she said she gets small as she logs into the facility’s system to see the name that is the last one to appear on her screen as “expired”.

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