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Nursing homes feel brunt of COVID-19 pandemic

  • CareOne at Northampton. CareOne's website describes the senior care center on Elm Street as a sub-acute rehabilitation facility. Photographed on Tuesday, April 28, 2020. STAFF PHOTO/KEVIN GUTTING

  • CareOne at Northampton. CareOne's website describes the senior care center on Elm Street as a sub-acute rehabilitation facility. Photographed on Tuesday, April 28, 2020. STAFF PHOTO/KEVIN GUTTING

  • CareOne at Northampton. CareOne's website describes the senior care center on Elm Street as a sub-acute rehabilitation facility. Photographed on Tuesday, April 28, 2020. STAFF PHOTO/KEVIN GUTTING

  • CareOne at Northampton. CareOne's website describes the senior care center on Elm Street as a sub-acute rehabilitation facility. Photographed on Tuesday, April 28, 2020. STAFF PHOTO/KEVIN GUTTING

  • CareOne at Northampton. CareOne's website describes the senior care center on Elm Street as a sub-acute rehabilitation facility. Photographed on Tuesday, April 28, 2020. STAFF PHOTO/KEVIN GUTTING

  • CareOne at Northampton is shown April 28. CareOne’s website describes the senior care center on Elm Street as a sub-acute rehabilitation facility. STAFF PHOTO/KEVIN GUTTING

  • Phyllis Marcinowski, 80, of Hatfield died this past Saturday at CareOne at Northampton after testing positive for COVID-19. SUBMITTED PHOTO/KATHLEEN FAY

  • Robert Jensen SUBMITTED PHOTO

  • Robert Jensen SUBMITTED PHOTO

  • Robert Jensen and his daughter Diane Jensen-Olszewski SUBMITTED PHOTO

Published: 5/5/2020 6:39:12 PM

NORTHAMPTON — A few days after Phyllis Marcinowski tested positive for COVID-19, her family gathered outside the nursing home in which she was quarantined and celebrated her 80th birthday through a window.

That was one of the last times her family saw her, and Marcinowski’s daughter Theresa Laizer said her mother appeared ill — “as if she was going to go any hour.”

Five days after her birthday in quarantine, on April 25, Marcinowski died at CareOne at Northampton.

“She was a caretaker by nature,” Laizer said. “She was self-sacrificing. She never cared if she had anything in life, but she wanted everybody else to be taken care of.”

Marcinowski is one of the thousands of COVID-19-related fatalities in Massachusetts’ long-term care facilities — accounting for over half of all coronavirus-related deaths in the state. About a fifth of all deaths from COVID-19 in the United States have been tied to long-term care facilities, according to The New York Times.

Figures released Monday by the state Department of Public Health show that of the 69,087 total reported cases of COVID-19 in Massachusetts, 13,708 are residents or health care workers in long-term care facilities. And of the 4,090 reported deaths, 2,428 have been in the state’s long-term care facilities.

In Hampshire County, CareOne at Northampton and the Center for Extended Care in Amherst have emerged as hot spots of COVID-19 cases, with the state reporting more than 30 positive cases of the infectious and deadly disease among residents and staff in each facility.

But according to a nurse at CareOne at Northampton, who spoke on the condition of anonymity due to fears of retaliation by their employer, the true numbers of those infected at that facility are much higher than in the state database, which doesn’t provide precise numbers and tops out at listing over 30 cases for all nursing homes and assisted living facilities.

The nurse at CareOne at Northampton told the Gazette last week that at least 20 staff members have tested positive for COVID-19, around 35 residents have tested positive and several residents have died, though it’s unclear how many died from COVID-19 versus other causes. CareOne at Northampton has 125 licensed beds. The Northampton Health Department and CareOne at Northampton did not release more detailed case data.

“It’s just ravaging through our building,” the nurse said.

Other nursing homes in the area have been feeling the pressure caused by COVID-19, with DPH figures showing three other facilities with positive cases in Hampshire County as well as five facilities in Holyoke. In Greenfield, Buckley HealthCare Center has confirmed that 68 residents and staff members have tested positive for COVID-19, according to the Greenfield Recorder.

Laizer and her sister, Kathleen Fay, said they had taken care of Marcinowski, who had vascular dementia and Alzheimer’s disease, until last August when they recognized their mother’s need for more individualized care. Earlier this year, Marcinowski, who suffered from COPD, a chronic lung disease, and some other health conditions, lost weight and qualified for hospice care, said Fay, who worked at CareOne at Northampton about 10 years ago.

When nursing homes such as CareOne at Northampton locked their doors due to the coronavirus pandemic, Fay said she and her sister became nervous because they couldn’t visit their mother.

Having received a call that Marcinowski, of Hatfield, had fallen only a few days before, Laizer said she had seen her mother through a glass partition with some family on Easter Sunday, April 12, and noticed she looked underweight, with red circles under her eyes. Laizer said she was shocked by her mother’s appearance.

Laizer said she struggled to connect with a CareOne at Northampton employee who would communicate with her about her mother’s condition following her visit on April 12. The phone would keep ringing, Laizer said, adding she wasn’t convinced she was being told the full story when she did manage to connect with someone who said her mother was doing fine. According to Laizer, she eventually reached a receptionist who said her mother had been sick, though no one had told her this before.

“Trying to get in touch with anyone was ... a major nightmare,” Laizer said.

Lazier was told of her mother’s positive COVID-19 test result on April 17. Then, the Sunday before Marcinowski’s 80th birthday, staff said her mother was “asymptomatic” and fine, she said, adding that she was shocked at the speed at which her mother’s health deteriorated.

Laizer and Fay said they believe CareOne is partly responsible for the circumstances surrounding their mother’s death because she was in the facility’s care. Laizer acknowledged that there are more structural issues with nursing homes in the country that need reform, pointing to a lack of proper staffing — and noted she had seen such problems at her mother’s facility before the pandemic.

“I feel they failed,” Laizer said about CareOne at Northampton. “They failed because they weren’t transparent, and they didn’t keep families in the loop.”

In a statement, CareOne at Northampton said it could not comment on a specific patient’s care, but that procedures are designed to ensure daily communication with families, residents and employees, such as through a hotline.

“These protocols include immediate notification of family contacts (as designated by the patient) and residents whenever on-duty staff (1) confirm a Covid-positive test, (2) identify a significant change of condition, and (3) or have a patient who does not survive. The protocols also include documenting all family notifications,” the statement reads.

“CareOne empathizes deeply with every family that loses a loved one to this insidious virus. As we always stress, CareOne residents are real people who become a part of our family,” the statement said. “We mourn their losses, celebrate their positive outcomes and always do our best to care for them and treat them as their families would.”

According to the nurse at CareOne at Northampton, some nurses, CNAs and much of the facility’s housekeeping staff stopped working due to the outbreak — though a handful of employees left because of fears over their own health.

“You do your eight-hour shift, and there’s nobody to relieve you. People are getting worn out, and we’re all working every day of the week doing doubles,” the nurse said.

“We’re working so short-handed that people’s parents aren’t getting the care that they should get,” the nurse added. “I would never leave patients high and dry, but you can only do so much … You only got two hands and two feet.”

CareOne at Northampton also said in its statement that the facility “expends significant resources to maintain sufficient staffing during a time when labor remains in great demand.”

“CareOne has various forms of incentive pay in place for its workforce to reward their dedication and compassion,” the nursing home’s statement said. “In addition, every day our center team works with staffing agencies, per diem workers and employees from other CareOne facilities to ensure satisfactory employee levels.”

CareOne has another facility in Holyoke with more than 30 cases of COVID-19, according to DPH data. CareOne is a New Jersey-based, post-acute and long-term care provider with over 68 care centers located in nine states, according to the company’s Linkedin page.

Northampton Mayor David Narkewicz said in a statement that Merridith O’Leary, the city’s director of public health, first heard of a staff member case of COVID-19 at CareOne at Northampton on April 14 from a community member. The city was informed April 17 that two patients at the nursing home had tested positive, and the nursing home was designated as a COVID-19 “cluster” by the city so cases could be better tracked, Narkewicz said.

CareOne said in its statement that families were notified on April 17 that a floor was dedicated to positive COVID-19 cases, one day after “receiving notice of the first Covid-positive test at the facility,” according to the statement, though Narkewicz said O’Leary made this recommendation on April 18. Subsequent tests of every resident found some “asymptomatic” cases of COVID-19, CareOne’s statement read.

All staff and residents were tested for COVID-19 on April 17 and 18, the mayor said.

An assigned nurse and epidemiologist has been in contact with the facility to monitor the facility and provide support. The National Guard did conduct onsite testing, and DPH has not inspected CareOne at Northampton during the pandemic. The city has been in “daily communication” with the state DPH as well as CareOne at Northampton, Narkewicz said.

Amherst

At the Center for Extended Care in Amherst, which has seen 12 residents positively diagnosed with COVID-19 over the past two weeks, including two who have since died from the disease, rigorous protocols have been in place to keep the illness away from other residents, said Laureen Pieciak, the center’s director of nurses and an infectious disease specialist.

Pieciak explains that family members are not allowed into the building and staff screens anyone coming into the center. Those people wash their hands with alcohol-based sanitizer and wear masks, have their temperature and oxygen levels checked, and fill out a questionnaire about symptoms such as a sore throat and shortness of breath.

For any resident who develops symptoms associated with COVID-19, a test is administered, through a partnership with Cooley Dickinson Hospital, and that person is kept in isolation until the results are provided.

Those who test positive are immediately moved to an isolation area of the building that has 15 rooms available.

“Now that we have positives, we have to keep them contained,” Pieciak said.

A negative pressure room, which has its own source of air that is separate from the air handling systems through the rest of the building, is also available in this part of the nursing home. David Ianacone, administrator for the center, said this is a feature that is desirable, though not mandatory, to controlling any outbreaks of respiratory illnesses.

In the isolation area, a nurse and CNA are working 12-hour shifts and don’t interact with any other patients or staff during their time. Pieciak said there will be an increase in staffing if the number of patients who need to stay in that part of the center continues to grow.

One resident, Robert Jensen, who has been battling stage 4 prostate cancer but was supposed to leave Wednesday, now will have to remain at the site for at least two more weeks after being diagnosed with COVID-19 on April 24.

In a phone interview last Tuesday, Jensen said he had a cough but never a fever or chest pains.

“The slight headache I had has gone away. All things so far look good,” Jensen said.

A day later, though, the cough had returned, along with a mild fever.

He said he is concerned that another resident who has COVID-19, and is in significantly worse health, became his roommate, and only a cloth curtain separates the beds. Jensen said he is wearing a mask most of the time, but he’s still worried.

This is a worry that is shared by his daughter, Diane Jensen-Olszewski, whose mother-in-law died of COVID-19 the week before last at the same nursing home.

“He’s in a room with a person who’s dying,” Jensen-Olszewski said.

She is also nervous that not all information is being shared with family members.

“I don’t think that they’ve been transparent at all,” she said. She points to families not being able to get accurate tallies daily of how many people have COVID-19.

Pieciak said having two COVID-19 positive people in one room is not posing any dangers.

“They’re not going to transmit to each other,” Pieciak said. “If you’re not positive with it, we would never put you over there.”

Those who are successfully treated for the coronavirus after two weeks return to their regular rooms, after a deep cleaning.

Jensen-Olszewski said her frustration is as much with testing capacity as it is with the nursing home’s seeming inability to quickly diagnose those with the illness. She said nursing homes and hospitals should be able to identify those carrying and spreading infection in a more timely manner.

“The fact that we live in the richest country in the world and don’t have enough tests is horrifying,” Jensen-Olszewski said.

Michael Connors can be reached at mconnors@gazettenet.com. Scott Merzbach can be reached at smerzbach@gazettenet.com.


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