EAST VINCENT — The Pennsylvania Department of Health has conducted at least two inspections at the Southeastern Veterans Center in recent weeks in the wake of concerns about the high number of deaths there from the COVID-19 virus.
The inspections at the 238-bed facility came as increased scrutiny has focused on the home's handling of the coronavirus pandemic.
Since April 1, at least 28 deaths at the center have been confirmed as being due to the COVID-19 virus, according to state Sen. Katie Muth, D-44th Dist.
There have been a total of 47 deaths at the center since April 1, Muth said, a drastically higher rate than the home's usual rate of 1.2 deaths per month.
Problems with testing and procedures have raised questions about how many other of those 47 deaths may be due to the virus, according to Chester County Coroner Dr. Christina VanderPol.
“We are in the midst of an emergency," according to Major General Anthony J. Carrelli, Adjutant General with the Pennsylvania Department of Military and Veterans Affairs, who oversees Pennsylvania's six veterans homes.
"None of us have experienced anything like this in our lifetimes," he told a May 6 hearing of the state Senate Democratic Policy Committee.
Infections at Care Homes are Widespread
Problems at the veterans' home mirror difficulties nursing and continuing care homes across the commonwealth and across the country have had to deal with the virus.
One thing statistics from the pandemic, which seem to change daily, show with increasing clarity is the much higher death rate the diseases is causing in these homes. In fact, it clearly seems to comprise the majority of COVID-19 deaths in the Southeastern Pennsylvania region.
State statistics show that as of May 15, nearly 85 percent of deaths in Chester County, where the Southeastern Veterans Center is located, occurred in 38 care homes with confirmed cases.
Similarly, statistics show:
- 83 percent of Montgomery County's COVID-19 deaths have occurred in 88 different care facilities;
- 81 percent of Delaware County's COVID-19 deaths have occurred in 39 facilities there.
- 67 percent of Berks County's COVID-19 deaths have occurred in 25 facilities there.
And as this picture has been made clearer, state officials in the last week have shifted to a call for "universal testing" in nursing homes.
Failing With the Test
But on Thursday, The Philadelphia Inquirer reported that "not much has changed" for nursing home operators, and there is still no discernible plan in place to carry out the weekly testing regimen.
That echoes the problems outlined by officials at the Southeastern Veterans Center who told a state Senate committee that from the start, getting testing done, and getting the results back in a timely fashion, has been a challenge.
"Our biggest problem is we didn’t have control of our testing," Darryl Jackson, medical director of the Bureau for Veterans Homes, testified during a May 6 hearing before the state Senate Democratic Policy Committee, which was livestreamed.
"The Department of Health told us who we were allowed to test," Jackson testified. "We had to test, but in the beginning we were not allowed to test."
He said until the center was permitted to take control of its own testing and use an outside vendor "a couple of weeks ago," it took "five to seven days to get test results back and the majority of them were positive."
Jackson said "we could screen the staff but there is no guarantee. If they are asymptomatic, they could be carrying it, moving here and there and two weeks later, test positive. By then, the infection is out of control."
"There's was always the chance someone can have it for three or four days while we wait for the test, and can be working in a clean ward," Carrelli testified.
Close to 100 percent of the residents at the veterans center had been tested by the first week of May, Carrelli testified.
"We were very aggressive across the commonwealth. We didn’t want to wait for the virus to show up," Carrelli told the committee. "We were successful for a couple weeks at keeping the virus out."
Andrew Ruscavage, director of Veterans’ Homes for the Department of Military and Veterans Affairs, testified planning for the pandemic in the six homes the department oversees, began in the first days of March.
On April 2, the Southeast Center was notified one of its staffers had tested positive and a day later, the first positive result among residents was received, Ruscavage said.
"Initially, we were isolating them in their rooms if one had symptoms, while waiting for test results," said Jackson.
"For us the biggest issue was too many with symptoms, we ran out of isolations rooms," Jackson testified. "You can test every day for seven days and that person can later test positive. Once the numbers got higher, it was difficult to isolate patients."
"The original recommendation was dedicated staff to each unit, but we could not guarantee coverage," Jackson told the committee, "There is a significant nursing shortage, that’s why we brought in the national guard."
Families Left in the Dark
Muth said she has been in contact with staffers and relatives of residents at the home who have detailed a wide variety of missteps and questionable practices there.
One of those people complaining about a lack of information about relatives in the center was Delaware County resident Fran McDermott.
She testified her mother is a resident of the Southeastern Veterans Center, and until recently, "we were always very happy with her treatment there."
"In early April, I heard about one positive case there through several people," McDermott testified. "I contacted the social service director and I was told they were not allowed to answer how many cases there are, or how many tested positive."
Officials from the home said this restriction had to do with health privacy laws and that they are in regular contact with those who have power-of-attorney for their residents.
McDermott, who has power-of-attorney for her mother, testified that "on April 10, I saw an Inquirer article saying COVID had killed 10 people in the Southeastern Veterans Center," McDermott said. "After I read the story, I called the director of nursing, but still could not get any answers."
That's when she got in contact with Muth, whose district includes the home.
Muth said Thursday that McDermott's mother is still alive "but she has watched three roommates die."
Newspaper Spurred Inspection
Carrelli testified that it was the Inquirer article that spurred him to ask for the inspection, the formal results of which are not expected for about a month.
"Because of the high profile on this, I had great concerns," Carelli said, adding it "was a spot inspection, not a normal, scheduled one. It was a special case."
Both Muth and fellow state Sen. Andy Dinniman, D-19th Dist., expressed surprise during the May 6 hearing at Carrelli's announcement that the veterans home had been inspected on May 1.
They expressed further surprise that, although the official report will not be out for weeks, Carrelli said he was told the "spot inspection" found nothing awry in the operations of the center.
Carrelli said the inspectors checked on the COVID-19 ward. "They looked at governance, PPE, testing, a whole array of things."
Muth told MediaNews Group Thursday that she had confirmed that a second inspection took place the day before Mother's Day, on Saturday, May 9.
However, Muth worries both were "sham inspections."
After Carrelli's testimony May 6, Muth said she contacted the Department of Health to ask what measures and procedures were inspected, in other words, whether it was specific to COVID-19. She has yet to receive an answer.
"I am in constant contact with 20-some staffers and families there," alerting her to problems with the operation of the center, "so I know what is happening there, whether I want to or not," Muth said Thursday.
Ruscavage said there is an anonymous website where staff can lodge complaints as well as a grievance process through the union that represents the workers.
But Muth said staff and families are reaching out to her, "because the staff is terrified the administration will retaliate. They don’t have a safe space."
She said Thursday when staff complains "they do the interviews on-site, where their supervisors can see them."
Muth said she was told by staff onsite that on the two days prior to the May 9 inspection, "they were moving people around like crazy to different units on different floors so they could be in isolation."
And when the two state inspectors arrived, administrators who normally do not work on Saturdays just happened to be on-site for the "surprise" inspection, Muth said she was told.
Not All COVID Deaths Certified
There is even difficulty getting a handle on what has been killing people at the center, due largely to the paucity of testing.
VanderPol testified that she has been frustrated by inconsistent reporting on deaths from the center.
"When we certify" that a death is due to COVID-19, "we test. We go the nursing home, we test. We go to the funeral home, we test," VandePol said. "Even after they have been embalmed, we can still test."
But testing was not being done on all the bodies at the center, and the coroner was not always contacted, she testified.
"We spoke to Southeast Veterans Center, and we recognize they are doing their best in a frustrating and difficult situation," VandePol told the senators. "Some deaths were reported as COVID, but they were not tested."
VandePol said lack of testing "hampered the ability to certify the cause of death. At first, nobody knew people were dying of COVID-19."
"Now we can’t go back and look at what happened to those people. There is no record in some cases, in some, there is," she said.
In addition to determining the cause of death being the legal responsibility of the coroner's office whenever an infectious disease is suspected, VandePol said knowing the answer can help families find closure about the death of a loved one.
Muth told MediaNews Group she was contacted by the relative of a resident who died at the center "and the death certificate listed the cause of death as Alzheimer's disease. They told me in all the years, they had never had a single conversation with the doctor that mentioned Alzheimer's."
'You Waited Too Long to Act'
State Sen. Pam Iovino, who represents the 37th district outside Pittsburgh, told Carrelli "up until April, the death rates at the Southeastern Veterans Center were single digits, then in April, it went up nearly seven-fold."
"But this isn't a hearing about numbers, this is a hearing about lives," she said, telling Carrelli, "you waited too long to act."
"I take exception to the idea that we were waiting for the situation to get worse," Carrelli replied. "We thought we were undertaking the most aggressive way to stop COVID in our veterans' homes.
"The results were not satisfactory," Iovino said. "You can delegate authority, but you cannot delegate responsibility."