COVID-19, News

COVID-19 positive cases, deaths increase at NC nursing homes, including one staff member

Image: Adobe Stock

The number of deaths related to COVID-19 in North Carolina nursing homes has increased by 57%, according to May 1 data from the NC Department of Health and Human Services. One hundred ninety-eight people have died in these facilities, including one staff member at Pinehurst Health Care and Rehab in Moore County.

Meanwhile, the number of positive cases rose by 28% among both nursing home residents and staff, with a total of 1,768 as of May 1.

Of those, 1,274 are residents and 426 are staff. The May 1 report is the first time DHHS broke out the data by staff and residents.

The time period for the increase is unclear because DHHS didn’t disclose full numbers until April 27. NC Policy Watch was among a coalition of 20 media outlets that threatened to sue the agency for withholding the public records.

  • 51 nursing have reported outbreaks.
  • 8 facilities had no increases.
  • New outbreaks were reported at 3 nursing homes.
  • DHHS is investigating three facilities to determine accurate numbers of cases and deaths that occurred in residents and staff: The Citadel of Salisbury, the NC State Veterans Home, also in Salisbury; and Wellington Rehab and Healthcare in Wake County.
  • Louisburg Healthcare and Rehab Center had the greatest number of deaths — 18.
  • Signature Healthcare in Orange County, had the largest increase in number of deaths — 10. The facility now has a total of 12.
  • In terms of cases, the Laurels of Chatham County reported the largest increase — 34. It now has 101.
  • A third of all facilities with COVID-positive residents also reported 10 or more cases among staff.
  • The outbreak at Village Care of King, in Stokes County, is over.

May 4 figures, which haven’t yet been broken down by nursing home, show 1,832 cases and 198 deaths; DHHS updates facility-specific numbers each Tuesday and Friday by 4 p.m.

CountyFacility NameStaff CasesStaff DeathsResident CasesResident DeathsTotal CasesTotal DeathsPrevious Week CasesPrevious Week DeathsIncrease in casesIncrease in deaths
CountyFacility NameStaff CasesStaff DeathsResident CasesResident DeathsTotal CasesTotal DeathsPrevious Week CasesPrevious Week DeathsIncrease in casesIncrease in deaths
AlamanceWhite Oak Manor-Burlington208010000100
BertieThree Rivers Health & Rehabilitation1020303000
BurkeAutumn Care - Drexel2041615110
BurkeGrace Heights Health and Rehab24043667659680
CabarrusFive Oaks Manor Rehab150727877746131
ChathamThe Laurels Of Chatham2807381018675343
ClevelandCleveland Pines606112112100
ColumbusLiberty Commons Nursing & Rehabilitation Center of Columbus County1012213212111
ColumbusPremier Living & Rehab Center7016423422311
CumberlandVillage Green Health & Rehab10012322320221
DarePeak Resources-Outer Banks2041616100
DavidsonAlston Brook150416566412154
DurhamDurham Nursing & Rehabilitation Center320791211112957165
DurhamDurham VA Community Living Center1040503020
DurhamHillcrest Convalescent Center0021212100
DurhamTreyburn Rehab & Nursing160336496333163
FranklinLouisburg Healthcare and Rehab Center13056186918621474
GuilfordCamden Health & Rehab2306029060230
GuilfordClapps Nursing Center13016129160231
HarnettHarnett Woods Nursing and Rehabilitation Center901010000100
HarnettUniversal Health Lillington130493623421202
HendersonBrian Center Health & Rehab/Hendersonville50378428304124
HendersonThe Laurels of Hendersonville100443543240203
HendersonThe Lodge at Mills River1011212001
IredellAutumn Care - Statesville2010302010
JohnstonSpringbrook Nursing and Rehab22057117911657144
LenoirNC State Veterans Home - Kinston2021414100
MecklenburgAutumn Care - Cornelius21037145814531054
MecklenburgCarrington Place, Matthews80272352181171
MecklenburgHunter Woods Nursing & Rehab1040504010
MecklenburgHuntersville Oaks1030402020
MecklenburgPavilion Health Center at Brightmore2025327326310
MoorePinehurst HealthCare & Rehab231572803653150
NorthamptonRich Square Nursing and Rehabilitation60521124171
OrangePruitt Health-Carolina Point2508416109161081115
OrangeSignature HealthCARE8048125612522410
PolkAutumn Care - Saluda1080902070
PolkWhite Oak Manor-Tryon1020302010
RandolphUniversal Healthcare Ramseur10203030
RowanLiberty Commons Salisbury2000202000
RowanNC State Veterans Home - Salisbury 16316300
RowanThe Citadel at Salisbury 014416144161441006
RowanThe Laurels of Salisbury2010300030
UnionAutumn Care- Marshville1010202000
UnionMonroe Rehab Center150514664353311
VancePelican Health Henderson40213253101152
WakeCapital Nursing & Rehab2000200020
WakeSunnybrook Rehabilitation Center8025233226171
WakeWellington Rehab and Healthcare **52649630
WayneMount Olive Center3033736731453
WilsonLongLeaf Neuro-Medical Treatment Center16015131130110
Environment, Trump Administration

DEQ, NC Attorney General sue Trump administration over Clean Water Act rollbacks

The NC Department of Environmental Quality and the state Attorney General’s office have joined 16 other states in suing the Trump administration over rollbacks of Waters of the United States rule, also known as WOTUS.

The rule, which narrows the scope of waters that must be protected under the Clean Water Act, is scheduled to take effect on June 22, 2020.

Enacted by Congress in 1973, WOTUS,  regulates “navigable waters” — rivers, lakes, streams, wetlands and seas, as well as any waters that directly connect to them. This rule plays out in real life when an industrial plant wants to discharge pollutants into a river or a state transportation department wants to fill in a wetland to build a road. In each case, the entity must get a federal and state permit detailing the extent of the harm it can exact.

In. 2015, the EPA under the Obama administration strengthened the WOTUS rule based on science. New research showed the importance of underground hydrological connections between ephemeral or intermittent streams and their more robust counterparts. Obama’s WOTUS rule acknowledged the ecological value of isolated wetlands in providing flood control and wildlife habitat. It did not, contrary to the rule’s opponents, apply to most farm ditches, farm ponds, and storm water retention areas in housing developments.

But the Trump administration, catering to the real estate interests, agribusiness, mining companies, pipeline builders, and industrial dischargers, has rolled back WOTUS and other key provisions in the Clean Water Act. Fewer protections for streams and wetlands mean some of these sensitive waterways would be polluted, filled in, dredged, or paved over with impunity.

The EPA’s own documents show that nationwide, 18% of all streams are considered “ephemeral,” meaning they are only filled with water primarily after rainfall; they would lose protections, even though they contribute to ecosystems and aquatic habitats.

Wetlands, too, are imperiled by the EPA rollback. “This rule threatens decades of improvements in water quality and endangers North Carolina’s unique wetlands,” said DEQ Secretary Michael S. Regan. “This historic rollback of protections will result in a significant loss of natural resources and it is not based on science and runs counter to decades of EPA policy. DEQ will continue to use the state’s authority to protect water quality and the associated economic benefits to North Carolina.”

For example, wetlands that are connected by groundwater to a regulated lakes or stream would no longer be protected. Nor would wetlands that physically separated from those waters by human-made dikes or barriers. (Technically, all that would be needed to circumvent the Clean Water Act is to build such a barrier.

In its court filings, DEQ and the NC Attorney General argue that the new rule arbitrarily narrows the existing definition of waters protected under the Clean Water Act and excludes many of North Carolina’s wetlands. These wetlands play a critical role in filtering pollution and slowing stormwater during flooding events.  “The new rule also reduces protections for drinking water sources, risks damage to our fishing industry and increases flooding risks from runoff and sea-level rise,” DEQ said.

The case has been field in US District Court of Northern California. It asks the court to vacate the Trump administration rule and to declare it “capricious, arbitrary and unlawful.”

COVID-19, public health

Family member says aunt died at Citadel of COVID-19 but he found out from the funeral home

Notes from recently court documents filed against Accordius Health, which owns the Citadel in Salisbury. A new lawsuit includes sworn affidavits of dire conditions, short-staffing and substandard care for the residents.

This story was updated at 5:15 p.m. with comment from Accordius, which owns the Citadel.

In early April, the Citadel, a poorly rated nursing facility in Salisbury, called Ronald Barber to inform him that a resident had tested positive for the new coronavirus and had been sent to Rowan Novant hospital.

It wasn’t his 98-year-old Aunt Dot who was ill, but the facility staff wanted him to know there had been a case of COVID-19.

It was “the last call I ever received from Citadel,” he said.

The next one came from a funeral home.

In a sworn affidavit filed with the court, Barber said that roughly two weeks later, on the morning of April 15, he received a call from James Alexander, director of the Noble & Kelsey funeral home in Salisbury.

“I had no idea why he was calling,” said Barber, who was also his aunt’s power of attorney. Alexander then told him that his Aunt Dot had passed away the day before and the Citadel had sent her body to them.

“I was in shock,” Barber said. “They assumed I knew, but I didn’t … I never received a call from the Citadel to even alert me of any dire condition, much less to tell me that she had passed away. They simply had the funeral home take her away without my knowledge.”

Barber’s sworn affidavit is one of 12 — including several from certified nursing assistants who work or have worked there — alleging rampant substandard care at the Citadel contributed to the deaths of several residents with COVID-19. One CNA said in an affidavit that the facility continued accepting patients after residents had tested positive for the virus; others said they learned of an outbreak from the media.

There were inadequate supplies, too few staff and “the problem of the facility knowing individuals were not going to come in but doing nothing about it,” the CNA said.

A one-star facility, it has also been cited for abuse by the Centers for Medicare and Medicaid Services. The affidavits were taken by two law firms, Wallace & Graham and Gugenheim Law, who are suing Accordius Health “seeking a comprehensive view of the facility’s policies” to prevent further neglect. The firms and their clients are not asking for monetary damages.

Accoridius spokeswoman Kim Morrow said the company had not see the complaint and could not comment on the allegations.

“It is unfortunate that there has been so much misinformation put out by a source clearly not familiar with the facts of what has been going inside this building,” she wrote in an email. “The negative press this law firm is trying to create for the sake of building their own reputation, only hurts the patients and staff they claim they are trying to protect. I only wish that those individuals responsible for such reckless and selfish behavior would put those efforts to helping our facility care for our residents as so many people from the community already have, rather than trying to capitalize on this pandemic for personal gain and recognition.”

The Salisbury Center has reported 144 positive cases of COVID-19 and 10 deaths, according to the most recent figures from the NC Department of Health and Human Services.

It’s unclear whether those numbers include another resident Marjorie Galvin, 96, who died last night.

A CNA, whose name is redacted in court documents because they are afraid of retaliation from the company, stopped working at the Citadel two weeks ago. “I could not continue to work under the direction of the Citadel management. It was heartbreaking for me to make the decision that I would not return to the facility because of my love and concerns for the residents there,” they said.

Many of the residents who had tested positive were sharing bathrooms with residents that were tested and came back negative,” the CNA said, and the same thermometers were used throughout the facility.

On April 7, the CNA said, “I witnessed an event that disturbed me greatly.” Two staff employees transported a resident who had developed a high fever from his room to the quarantine hall. “He was wheeled outside of the rooms of the entire hall of residents and past the nurses’ station but he was not wearing a mask. I admonished them for this reckless behavior,” they said.

They immediately called Ardith Peacock the director of nursing, the CNA said. “She replied that she didn’t know what else to do, she had provided them in-service training.”

In the weeks leading to the CNA’s departure, they said, “the condition at the facility had become dire. Residents were ill with the virus, the staff members were sick and not reporting to work, and we had no meetings whatsoever advising us of what was occurring and how to deal with the epidemic.”

Morrow, the Accordius spokeswoman, said the Citadel has been doing “everything we can in lockstep with the CDC guidelines, the local department of health and local hospitals, and have been working around the clock to protect the safety of our residents and the staff during this unprecedented, worldwide pandemic,” Morrow said in an email. “The Citadel Salisbury had an emergency preparedness plan in place and also implemented a COVID-19 pandemic plan even before Gov. Cooper’s Emergency Declaration on March 10, 2020, and more than a month before the first confirmed case at the Citadel Salisbury on April 7, 2020.

“These plans have been reviewed daily and revised as needed with input from Department of Health and our local hospitals.  In fact, the N.C. Department of Health completed a COVID-19-Focused Infection Control inspection of the Citadel Salisbury on April 17, 2020, and found the facility to be in full compliance with the applicable regulations, including in the area of infection control.”

Another CNA, who’s name is also redacted, said they and another employee “cornered” a supervisor and asked “why on earth” Citadel was “accepting new admissions during the coronavirus outbreak.”

The CNA said they became ill the week of April 20th with chest congestion, coughing, loss of taste and smell, and diarrhea. They remain in 14-day quarantine, but others have continued working at the Citadel despite having tested positive, they said.

The CNA said that they were told by a Citadel administrative employee to take off a mask that they had put on while handling a newly admitted patient. “Earlier in the outbreak the staff was told not to wear masks because it frightened the patients.”

“My hall received two new patients and both are dead now,” they said.

COVID-19, public health

Among nursing homes, lowest-rated facilities account for most COVID-19 cases, deaths

PruittHealth-Carolina Point, one of the nursing homes with the largest COVID-19 outbreaks (Photo: Lisa Sorg)

Three nursing homes rated as “much below average” by federal regulators have the largest number of COVID-19 cases, according to data released yesterday afternoon by the NC Department of Health and Human Services.

These one-star facilities also are in the top five for reported deaths in North Carolina from the coronavirus.

The Citadel at Salisbury, also known as the Salisbury Center, leads the state with 144 cases; 10 residents have died.

PruittHealth-Carolina Point in Orange County has reported 108 cases and 11 deaths.

At the Durham Nursing & Rehabilitation Center, 95 cases have been confirmed, and seven deaths.

All three nursing homes have also been cited for abuse in the past, according to the Centers for Medicare and Medicaid Services.

As of yesterday, there were 1,380 reported positive cases of COVID-19 in North Carolina nursing homes, and 126 deaths. More than two-thirds of the cases and 70% of the deaths in these facilities occurred in those with 1-star or 2-star ratings — much below average or below average.

NC DHHS released the data after more than 20 media outlets, including NC Policy Watch, threaten to sue the agency under the Public Records Act. Previously, DHHS had refused to disclose the names of the facilities citing privacy laws.

Further analysis of the data shows that the nursing homes accounting for 83% of the positive cases also scored low in staffing benchmarks. In fact, inadequate staffing is common among most facilities in North Carolina; 31 of 47, rated by the Centers for Medicare and Medicaid Services received either “below average” or “much below average” marks.

Only six nursing homes were “above average” or “much above average” for staffing.

Even several of the highest-rated homes, though, reported positive cases, but the numbers were lower than their lesser-rated counterparts. The lowest percentage of cases that resulted in or contributed to death were in five-star facilities.

However, several factors besides the facilities ratings could influence the outcomes, such as the overall health of the resident. For example, some facilities house more people who are medically fragile.

According to DHHS data, there also have been 22 positive cases in “other congregate living facilities,” and 1 person has died.

In residential care facilities, which include assisted living homes for senior citizens and people with disabilities, 220 positive cases have been reported. Of those, 17 people have died.

These figures often change. Within the last 12 hours Durham County added to its total: 111 at the Durham Nursing and Rehabilitation Center, 47 at Treyburn Rehabilitation Center, five at the Durham Recovery Response Center, 4 at Durham VA Healthcare System Community Nursing Home and two at Hillcrest Convalescent Center. These are not included in the tables below. Sources: NC DHHS, Centers for Medicare and Medicaid Services

Overall rating (1 worst to 5 best)Total nursing homes in NC, by ratingNumber of facilities with outbreaksTotal number of reported positive casesTotal number of reported deathsPercentage of cases that resulted in or contributed to death   
1 star9710614437
2 star88103374613.6
3 star7814234229.4
4 star877127129.4
5 star7656534.6
*Durham VA Community Care Center had 3 cases; they were not in the Medicare database
FacilityCountyLab-Confirmed CasesDeathsOverall rating medicare.govHealth InspectionsStaffingQuality Measures
The Citadel at SalisburyRowan144101112
Pruitt Health-Carolina PointOrange108111122
Durham Nursing & Rehabilitation CenterDurham9571221
Five Oaks Manor RehabCabarrus7462224
The Laurels Of ChathamChatham6751122
Springbrook Nursing and RehabJohnston6572224
Pinehurst HealthCare & RehabMoore6531121
Louisburg Healthcare and Rehab CenterFranklin62142222
Grace Heights Health and RehabBurke5964434
Autumn Care - CorneliusMecklenburg53102224
Signature HealthCAREOrange5221113
Wellington Rehab and HealthcareWake4963323
Universal Health LillingtonHarnett4211111
Alston BrookDavidson4123333
Monroe Rehab CenterUnion3533323
Treyburn Rehab & NursingDurham3331124
Mount Olive CenterWayne3142224
LongLeaf Neuro-Medical Treatment CenterWilson3015355
Brian Center Health & Rehab/HendersonvilleHenderson3043332
Pavilion Health Center at BrightmoreMecklenburg2634423
Sunnybrook Rehabilitation CenterWake2614325
The Laurels of HendersonvilleHenderson2405435
Premier Living & Rehab CenterColumbus2232222
Village Green Health & RehabCumberland2022314
Carrington Place, MatthewsMecklenburg1813323
NC State Veterans Home - SalisburyRowan1633254
Cleveland PinesCleveland1213322
Liberty Commons Nursing & Rehabilitation Center of Columbus CountyColumbus1213324
Pelican Health HendersonVance1013323
Peak Resources-Outer BanksDare614431
Clapps Nursing CenterGuilford604325
Camden Health & RehabGuilford602222
Autumn Care - DrexelBurke515534
NC State Veterans Home - KinstonLenoir415452
Rich Square Nursing and RehabilitationNorthampton411133
Hunter Woods Nursing & RehabMecklenburg401214
Three Rivers Health & RehabilitationBertie303323
Durham VA Community Living CenterDurham30N/A
The Lodge at Mills RiverHenderson205435
Hillcrest Convalescent CenterDurham214443
White Oak Manor TryonPolk204444
Huntersville OaksMecklenburg203243
Village Care of KingStokes203333
Autumn Care - MarshvilleUnion203333
Autumn Care - SaludaPolk203322
Autumn Care - StatesvilleIredell202224
Liberty Commons SalisburyRowan202115


COVID-19, public health

Lawsuit: Once “lucid and vibrant,” Citadel nursing home resident gravely ill with COVID-19 because of substandard care

Ms. Garvin died on the evening of April 27, five days after this story was published.

Marjorie Fuller Garvin, 96 years old, was “lucid and vibrant” when her family and caretakers decided to place her at the Citadel of Salisbury in February. For $11,000 a month, paid by the family, not Medicare, Garvin was “assured she would have a private room and quality care.”

Instead, Citadel staff Garvin moved her to a “quarantine hall” and unnecessarily exposed her to COVID-19, according to a civil lawsuit filed yesterday. Now Garvin is gravely ill and among the nearly 100 residents who are sick with the disease.

The lawsuit filed on behalf of the Garvin family by the Wallace & Graham law firm, names several defendants, including the nursing home owners and its administrator, Sherri Stoltzfus. A for-profit facility, Citadel is owned by Accordius Health, which owns and operates a large chain of nursing homes, and the Portopiccolo Group, a private equity firm. Both are based in New Jersey.

An official reached by phone this morning at the New Jersey office asked Policy Watch to seek comment via email. Policy Watch has yet to receive a message from the company.

The Citadel of Salisbury, also known as the Salisbury, is a one-star facility out of five, as rated by the Center for Medicare and Medicaid Services. It has an extensive violation history, and was cited for abuse last fall after a resident broke their ankle and shinbone, but did not receive effective medical treatment or pain medication.

The recent complaint alleges that Accordius Health had not only a duty to implement infection-control measures to prevent the spread of the virus, but it had the financial resources to do so. However, the Citadel, a 160-bed facility in Rowan County, “laid the groundwork for the virus to flourish,” the complaint reads.

Garvin had been living at a different rehabilitation facility, but needed long-term care. That’s how she came to live at Citadel in February. Initially, Garvin lived in the private room she had paid for. But at some point, Citadel staff allegedly moved Garvin, who had a urinary tract infection and a fever, from her normal room to an “apparent ‘quarantine hall,'” according to the complaint.

A fellow resident on the quarantine hall had tested positive for COVID-19. The facility did not notify Garvin’s family, friends and a caretaker who has power of attorney of her infection or the move. “They were left utterly in the dark as her life was placed in jeopardy,” the complaint reads. Only after Garvin called her son did they learn of the situation. “They sought over and over again to reach the nursing home desk by phone to no avail,” the complaint reads.

Meanwhile, on April 4, the first Citadel resident was rushed to emergency room and tested positive for the coronavirus, followed by several more residents in the coming days. On April 7, the Novant Health Rowan Medical Center leadership met about the apparent outbreak; the next day emergency room personnel contacted the Rowan County Health Department.

Three days later, on April 10 all staff and residents were tested, but no one told the Garvin’s family or her power of attorney, the complaint alleges.

On April 13, a Garvin family member finally spoke to an administrator who said in effect “that corporate was handling this,” according to the complaint. Local staff did not have a copy of information showing who had tested positive or negative. “Only corporate had it,” documents read.

Finally, on April 15, family and friends learned that Garvin had tested positive. She remains hospitalized and is extremely ill, according to attorneys at Wallace & Graham.

Earlier this week, 96 residents of the Citadel in Salisbury had tested positive, as well as 17 employees, according to media reports. The number of fatalities is unknown, but according to media reports, there have been at least two.

Months before Garvin arrived, the Resident Council had complained to inspectors that nursing assistants weren’t cleaning the shower room; nor were they answering call lights for 30 to 45 minutes. Thirteen of 23 residents who attended a January meeting indicated the nursing assistants would enter their rooms, turn off the call lights, but “leave the room without addressing their concerns.”

Inspectors also found dirty shower rooms, including one with a wadded used washcloth that had dark brown spots.

An inspection in February revealed multiple violations regarding plans of care for the residents, medication and a dirty kitchen and food preparation area, which had attracted cockroaches and ants.

Because of the close living quarters and vulnerability of their residents, nursing homes are prone to disease outbreaks. So far, there have been more than 1,000 lab-confirmed cases of COVID-19 in North Carolina nursing homes, accounting for 14% of all cases statewide. Seventy nursing home residents have died.

Complaint Citadel (Text)