Elder abuse: Nursing homes, COVID-19 and the bottom line
Mark Crispin Miller
Elder Abuse
https://harpers.org/archive/2020/09/elder-abuse-nursing-homes-covid-19/
At the beginning of this year, Canterbury Rehabilitation and Healthcare Center, a nursing home in Richmond, Virginia, housed 160 elderly residents, roughly half of whom were African-American. Most of them were there courtesy of Medicaid, the government program that finances health care for those with little or no money. By mid-May, 80 percent of Canterbury’s residents had been infected with the novel coronavirus. A third of them were dead.
Sharon Mitchell, a sixty-two-year-old former dental receptionist, was one of the casualties. She had been at Canterbury for two years, following a stroke brought on by the shock of losing her longtime receptionist job, her son Ronald told me. She had been healthy enough to have poststroke rehabilitation therapy at home, but therapists refused to travel to the public housing project where she lived, deeming it too dangerous. So, after much discussion, the family elected to send her to Canterbury (then known as Lexington Court), where Medicaid would cover poststroke treatment.
Even before the pandemic, the facility had a poor reputation. In 2018, a staff nurse was convicted of attempting to rape a seventy-two-year-old Alzheimer’s patient. In October 2019, a report from the Centers for Medicare and Medicaid Services (CMS) cited major staffing shortages and almost three times the number of “health deficiencies” as the national average. By Ronald’s account, Canterbury was “a bad place, a very bad place.” On his weekly visits, his mother told him of “people going to the bathroom on the floor in the hallways” and described Alzheimer’s patients wandering into her room at night. “Her clothes were stolen; her jewelry was stolen,” he told me. The therapy, it turned out, consisted of biweekly sessions in which she was asked to spin a wheel with her hand for fifteen minutes. He was shocked when his mother told him she was given a shower just once a week: “ ‘Thursday’s my shower day,’ she told me. Otherwise they gave her a wipe-down with a baby wipe every two days.”
Unsurprisingly, Sharon routinely contracted hygiene-related urinary tract infections, which led to seizures that sent her to nearby St. Mary’s Hospital. During one of these hospitalizations, a year into his mother’s stay, Ronald spotted blood on one of her socks. Pulling it off, he found that her big toe was infected—it had been neglected by the staff for so long that “the flesh was all eaten away; I could see the bone.” Gangrene had invaded her leg, which eventually had to be amputated above the knee. Immobilized thereafter, Sharon spent most of her time in bed. She was often dehydrated because she could not hold a cup, Ronald said, “but they wouldn’t help her drink, or put her on an IV.”
Ronald saw his mother for the last time in February, before visitors were barred as a precaution against the coronavirus, which had already attacked a nursing home outside Seattle. Two months earlier, Canterbury had been acquired by Tryko Partners, a fast-growing private equity concern, which operated it through an affiliate, Marquis Health Services. A Marquis spokesperson told me that by the time of the COVID-19 outbreak, “in-house staffing was at its highest point in years,” and that wages had been temporarily doubled. But so far as Ronald was concerned, “Nothing had changed. Nothing.” On March 18, a Canterbury patient was diagnosed with the virus. Sharon also tested positive soon after, and was moved into a quarantine unit the center had set up. When Ronald called her after the move, she told him she needed a drink of water. “I stayed on the line for an hour and a half while she pressed the bell for a nurse, but no one ever came,” he said. When he complained, Canterbury staff told him they had just two nurses looking after forty patients. (A Canterbury spokesperson excused the inadequate staffing on grounds that it met CMS guidelines.) Three weeks later, Sharon was dead. “My mom died all alone,” Ronald told me, bitter at the neglect—the dehydration, the pro forma therapy, the gangrene—that he is convinced led to her death. “She was only sixty-two. She was capable of getting better. She didn’t deserve to die like that.”
Click on the link for the rest.
