In a letter to the Life Care Center in Kirkland on Wednesday, the Centers for Medicare and Medicaid Services wrote that the nursing home had not reported an outbreak of respiratory illness to local authorities for two weeks, as required by law , provided inadequate care to its residents during the epidemic and did not provide 24-hour emergency medical services.
The inspectors said that if the nursing home northeast of Seattle “does not correct all the shortcomings and does not fully recover by September 16, 2020, then CMS will terminate your facility from participating in the Medicare / Medicaid program. “
In a statement released Thursday, Life Care said it would “continue to work with CMS to find solutions” to the issues raised in the inspection report.
“We are working hard to respond to their current concerns in a timely and respectful manner to provide our residents with the best care,” said the release. The company noted that the Kirkland home had received a five-star CMS rating before the pandemic.
The inspectors imposed a civil fine of $ 13,585 per day for the alleged impairments, dating back to February 12, around the time of the outbreak and continuing until March 27. They said the fine could be increased or decreased. , based on the facility’s compliance with its remediation plan. The company has the right to appeal.
In addition to losing its federal payments under the Medicare and Medicaid programs, the establishment could also lose its program for training and assessing the skills of licensed practical nurses and lose the federal payment for patients it admitted from 21 until March 27.
“These remedies will remain in effect until the effective date of termination of your health insurance provider agreement, or until the establishment is found to be in substantial compliance,” said Patrick Thrift , branch manager for the investigation and application of long-term care at CMS in Seattle.
Officials said 129 residents, staff and visitors were infected with the coronavirus, which causes mild to moderate symptoms in most people but can be fatal for the sick and the elderly. According to King County, which includes Kirkland, thirty-seven people associated with Life Care died on March 23.
In figures updated on April 1, the county said that a total of 2,496 people tested positive for covid-19 and that 164 people died from covid-19 disease.
In a summary of its findings published last month, CMS said the inspectors found that Life Care had not promptly informed regional authorities of the sudden increase in respiratory infections and had continued to admit new patients and organize events such as a Mardi Gras party for dozens of residents and guests.
The Washington Post found that Life Care did not report to authorities for more than two weeks after it began to discourage visitors on February 10 due to residents’ illness, which it supposedly was a seasonal flu.
King’s County said it received notification of an increase in respiratory illnesses in the nursing home on February 27. Life Care said it also left a voice message to county officials the day before. State law and county regulations required Life Care to report any suspected flu outbreaks within 24 hours.
The Seattle area was the site of the first confirmed coronavirus case in the United States. Authorities said on January 21 that a 35-year-old man in Snohomish County, neighboring King County, had tested positive after traveling from the Wuhan region of China, where the virus is believed to have originated. Since then, the man has recovered.
Relatives of residents who were at Life Care during the epidemic said they were shocked by the inspectors’ findings.
Todd Campbell, 59, was surprised that Life Care continued to accept patients like his father, Gene, and that they did not have an adequate plan to cope with the infection.
Campbell’s father, 89, was admitted to Life Care on February 21 after a short stay in hospital for a stroke, and then tested positive for covid-19. He is recovering now, said Campbell.
“It is surprising that they have until September to fix the problems,” said Todd Campbell. “No one will want to go there … I wouldn’t want my father to go back there.” “
Federal inspection records requested by The Post contained new details about the pandemonium as the virus descended on Life Care. The facility did not follow basic protocols to prevent infection, the inspectors said, and instead created conditions that could have allowed it to spread from room to room.
The report found that Life Care did not organize “consistent or effective” Quality Assurance and Performance Improvement (QAPI) meetings in 2019 – which are intended to report infection control and other problems.
Facility officials held quality assurance meetings on January 27 and February 19 after the virus had already been detected in a neighboring county.
The director of the home, who joined the establishment in January, told CMS inspectors: “Normally, if there were infection control issues, this would have been discussed at the QAPI meeting. “
CMS said infection issues were not raised at any of the meetings, including the February meeting, held a few days after Life Care said it had posted signs warning visitors to the site. respiratory epidemic that staff thought was the flu.
“A closer look at the monthly minutes of the QAPI meeting of 02/19/2020 in the nursing section revealed: no reports of infection problems in the facility,” said the CMS report.
The medical director of the nursing home, who was not identified, did not attend any of these meetings, the report said. Life Care’s Infection Preventionist nurse attended the January meeting, but did not attend the February 19 meeting.
The executive director and two unidentified administrative staff said that “it was very chaotic” in Life Care, as patients and dozens of staff fell ill in February and March. Patient records were incomplete. Staff members were sick and could not care for residents, they told inspectors.
“We were sorting through the residents as the residents crashed, so there wouldn’t be much documentation,” said an official at the nursing home, who was not identified in the report, to CMS inspectors.
CMS said the establishment “does not have effective systems in place” to prevent or respond to infection. Life Care officials only informed health care officials of the epidemic on February 26 and did not have a 24-hour emergency doctor or adequate staff to respond to the epidemic.
The facility did not have a “clear medical action plan,” said the inspectors, which resulted in “systemic failure.”
On March 7 – almost a month after the epidemic began – inspectors said that two certified nursing assistants, a man who had worked at Life Care for 15 years and a woman who had been there for four years, said that ‘They were not trained to properly disinfect the items. with bleached wipes.
That same day, the inspectors spotted a member of the laundry staff who delivered clothes to residents in several rooms without changing their dress, gloves and other protective equipment despite the warning signs that the patients could have been contagious.
Bridget Parkhill, a 54-year-old medical assistant whose mother, Susan Hailey, 76, remains in life care after being tested positive for covid-19, said that the fine imposed by CMS was “not even close ”enough to make a difference.
“It is very obvious that it is as usual,” she said.