TN Veterans Homes Report Covid-19

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The Tennessee agency that operates nursing homes for veterans, which had previously boasted that not a single resident or employee tested positive for Covid-19, has now reported that two patients and seven employees have tested positive for the virus.
The two patients and four of the staffers are at the state Veterans Home in Clarksville. An employee at the Humboldt Veterans Home and two staffers at the state Veterans Home in Murfreesboro have also tested positive.'
According to a statement posted on the agency website, the employees who tested positive were sent home. They are all asymptomatic.
Family members of the two residents who tested positive were informed, according to the agency announcement.
Weekly testing of staff will continue, according to the agency statement. And residents will be monitored daily for coronavirus symptoms.
Veterans homes in other states including Massachusetts and New Jersey, have reported multiple Covid-19 deaths.

Hospital Cited in Suicide Attempt

By Walter F. Roche Jr.

A Pennsylvania hospital has been cited for failing to keep a suicidal patient under constant watch enabling the patient to attempt suicide.
The report on the Geisinger Wyoming Valley Medical Center states that a sitter had been assigned to maintain a constant watch while the patient was showering but the employee did not have an unobstructed view.
At 2:39 p.m. on June 4 the patient was found slumped over in the shower.
The facility "failed to ensure staff had an unobstructed view of a suicidal patient," according to the report from the state Health Department.
Earlier the patient "verbalized thought of killing self," prompting a physician to order a one-to-one sitter.
Geisinger officials did not respond to questions about the incident including whether resuscitation efforts were successful.
According to the report the employee activated an alarm and staff subsequently attempted to resuscitate the patient including intubation and administering Narcan.
Hospital records showed that hospital employees subsequently found "the end cap of an intravenous" in the back of the patient's throat.
The same hospital was cited in a separate report for failure to document a patient assesment after the patient was exposed to urine and fecal matter due to an overflowing commode. The hospital filed plans of correction in response to both reports. Both plans call for staff education and monitoring to ensure compliance.

Deadly Covid Attack at State Veterans Home Detailed

By Walter F. Roche Jr.

The management of a state run nursing home for veterans placed 124 of 154 patients in immediate jeopardy when they failed to institute a proper infection control plan even as Covid-19 ravaged through the facility ultimately killing 42 residents.
The report on the Southeastern Veterans Center shows that even as state surveyors were inspecting the facility in early June, proper infection control procedures were not in place.
The report also provides a timeline of when patients began to get sick at the Chester County facility.
In fact the first sign of the impending disaster came when an employee tested positive for the coronavirus on March 31. At that point only employees were being tested
Two days later the first patient tested positive although no one on the staff was specifically trained on how to perform the test.
On April 13 and April 14 "resident deaths started occurring." On April 21 there were two more deaths, according to the report.
The commandant and the director of nursing did not effectively manage the facility the report states.
"The facility failed to consistently maintain an infection control program."
In fact the commandant, Rohan Blackwood, was replaced along with the nursing director.
Even as the inspection was underway, state surveyors observed violations including a nurse who hugged a patient without a mask.
The report also cites a nurse who worked in the regular and Covid-19 areas without a proper mask. Another employee told surveyors she removed her mask because it was hot.
Employees at the facility told the inspectors that they were not allowed to wear the proper protective equipment because management said it would scare the residents.
The employees also stated that testing was delayed because of arrogance.
"We will be fired for talking to you," one facility employee told the surveyors.
The report also faults the nursing home for placing a patient who tested negative for the highly contagious virus in a room with two patients who tested positive. In addition male and female patients were placed in the same room.
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Hospital Cited on Covid-19 Requirement

By Walter F. Roche Jr.

A Pennsylvania hospital has been cited for failing to screen visitors and patients entering the hospital or its emergency room for symptoms of Covid-19, as required under state and federal regulations.
The violation notice was issued on May 28 to St. Luke's Hospital Anderson Campus in Easton by surveyors from the state Health Department. The 108 bed hospital is apparently the first hospital in the state to be cited for failure to meet a coronavirus requirement. The report became public this week.
"All facilities will actively screen visitors by assessing for fever and signs and/or symptoms of respiratory infection and other criteria such as travel or exposure to Covid-19," a state Health Department report states.
Nate Wardle, a Health Department spokesman confirmed that state surveyors have been checking for compliance with both the state and federal requirements relating to Covid-19.
Hospital officials did not respond to a request for comment but in a plan of correction filed in response to the complaint the hospital said it is now screening all visitors from 5 a.m. to 9 p.m. Patients entering the emergency room will be screened 24/7.
The plan of correction also includes audits and monitoring along with staff education to ensure compliance.
"The data obtained is recorded in the visitors' log and retained by the organization," the plan of correction states.
A review of recent survey reports for other Pennsylvania hospitals shows state inspectors routinely note compliance with state and federal Covid-19 requirements.
"The facility was in compliance with the current Pennsylvania Department of Health, CMS (Center for Medicare and Medicaid Services) and CDC (Centers for Disease Control and Prevention guidelines as they pertain to Covid-19," one recent report states.
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Coronavirus Still Hitting PA Veterans Homes

Thiry-one patients at a Philadelphia nursing home for veterans have contracted the coronavirus and 13 of them have died, according to officials of the state Department of Military and Veterans Affairs.
The deaths at the Delaware Valley Veterans Center are in addition to the 42 reported at another state veterans facility in suburban Chester County.
At the Philadelphia facility 17 staff members also have tested positive for Covid-19.
At the 238 bed Southeastern Veterans Center in Spring City 105 patients became infected including the 42 who died. Forty-seven employees at the center have tested positive for the virus.
At the four other state homes for veterans any serious outbreaks have apparently been averted.
At the Southwestern Veterans Center in Pittsburgh nine employees tested positive.
The other state veterans homes are located in Scranton, Hollidaysburg and Erie.
State run veterans homes in other states like New York and New Jersey have seen multiple coronavirus deaths. A total of 146 deaths have been reported at New Jersey's three homes, including 81 at the Menlo Park home.
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VA Official Engaged in Unethical Conduct

By Walter F. Roche Jr.

A former top official in the U.S. Veterans Administration engaged in unethical conduct when he steered a $5 million contract to two friends, a contract that netted a $5 million loss to taxpayers.
That was the conclusion of the VA's Inspector General on a contract awarded to an unnamed contractor participating in a program established to benefit service disabled veterans.
The report concludes that Peter Shelby, the former Assistant Secretary for Human Resources and Administration, a Trump appointee who resigned under fire in July of 2018.
The report states that Shelby "ranted and raved" when VA employees raised questions about awarding the contract on a "sole source" basis to the company under the Service Disabled Veteran program.
The report states that the contract benefited Shelby's friend at the contracting firm and another friend at a subcontractor on the contract, Blanchard Training and Development.
VA employees interviewed by the IG said that Hoskins was "insistent and intimidating" as he demanded subordinates take the necessary steps to award the contract.
Stating that the contract resulted in a $5 million "resulted entirely in waste," the IG made a series of suggestions to avoid a repetition which the agency agreed to implement.
The report states that Shelby's resignation was triggered by an investigation into an unrelated issue, the IG concluded that Shelby engaged in unethical conduct to benefit two friends.
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3,000 Covid Deaths in PA Nursing Homes

By Walter F. Roche Jr.

Nearly 3,000 patients in Pennsylvania nursing homes have died from Covid-19, according to data compiled by the state Department of Health.
The data, which was updated this week, shows some 20 nursing homes had 30 or more deaths. The Conestoga View nursing home in Lancaster has reported 75 coronavirus deaths. A Beaver nursing home, the Brighton Rehabilitation and Wellness Center, reported 73 covid-19 deaths.
The Northampton County Home-Gracedale reported 72 Covid deaths.
The same homes reported multiple employees tested positive for the virus. The Beaver home, for instance, reported 109 employees were infected while the Lancaster home had 75 infected employees. The Northampton county home reported 53 employees were infected.
The exact state total of Covid-19 deaths in Pennsylvania nursing homes is likely much higher because the health department was unable to collect any data from dozens of nursing homes
Other homes with 30 or more Covid deaths include Brandywine Hall in West Chester reported 30 deaths, Abramson Residence in North Wales reported 34 deaths, Allied Services in Scranton reported 50 deaths, Chapel Manor in Philadelphia reported 34 deaths, the Neshaminy Manor Home in Warrington had 47 deaths and Parkhouse Rehabilitation and Nursing Center in Royersford reported 52 deaths.
Still others with 30 or more deaths include Shippensburg Health Care Center with 31, Southeast Veterans Center in Spring City with 42, Spring Creek Rehabilitation and Nursing in Harrisburg with 42, St.John Neumann Center for Rehabilitation and Healthcare in Philadelphia with 36 and Enhanced Living at Stapely in Philadelphia with 30.
Easton Gardens for Memory Care in Easton had 30 deaths, Green Meadows Nursing and Rehabilitation in Malvern had 36, Manorcare Health Services in Sinking Springs had 48, Mountainview Care and Rehabilitation in Scranton had 32, Old Orchard Health Care Center in Easton had 33, Rosewood Gardens Rehabilitation and Nursing Center in Broomall had 33 and Saunders House in Wynnewood had 38.
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VA Missed Two Warnings Before Patient Death

By Walter F. Roche Jr.

A primary care physician and a clinical pharmacy specialist at the Nashville Veterans Administration failed to take proper action on a patient who was later diagnosed with pancreatic cancer and died.
That was the conclusion of the VA's Inspector General in a 15-page report issued this week. According to the report the omissions resulted in a three month delay in the patient's diagnosis and treatment.
"The OIG was unable to determine if immediate action by the Clinical Pharmacy Specialist would have led to this patient receiving a prompt diagnosis and treatment," the report states.
According to the report the specialist failed to inform the patient, who was in his 60s, of an abnormal liver test result. He also failed to initiate a change in the patient's care plan, based on those abnormal results.
In addition a primary care physician who examined the veteran in 2018 failed "to acknowledge or assess" the patient's unintentional weight loss of 48 pounds in one year.
"Unintentional weight loss may be symptomatic of a disease process and must be further evaluated," the IG stated.
The physician, who is no longer with the VA could not be reached by IG investigators who visited the Nashville facility in 2019.
According to the report the pharmacy specialist told investigators that he did not recall the specific case, but said it was normal practice to take no action if the test results were considered insignificant.
"The OIG does not believe the laboratory results were clinically insignificant," the report states, adding that the minimum expected plan of care for the patient should have included repeat liver function testing within four to six weeks and communication of test results to the patient."
In addition, the IG stated, the patient should have been counseled on warning signs of a worsening condition.
According to the report the patient returned to the VA three months after the annual physical complaining of abdominal pain. He was subsequently diagnosed with pancreatic cancer and died in the spring of 2019.
The report also cites deficiencies in the VA's electronic health records which do not have a "fail safe" feature that could have triggered a reassessment of the patient's condition at an earlier date.
The report also faults the local facility's management for two inadequate responses to the initial inquiry.
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