State orders closure of Norwich nursing home, residents to be relocated
Norwich — The state on Wednesday took the unusual move of ordering the closure of the troubled Three Rivers Healthcare nursing home, where 22 residents and six staff became infected with COVID-19.
The move came after a temporary manager determined the lack of staff, infection controls and other safety problems could not be corrected by the Sept. 30 state deadline.
State acting Commissioner of Public Health Deidre Gifford and several Department of Public Health staff, local legislators and Mayor Peter Nystrom attended a news conference outside City Hall on Wednesday to announce the closure and the procedure for relocating residents from the 60 Crouch Ave. facility, owned by JACC Health Center of Norwich.
Gifford said since late July, 22 nursing home residents and six staff have become infected with COVID-19, and four residents of the home have died. Later during the news conference, state Sen. Cathy Osten said the COVID-19-related death toll is likely five at the nursing home.
Gifford signed an emergency order requiring the emergency discharge of all residents at Three Rivers. "This is a difficult and sad step we have to take, but the department has concluded it is in the best interests of the health and safety of the residents, staff and families at this facility," she said.
The nursing home had been cited for numerous, serious deficiencies in the wake of the outbreak. The state assigned a nurse consultant, who discovered "significant additional and ongoing deficiencies," Gifford said. That led to the Sept. 10 appointment of temporary manager Katharine Sacks, who has 20 years of experience working to bring some 30 "distressed" nursing homes into compliance.
Gifford said Sacks discovered "widespread problems" related to care delivery, inadequate infection control, lack of staff education, inadequate staffing, absence of management policies and ongoing management, staffing and financial controls.
"The identified issues significantly threatened the health and safety of residents and staff in the facility," Gifford said.
Officials at the news conference said appointment of a temporary manager is itself rare, the last time it happened being in 2006. And this was the first time anyone could recall that the state ordered a nursing home to be closed for noncompliance with health and safety requirements.
Sacks said after just 30 hours of working on site, she realized for the first time in her career that she had encountered a nursing home that could not be brought into compliance. She recommended Three Rivers be ordered closed.
Sacks said 17 Three Rivers residents currently have COVID-19 and seven others are under observation for possible COVID-19 infection. The remaining 29 residents who have tested negative for COVID-19 will be relocated to other nursing home facilities in the greater Norwich area, state officials said.
The COVID-19-positive residents will be moved to the Riverside Health and Rehabilitation Center in East Hartford temporarily until they recover. Once they fully recover, they will be given top priority to move to a nursing home of their choice, Gifford said. The state expects to accommodate the top or second choices of residents who don't have the disease, Gifford said. They will have to quarantine for a time when they first arrive at their new homes.
Sacks said residents will be moved "in an orderly, slow set of discharges," fewer than 10 people per day with separate transports, and not with people lining up in hallways awaiting transport. She hopes the COVID-19 residents and those under observation can be moved by the end of this week.
"If we have a problem, we're going to slow it down and do it right," she said.
Families, residents considering options
Reached by phone about an hour before the state officials’ news conference, Three Rivers nursing home resident Edward Pratt said residents had not been told of the pending order to close the facility. As he spoke, an announcement was made for an emergency staff meeting at the facility.
Pratt is recovering from COVID-19 and believes he was the resident who first alerted state officials to the problems, including receiving direct care from a nurse who was sick and was not wearing a mask. Pratt said he was told by a physician that he nearly died and has had trouble sleeping since then.
He feels fully recovered but is awaiting test results he hopes will show his body is cleared of the coronavirus. He said he wants to be sure he is not transferred to a COVID-19 nursing home wing. Pratt, who is recovering from an amputation, said he hopes to be discharged from nursing care entirely by Sept. 22 if he tests negative for COVID-19.
He agreed with the order to close the Three Rivers home.
“My opinion, they get what they get, because they hurt too many people,” Pratt said. “I’m one of those who almost died. Four people died because of it. If my wife and I didn’t open our mouths, nobody would know what’s going on over here. A lot of people can’t talk for themselves.”
Meliss Swanson, conservator for her sister, a Three Rivers nursing home resident with disabilities after suffering a stroke, said she learned too late about a live online conference state officials held with family members earlier Wednesday.
Swanson hopes her sister can be discharged into the care of her husband, who has secured a handicapped-accessible apartment. She said Three Rivers had refused to consider discharging her sister, who has not contracted COVID-19. Swanson said she will contact state Long-term Care Ombudsman Mairead Painter to discuss her sister's situation.
Painter, who spoke at Wednesday's news conference, said she will be contacting residents' families to discuss the closure. She said some residents and families have contacted the office and she invited others and residents at all state nursing homes to call the office at the toll-free number (866) 388-1888 if they have concerns.
"Our program will continue to work directly with the temporary manager and the staff at Three Rivers in order to ensure that all the residents' rights are protected as they work to find new places to receive their long-term care supports," she said.
In a statement issued Wednesday through its public relations firm, JACC Health Center of Norwich said, “This is a challenging time for Three Rivers Health Care, our residents and our staff."
Since the initial outbreak, the company said, it has been cooperating with DPH "to bring our facility into full compliance with state and federal regulations," which included the engagement of the temporary manager, Sacks, to oversee those efforts.
Citing Sacks' assessment, the commissioner of public health "has ordered that all residents be transferred to other facilities that can safely meet their needs," JACC said. "Under these circumstances we support this order."
“Our priority now is acting safely and swiftly to relocate our residents to other homes, working closely with their families and loved ones,” the company said.
On Aug. 31, DPH issued a statement of deficiency for Three Rivers, finding the COVID-19 outbreak began when a staff member tested positive through routine weekly testing. Serious violations were found in general infection control practices, staffing, the grouping of residents who tested positive, and use of personal protective equipment, or PPE.
Osten and state Rep. Kevin Ryan, D-Montville, said at Wednesday's news conference they want the state to continue its investigation into how the outbreak at Three Rivers became so serious and even spread to the Backus Hospital, where at least nine hospital staff have become infected.
Osten said residents have been asking to be transferred elsewhere because they don't feel safe at Three Rivers. "I'm very relieved a decision has been made to protect the residents," she said.
She said the state Attorney General's Office is investigating the nursing home.
"We need to know those answers, and we need to know those answers in a timely fashion," Osten said. "We need to sit down and ask the hard questions and get to those answers. What happened here was unacceptable. It was not what we expect from nursing homes, and it was not what we expect of care of people who are at risk here in Norwich."
A group of area legislators wrote to Lamont on Sept. 3 to ask for an executive order requiring employees of nursing homes who have had known COVID-19 exposure to report the incident to their employers and stay home if they are ill.
According to a state inspection report, a nurse at Three Rivers who had traveled out of state with family returned to work with illness symptoms. Several employees said she was interacting with residents and staff without wearing a mask.
DPH began investigating Aug. 17, making a series of on-site visits, reviewing facility records and interviewing multiple residents and staff.
DPH issued a finding of immediate jeopardy, meaning the violations were serious enough to risk imminent harm to life. In addition to these findings of violation of federal standards, DPH is investigating whether state regulations, laws or executive orders were violated by the facility. DPH personnel have remained on site to monitor the situation.
Several speakers, including Mayor Peter Nystrom and state Rep. Ryan, said they remain concerned for the staff at Three Rivers who are losing their jobs. Norwich already has one of the highest unemployment rates in the state tied to pandemic-related business closures.
Local 1199 of the New England Health Care Employees Union issued a statement Wednesday blaming DPH for not discovering the deficiencies at Three Rivers sooner to force corrections short of closing the facility. The union said the closure will put residents through disruptions and could put dozens of front-line workers out of their jobs.
"DPH must do better, much better, to ensure that infection control protocols are enforced at every nursing home in Connecticut," the union statement said. "The reprehensible management behavior observed at Three Rivers may merit discharging patients immediately from the facility. But closing the facility is not the best outcome for residents and their families, for (front-line) workers or for the community as a whole."
Closing the facility also could "allow the operator to be let off the hook for the irresponsible administrative decisions that accelerated COVID-19 infections," the union said.
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