Fearful that COVID-19 would devastate elderly residents, the federal government on March 12 ordered nursing homes nationwide to bar visitors.
Though residents’ families and staff at the Brighton Rehabilitation and Wellness Center were all too aware of the growing pandemic around the country and world, until then nothing had changed for staff or residents in the building.
Brighton had been unable to find a lab to test for COVID-19, so none of the increasing number of sick residents by March 12 had yet been confirmed to have it.
But if the government-ordered lockdown itself wasn’t enough to get Brighton’s attention, the increasing number of suspected COVID-19 cases and their severity over the next two weeks was.
The daughters of Brighton resident Ala Mazzocca, 91, called almost daily after the lockdown, trying to get updates on her health or to get someone to put her on the phone.
Barbara Macurak said she called the nurse’s line repeatedly, letting the phone ring for up to 20 minutes. Someone finally answered March 25.
“Everyone’s sick,” a nurse told Ms. Macurak. “We’re just too busy. We don’t have time to answer the phone.”
Mrs. Mazzocca died April 13. Her family believes it was from COVID-19, although she was never tested.
After finally finding a lab to test residents and get the diagnoses back in one day, Brighton got its first two positive results Friday, March 27.
Families were not the only ones with concerns by that point.
“Our officers were reporting that multiple ambulances had been showing up all week and taking patients out to the hospital,” said Keith Pudlowski, vice president of St. Moritz Security Services, which had a contract at the time to provide security at Brighton.
“They’re standing there with no protective equipment, holding the door for them, and no one is telling them anything about what’s going on,” he said.
Mr. Pudlowski said the company’s eight guards were initially told that Brighton would not provide them with personal protective equipment, such as the masks and gowns that the staff and ambulance employees were wearing.
“They couldn’t get anything, where other locations where we work provided our guards with protective equipment,” Mr. Pudlowski said.
By Saturday night, March 28, one of the guards had refused to come to work because of his age and health issues, and others expressed concern about going back. So Mr. Pudlowski called Sam Halper, the managing partner for Brighton’s owner, Comprehensive Healthcare.
By then, the Pittsburgh Post-Gazette and other news outlets were reporting that Brighton had already recorded 14 positive cases among residents, with more tests pending.
“I expressed our concerns” about getting security guards protective equipment, Mr. Pudlowski said. “And I told him media is reporting there are 14 cases, and he denied that was true and said there were a lesser number of cases.
“I told him it’s not like I want to pull out, but under the circumstances I couldn’t guarantee that we could get anyone to go in there.”
St. Mortitz said that Brighton eventually did provide some protective gear on March 29. But on Monday, March 30, St. Mortitz CEO Matthew Schwartz said he pulled the company’s guards and dropped the contract because of concerns that it was still unsafe there.
He said his company provides security nationwide for dozens of nursing homes and hospitals, all of which were facing the same outbreak threat.
Before March 28, Brighton officials never notified his guards or managers that there was a possible outbreak — even though Dr. David Thimons, Brighton’s medical director, and others knew there likely was, Mr. Schwartz said.
“We have pandemic policies and procedures in place to deal with these situations,” he said. “But they require notices, a heads-up that there’s a problem. And I got it at every location we serve but one.”
Asked about St. Moritz’s allegations that it was not given personal protective equipment, why there was no prior notice about a possible outbreak, and Mr. Halper’s claims that the outbreak was not as bad as was being reported, Brighton said in an emailed statement: “Brighton [has] provided PPE to all staff and contractors throughout the COVID-19 pandemic. Anything stating otherwise would be entirely untrue.”
Connie Sluzynsky’s concerns about her mother, Billie Namath, 83, a resident at Brighton, also grew throughout March.
She said she first called in early March, as COVID-19 cases began to appear in the region, to try to find out what kind of precautions were being taken with her mother, who has Alzheimer’s. She said she didn’t get any clear answers.
“There’s a lot of problems in there, but [lack of] communication is a big one,” she said.
Ms. Sluzynksy and other residents’ families pointed out that Brighton does not have a website where they can go for information. Any updates they received about the outbreak came through letters that Brighton mailed occasionally, or, more recently, through a phone line that provided updated numbers of cases.
Ms. Sluzynsky’s concerns increased March 27, when a Brighton employee called her to report it had recorded its first positive case.
She was shocked to read in the newspaper the next day that the case count had jumped to 14.
On March 29, she said she was able to talk to a nurse, asking whether staff members “cross units and floors,” something she knew was important from her work in medical offices.
When Beaver County ran the facility prior to its sale in 2014, employees regularly worked the same units, floors and wings, said a registered nurse who once worked there full time.
But Comprehensive had let go so many members of the full-time nursing staff that shortages became common.
“Instead of dedicated staff in the units, people are pulled from everywhere to work where they’re needed,” the former registered nurse said.
Having the nursing staff — particularly nursing assistants — work on different units, floors or wings between shifts and even within shifts became a common practice in Brighton over the past six years, staffers say.
“If I worked a 12-hour shift, I’d be in a different unit every four hours, sometimes in different wings,” said an agency nursing assistant who asked to remain anonymous out of fear that Brighton would fire her. “I mean, if you worked eight hours in 4E [where the outbreak began] and you spent the last four hours in The Grove [a rehabilitation unit], you could have taken COVID with you.”
Brighton temporarily ended that practice early on in the outbreak for staffers who worked in a unit where COVID-positive residents were initially isolated. But some staffers say they continued to move around the rest of the facility, working on different units, floors or wings on different shifts.
Brighton officials would not answer questions about how pervasive the practice was then or now.
Several other large nursing homes contacted for this report — Allegheny County’s Kane Nursing Homes, which include two of the state’s largest homes; Masonic Villages Elizabethtown; and Berks Heim Nursing and Rehabilitation — all said they try to minimize employee movement, even in non-pandemic times.
“Our goal is to have the same staff working with the same residents. It goes to continuity of care,” said Terry Brennan, administrator of Berks Heim in Berks County. “We want staff to know the residents.”
Berks Heim, a county-run home with 420 beds, has had 113 positive COVID-19 cases among residents and 37 deaths. Mr. Brennan said he believes the tally would have been higher had his staff been rotated around the building.
“You’re potentially moving the virus around,” he said.
Zach Shamberg, CEO of the Pennsylvania Health Care Association, which represents for-profit nursing homes, said, “Our providers have made a concerted effort to have the same staff on the same floors.”
The goal, he said, is obvious: “So you’re not spreading [disease] across the building.”
Comprehensive Healthcare, which owns Brighton and 13 other for-profit nursing homes in southwestern Pennsylvania, is not a member of the PHCA.
Learning that Brighton staffers indeed moved around the building, Ms. Sluzynsky made a quick decision: “I said, ‘I’ll be out there to pick her up tomorrow.’”
On March 30, Ms. Namath moved into Ms. Sluzynsky’s home. She and other families say they were told by staff that up to 20 residents were pulled out of the nursing home after the outbreak began. Brighton would not say how many residents moved out during the outbreak.
“We got her out of there in the nick of time,” Ms. Sluzynsky said. “It went to hell after that.”
Next: A New Business Model
Sean D. Hamill
Laura Malt Schneiderman