Aug. 9, 2020
By Jamie Martines and Natasha Lindstrom
Talk.
Kenneth Miller has heard a lot of it since March when night and day, people all around him began dying at Brighton Rehabilitation and Wellness Center.
There has been talk of change, talk of state and federal probes into how the aging, 589-bed Beaver County facility that one local official called “the place of last resort” became the epicenter of one of the nation’s deadliest covid-19 outbreaks.
Amid all the talk, Miller, 66, a former charcoal artist from Pittsburgh’s Hill District and a Brighton resident since 2019, has noticed only minor changes such as more staff wearing masks and cleaner shared bathrooms.
Fellow resident Evelyn Gilbert also has seen cosmetic changes: fresh paint and new curtains.
But both said serious systemic problems persist.
Miller, who uses a wheelchair and requires oxygen because of a damaged heart pumping at only 25% of its capacity, said, “I listen to the aides cry about not having enough help. I feel like I’m in prison. I don’t want to die here.”
“They’re always short-handed,” said Gilbert, echoing concerns expressed by more than a dozen other residents, family members and current and former employees.
Brighton has an overall two-star rating out of five stars by the Centers for Medicare & Medicaid Services, the federal agency that oversees nursing homes. The facility has “below-average” marks for staffing and a “far-below-average” rating for issues related to inspections, federal records show.
Many days, Miller said he waits hours for someone to answer his call for basics — a trip to the bathroom, a glass of water.
A few weeks ago, he chafed his nose raw from using paper towels after it took almost a week to get a box of tissues.
More than once, he has had sheets thrown at him and been told to make his own bed.
Though his body is failing him, Miller’s mind is sharp. He is keenly aware of how, in terms of care and staffing, the Brighton of today resembles the Brighton of March, April and May, when death was everywhere and he and other residents were locked down while 73 patients and a housekeeper died and more than 300 others were infected with the coronavirus.
Miller and others with ties to Brighton also say their frustration continues about the lack of transparency surrounding those horrific days when people were dying, the doors between them and their families were locked and no one in authority inside was talking.
Trib reporters spent more than two months talking with those closest to the Brighton tragedy — the residents, their families, local officials and advocates.
They found myriad persistent issues:
• Three years of inspection reports showing serious infection control, management and patient care deficiencies, including a failure to separate coronavirus-infected patients from healthy patients.
• Thirty months on a federal watch list for underperforming nursing homes, a situation that continues more than four months after the first death at the facility.
• A controversial drug, hydroxychloroquine, with known side effects including irregular heart rhythm, low blood pressure and muscle or nerve damage, was administered to 205 of 435 patients at Brighton without needed approval from the state health department, according to inspection records.
• A significant difference in the amount of actual care time — 40% to 50% less — devoted to each patient at Brighton versus other facilities in Pennsylvania and across the nation.
• Inspection reports issued days apart in April — when about three dozen residents already had died — paint dramatically different pictures of infection control issues and other issues at the facility. One report showed severe deficiencies, another none.
• Allegations by those with ties to Brighton about a culture of intimidation and a pattern of silencing those who speak out about safety concerns at the site.
• Claims by Beaver County officials that in the six years since they turned over the once county-owned facility to a private company with a complex network of mostly out-of-town owners, there has been little communication, particularly after the surge of covid-19 deaths began.
Reporters reviewed years of inspection reports about the facility and guidelines for nursing homes across Pennsylvania and the nation. They knocked on doors in unsuccessful attempts to speak with Brighton’s elusive owners.
For months, they doggedly pursued an interview with Pennsylvania’s state health secretary about what went wrong at Brighton and what was happening to ensure the events of those tragic months would not be repeated.
During that time, Brighton’s owners, the facility’s current state-appointed manager and state health secretary Dr. Rachel Levine ignored repeated requests in person, by phone and by email for interviews concerning findings revealed during the Trib’s investigation.
After weeks of unsuccessful attempts to interview Levine, reporters traveled to Penn State’s Milton S. Hershey Medical Center in June to speak with her following one of her daily press briefings.
On that day, she said, “we will work it out” in response to the interview request, but the interview never materialized.
Six weeks after that face-to-face encounter in Hershey, Trib reporters made one last effort to obtain an interview with Levine, informing her spokesman that their investigation would be published in just days. With that new information in hand, the spokesman offered to set up an interview with the secretary several days later, which which would have fallen after the reporters’ deadline. The spokesman issued a lengthy statement that, in large part, included information that had been contained in earlier news releases and discussed during press briefings. The one-on-one interview to address specifics of the Trib investigation never materialized. Here is the emailed statement from the department spokesman:
A reporter also visited two New York addresses listed in state records for Comprehensive Healthcare Management Services, which purchased Brighton from Beaver County for $37.5 million.
Notes left at the addresses prompted responses from public relations representatives, who declined to set up interviews.
Federal officials have blamed the state for not doing enough to stem the virus’s tide.
U.S. Health and Human Services Secretary Alex Azar questioned whether the state did enough to quash the spread of the virus at Brighton.
State officials blamed the facility’s owners.
“We don’t run the facilities,” Levine said during that news conference in Hershey. “We are keeping in contact with any facility on a regular basis that has cases of covid-19. It is the responsibility of the facility to keep loved ones up to date in terms of patients and their status in the facility.”
Family members of Brighton residents are disillusioned by the failure of so many to assume responsibility for oversight at the facility.
Judith Minegar, of Sewickley, whose 78-year-old mother, Dorothy Umstead, is a Brighton resident who was diagnosed with covid-19, tried to participate in as many of the state’s virtual public health briefings as she could in hopes of getting the attention of Levine and other top health officials.
“I would sit there for hours on Facebook Live and say, ‘Please help us in Beaver. Please help us at Brighton Rehab.’ I would type it over and over and over again,” Minegar said. “I tried to get the (resident advocates) to help me. There was no help.”
As late as April 30, when at least 50 people had died at Brighton, health department officials issued a statement that they did “not believe there were any serious red flags” regarding Brighton’s response to the pandemic.
“I mean, my God, people are dying at these numbers and no one wants to take responsibility?” said Elaine Ryan, vice president for state advocacy for AARP, formerly known as the American Association of Retired Persons.
The health department did take action May 11 when, in a rare move, the state appointed a temporary manager — New Jersey-based Allaire Health Services — to oversee operations.
At the same time, Pennsylvania National Guard troops deployed for one week at the request of Brighton officials to help with cleaning and assist with patient care.
But state oversight of chronically struggling nursing homes has been weak for years, state officials and experts said.
State Auditor General Eugene DePasquale said the health department has been “frustratingly slow” in revising regulations in response to recommendations in his 2016 audit citing issues confronting Brighton and other nursing homes.
In a follow-up report last year, he called for more frequent inspections, steeper penalties and institution of minimum staff-to-patient ratios.
Though residents say there has been change, they believe it’s not enough.
Cheryl Yevak, whose mother, Anna Mae Yevak, 88, has been at Brighton since 2017, has seen signs limiting elevators to no more than two people, and her mother now has one roommate instead of three.
Open bins with dirty diapers spilling onto floors have been replaced with closed receptacles.
“They have soap in all the dispensers. There’s paper towels in the bathroom. There’s signs up that everybody needs to wash their hands. There’s all new, fresh curtains,” she said.
But the changes aren’t sufficient for Yevak to keep her mother at Brighton.
“It used to be really gross. I’m glad they’ve made some changes … but I’m not real happy. It took somebody a long time to finally get it done,” she said. “That’s the way it should have been. I’ve applied for five other nursing homes, so God help us, I can get her out of there.”
In reporting the story, reporters found many fearful about speaking out about the facility.
Miller, a friendly man with a white beard, and his sister, Sandra Duke, of Florida, have kept in touch with Trib reporters, hoping that their actions, despite his fear of retaliation, might bring change.
During one visit, as Miller talked with a reporter through an open sliding-glass door, he was in mid-conversation when, while he was on video, an employee appeared. She announced that “this interview is over” and slammed the door before wheeling Miller away.
In a phone call a few minutes later, Miller told the Trib that “they’re freaking out.” He was told that talking to the media could get staffers fired.
Miller and others say they don’t blame individual workers for problems at Brighton and that many workers seem to be doing the best they can.
“There’s some bad people here. And there’s some good people here — some people that really care here,” Miller said.
Industry experts said it’s increasingly difficult to find workers for nursing home positions, particularly in light of the pandemic. To fill its gaps, Brighton has turned to recruiting traveling nurses and aides from other states.
Matthew Yarnell, president of Service Employees International Union Healthcare PA, which represents about 300 of more than 400 workers at Brighton, said, “There’s definitely a staffing crisis all across the commonwealth, and I think that’s going to get worse.”
“Now you have the impact of massive loss of life of residents, staff very sick, people trying to figure out if they even want to do the work anymore and a desperate need for caregivers,” he said. “We have a recipe for real disaster … that is not going to go away overnight.”
Though she agrees change will not come overnight, the AARP’s Ryan said she hopes the horrors at Brighton will be a call to action to policymakers and regulators to spur meaningful reform.
“I’m hopeful because we now see a devastating trail of death that can’t be ignored,” she said. “Can we fix it? Yes. The question is, when can we start?”
Jamie Martines and Natasha Lindstrom are Tribune-Review staff writers. You can contact Jamie at 724-850-2867, jmartines@triblive.com or via Twitter @Jamie_Martines. You can contact Natasha at 412-380-8514, nlindstrom@triblive.com or via Twitter @NewsNatasha.
Options for reporting issues at nursing homes include:
• Pennsylvania Department of Health: Call 800-254-5164, email c-ncomplai@pa.gov or use the online complaint form on the department’s website. Complaints can be kept anonymous.
• State Attorney General’s Office: To report neglect or possible criminal allegations, email neglect-COVID@attorneygeneral.gov or call 717-787-3391 and ask for the Medicaid Fraud Control Section.
• Long-Term Care Ombudsman Program: Call 717-783-8975 or email LTC-ombudsman@pa.gov.
For emergencies involving immediate danger, call 911 or 877-72-432584 (877-PA-HEALTH).
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