Every morning, a patient at Good Shepherd Health Care Center, a nursing home in Santa Monica, walks a mile east to a Trader Joe’s on Wilshire Boulevard and buys a few groceries.
Good Shepherd doesn’t have any confirmed cases of coronavirus, according to the Los Angeles County Department of Public Health. But family members of other patients in the facility are concerned that because the patient can come and go freely, it’s only a matter of time.
“We’re just sitting here waiting and hoping the worst doesn’t happen,” said Roy Goldman, whose mother has lived at Good Shepherd for two years.
Patients in nursing homes have the right to leave whenever they wish, according to the state long-term care ombudsman and the Department of Public Health.
For the past several months, the patient has visited the grocery store every day because she does not like the food provided by Good Shepherd, said administrator Nellie Agulto. She said she has offered to get the patient’s groceries for her or put a refrigerator in her room so she can go to the store less frequently, but the patient refuses.
Agulto has been giving the patient a mask before she leaves the facility, taking her temperature, asking her to wash her hands and keeping her in her room as much as possible.
“I’ve begged her to stop temporarily,” Agulto said. “I told her, “you have rights, but you also have responsibilities.” But she doesn’t want to listen to me.”
Following guidance from the Department of Public Health, Good Shepherd has limited all other nonessential trips in and out of the facility, takes the temperature of residents and staff frequently, and closed communal spaces, Agulto said. The facility will also soon begin testing all residents and staff, she said.
But the patient who leaves the facility every day still worries Goldman and other family members.
“Public Health says you have to maintain people’s civil rights,” he said. “Good Shepherd hasn’t done anything wrong, but their hands are tied. I'm disappointed with Public Health, because these are uncharted waters, and if there’s ever a time to make a common sense exception to a rule, this would be it.”
There were 111 COVID-19 cases and 12 deaths among staff and residents of four Santa Monica nursing homes and one assisted living facility as of Monday. It is unknown how many of the staff and residents permanently reside in Santa Monica and therefore are included in the city’s tally of cases and deaths.
Across L.A. County, 49% of people who have died from COVID-19 resided in nursing homes, according to the Department of Public Health.
Two weeks ago, county public health officials began requiring nursing homes to test all residents and staff, limit entry to essential workers, suspend communal dining activity and require residents to wear masks in common areas. The National Guard has been deployed to 10 nursing homes in the county with outbreaks to help provide medical support.
But advocates for nursing home patients said officials need to provide sustained oversight and assistance at facilities, particularly those with histories of poor infection controls.
Michael Connors, an advocate with California Advocates for Nursing Home Reform, said the group has called for public health inspectors to be stationed at such facilities during the pandemic, even if they do not yet have an outbreak of COVID-19.
“There should be preemptive oversight of nursing homes with poor inspection records,” he said. “Those are the facilities that are most dangerous to residents and the most likely to have outbreaks. Not nearly enough is being done to protect residents of substandard nursing homes.”
In inspections conducted last year, public health officials found multiple health violations at the two nursing homes in Santa Monica where multiple residents have died from COVID-19.
Beachwood Post-Acute & Rehab and the Rehabilitation Center of Santa Monica received one and two stars, respectively, under Medicare’s five-star rating system for nursing homes. Good Shepherd also received a one-star rating. The rating system is based on recent health inspection records, level of staffing and quality of care.
Good Shepherd and two other nursing homes without confirmed coronavirus cases were also rated below average.
The Rehabilitation Center has reported 14 cases among staff and 29 among residents. Nine deaths have been confirmed at the facility.
At Beachwood, 13 staff and 23 residents have tested positive. The facility has reported three deaths.
Jorge Newbery, whose 95-year-old mother Jennifer had been living at the Rehabilitation Center of Santa Monica for a year when she contracted COVID-19, is trying to prevent UCLA Medical Center, Santa Monica from sending her back to the facility or another nursing home with an outbreak.
Two weeks ago, the facility told Newbery and his sister that only three patients had tested positive and the outbreak was under control. But after he found a state registry of nursing homes with outbreaks that showed the Rehabilitation Center had 14 patients with COVID-19, he immediately contacted an employee and asked to be put on a video call with his mother.
It was the first time Newbery had seen her in weeks, and he said she looked close to death.
“My mom could barely talk or recognize me,” he said. “She looked neglected, dehydrated and malnourished.”
Newbery urged the facility to call 9-11 or take his mother to a doctor, but the facility initially refused, saying she had no COVID-19 symptoms.
After several hours of insisting, the Rehabilitation Center agreed to allow her to be transported to UCLA Medical Center, Santa Monica, where she immediately tested positive for coronavirus.
The nursing home’s staff later told Newbery that the facility was understaffed and some employees weren’t showing up to work.
A spokesperson for the Rehabilitation Center said the facility is working closely with public health authorities in implementing our COVID-19 infection control policies and procedures, including restricting outside visitors, disinfecting the facility, and providing personal protective equipment to employees and residents.
Newbery said his mother has been recovering over the last two weeks and the hospital is trying to release her to the Rehabilitation Center or to Ocean Pointe Healthcare Center in Santa Monica, which has confirmed cases among six staff and 15 residents. Her doctor said she may have short-term immunity from the virus, but could be infected again in the future.
Newbery said he is trying to convince UCLA to let her stay until she is well enough to fly to Chicago and live with him.
“She’s very fortunate to recover from COVID at 95, and we don’t want her to go back to a facility where she could contract it again,” he said. “And if they’re overwhelmed with cases, there’s no way they can provide proper care.”
madeleine@smdp.com