Two More Deaths In State Vet Home

By Walter F. Roche Jr.

Two more confirmed coronavirus deaths have been recorded at Pennsylvania run nursing homes for veterans and their spouses, according to a spokeswoman for the state Department of Military and Veterans Affairs.
The two additional deaths come on top of 26 Covid-19 deaths at the Southeast Veterans Center previously reported by the Chester County Coroner's Office.
Joan Nissley, the spokeswoman for the state agency, said that a total of 45 residents of the homes have tested positive, including 17 who have died.
Nissley said that in addition to the new deaths, 36 employees at the six state run veterans homes have tested positive for the virus although 18 of them have recovered and returned to work.
The coroner's death totals are higher than those reported by the state because some of the deaths occurred after the nursing home patients had been transferred to other health care facilities.
The deaths have prompted calls for an investigation from Christina Vanderpol, the county coroner and state Sen Katie Muth.
State Auditor General Eugene Depasquale has called on the state agency to release more details on the deaths.
The deaths at a Pennsylvania veterans facility come as deadly outbreaks from the coronavirus have been reported in veterans nursing homes in several other states. In Massachusetts a state run veterans home in Holyoke has had 68 Covid-19 deaths. An additional 82 residents have tested positive for the virus.
Other state run veterans home hit hard by the virus include New Jersey, Washington state and Alabama.
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State Hospital Patients Isolated

By Walter F. Roche Jr.
Twenty-one patients at the Norristown State Hospital who have tested positive for the coronavirus have been placed in isolation units, according to a spokeswoman for the Pennsylvania agency that oversees the state hospital system.
Erin James, the spokeswoman for the state Department of Human Services, said the isolated patients at the state psychiatric facility are provided with "medical care that supports their recovery."
She said that if necessary the ailing patients are subsequently transferred to an area general hospital for more intensive treatment.
The spokeswoman said hospital personnel caring for the infected patients are provided with personal protective gear as recommended by the U.S. Center for Disease Control and Prevention and the state Health Department.
The state reported this week that 21 Norristown patients and 67 hospital employees have tested positive for the deadly virus. The number of infected patients jumped by two over the past 24 hours. The facility has 343 patients and 776 employees.
Several employees at the facility have complained about the lack of protection from the disease and the failure of the facility leaders to provide adequate and up to date information on the pandemic's impact at the Montgomery County facility.
Meanwhile officials of the state Department of Military and Veterans Affairs reported no new Covid-19 deaths at the six veterans nursing homes run by the agency. However two more staffers have tested positive, pushing the total to 29.
One additional resident at the homes also tested positive pushing the total to 22. Most of the resident victims reside at the Southeastern Veterans Center in Montgomery County. Most of the deaths in the state veterans centers occurred at that same facility.
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Covid-19 At PA State Hospitals

By Walter F. Roche Jr.

Nineteen patients and 67 staffers at the Norristown State Hospital have tested positive for the coronavirus, according to data from the state Department of Human Services.
The facility, located in Montgomery County west of Philadelphia, is one of three state hospitals with COVID-19 cases.
The disclosure comes amid growing protests by the employees of Norristown facilities about the failure to protect employees and advise them of infection risks.
According to the report, 19 patients out of the 341 at the facility and 67 employees out of 776 have tested positive. The hospital serves as a long term psychiatric treatment facility.
At the Wernersville State Hospital in Berks County seven of the 262 current patients have tested positive, while 13 of the 580 employees have tested positive to the coronavirus. At Torrance State Hospital in Westmoreland County one staffer has tested positive, according to DHS data.
The agency reported that at other facilities under its supervision, including the division of youth services, no positive COVID-19 test results have been recorded.
A DHS spokeswoman said the agency has yet to compile the infection data at human services providers under contract with the state.
Meanwhile the death toll inched upward at six state veterans homes in Pennsylvania. A spokeswoman for the state Department of Military and Veterans Affairs said two additional deaths pushed the total to 14. Most of those deaths occurred at the Southeastern Veterans Center in Chester County.
She said 27 staffers have tested positive as have 21 residents.
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Death Toll Grows at Vets Homes

By Walter F. Roche Jr.

Additional deaths and infections from the coronavirus have turned up in state institutions for elderly veterans and those with disabilities.
In Pennsylvania a total of 12 deaths have now been recorded in state run nursing homes serving veterans.
According to Joan Nissley, a spokeswoman for the Pennsylvania Department of Military and Veterans Affairs, the death toll jumped from nine late last week to 12 today. At least 10 of the deaths occurred at the Southeastern Veterans Center, a 238 bed nursing home in suburban Chester County.
Some 34 Pennsylvania National Guardsmen have been assigned to provide assistance at the facility.
The agency oversees five other veterans homes from Erie to Pittsburgh to Philadelphia.
Nissley also reported that 25 staffers have now tested positive for the Covoid-19 virus throughout the system. That's up from 23 late last week.
A total of 19 patients have tested positive up from 16 last week.
In Tennessee the Department of Intellectual and Developmental Disabilities reported one death and 13 active Covid-19 cases among those placed in public and private facilties.
Multiple deaths among patients in state run veterans facilities have been reported in Massachusetts, New Jersey, Oregon and Alabama.
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National Guard at PA Vets Home

By Walter F. Roche Jr.

Some 34 National Guardsmen are on duty assisting staff at a Pennsylvania run nursing home for veterans, where multiple deaths from the coronavirus have been recorded.
Joan Nissley, spokeswoman for the state Department of Military and Veterans Affairs, said some of the guardsmen were working as certified nursing assistants, while others were providing housekeeping and recreational services.
Nissley also said that the official death toll at the facility in Chester County remained at nine, despite reports that a tenth resident had died.
The Southeastern Veterans Center is one of six veterans homes run by the state agency providing care to some 1,300 veterans and their wives. She said that system-wide, 23 employees have tested positive for COVID-19, along with 16 residents.
All six are licensed as nursing homes and undergo regular inspections by surveyors from the state Department of Health. In the most recent inspections, no deficiencies were reported at the Chester County home, but in a report last Fall the facility was cited for failing to provide adequate care to a patient suffering from severe bed sores.
The patient, according to the report, had to be hospitalized and underwent surgery.
Nissley noted that her agency also houses the Pennsylvania National Guard and guardsmen have provided assistance at the veterans homes in the past.
"We are fortunate to once again use the unique skill sets of our Guard members to alleviate some of the intense demands on the homes’ staff during the COVID-19 pandemic," Nissley said.
Noting that residents in the state homes are elderly and many suffer from multiple ailments "which make them particularly susceptible to coronavirus."
"We continue to be vigilant in our infection prevention and control plans and remain dedicated in doing everything we can to stop the spread of this virus," Nissley concluded.
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Ten from PA Vet Home Die

By Walter F. Roche Jr.

Ten residents at a Pennsylvania veterans home have died from Covid-19, according to officials of the Pennsylvania Department of Military and Veterans Affairs.
Records show all 10 died at the Southeastern Veterans Center in Chester County.
The deaths occurred despite renewed and updated efforts at infection control at the six facilities which stretch from Erie to Chester County.
Previously the state agency had reported five residents and one employee had tested positive for the virus at the facility. They also reported an employee at a sister facility in Pittsburgh, the Southwestern Veterans Center, had tested positive for the coronovirus.
In addition, according to agency spokeswoman Joan Nissley, systemwide, 16 residents and 22 staffers at the facilities have tested positive for the virus.
Other states have reported much higher numbers of deaths and infections in similar veteran facilities. Massachusetts has reported that 44 died at a single facility in Holyoke.
"When the concerns over COVID-19 first surfaced, staff at our six veterans’ homes reviewed and updated infection prevention and control plans in preparation for a possible outbreak, " Nissley said in an email response to questions.
She said the agency also implemented heightened safety measures including restricting visitors, cancelling outings, discontinuing group activities, ceasing the use of volunteers, conducting daily health screenings for employees, and putting new admissions on hold.
"Our highest priority is the health and safety of our staff and the residents we serve," Nissley said.

FDA Moves to Ease Covid-19 Drug Shortages

By Walter F. Roche Jr.

The U.S. Food and Drug Administration has issued an emergency advisory indicating it will, in effect, temporarily ease requirements for drug compounding firms to produce drugs being used to treat victims of the Covid-19 pandemic.
In a 16-page document, known technically as a "guidance," the FDA said it does not intend to enforce restrictions that currently bar drug compounders from producing drugs that are not on an official drug shortage list.
Citing complaints from hospitals and other providers that drugs needed to treat Covid-19 patients are not available, the guidance states that it does not intend to enforce the existing restrictions for some 13 drug products including midazolam, fentanyl citrate, lorazepam and verconium bromide.
"In light of the unprecedented disruption to, and demands on the global pharmaceutical supply chain as a result of the Covid-19 pandemic, additional flexibility is needed to ensure that treatment options are available when hospitals are unable to obtain FDA approved drugs," the guidance states.
The guidance applies to a new class of drug makers known as outsourcers created in legislation passed by Congress in response to the deadly 2012 fungal meningitis outbreak.
Citing the ongoing health emergency, the FDA said it was issuing the new guidance without first seeking public comment, which is the normal process.
Stating the the drugs in question were needed to in-tubate hospitalized Covid-19 patients, the guidance states that the relaxed enforcement policy will only remain in effect during the current public health emergency.
The guidance does set some minimum requirements drug compounders must meet in producing the Covid-19 drugs relating to beyond use dates and stability testing.
The drugs also must be provided directly to a hospital.
Ironically some of the drugs now on short supply for Covid-19 patients are also used by states like Tennessee in the execution of prisoners on death row. Those include midazolam and vercuronium bromide.
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PA Lists Deaths at Nursing Homes

By Walter F. Roche Jr.


Half of the Pennsylvania deaths from the coronavirus were residents in nursing homes, according to data released today by the state Health Department.
The data show the most nursing home Covid-19 deaths occurred in Montgomery County, west of Philadelphia. The deaths, according to Health Secretary Rachel Levine, occurred in 52 nursing home and personal care facilities in the county.
The report does not provide specific data for any specific nursing home. Overall the state has reported 647 deaths from Covid-19, 324 coming in nursing homes or personal care homes.
The Montgomery County nursing home deaths topped even the amount recorded in Philadelphia. The records show there were 34 deaths in 41 Philadelphia nursing homes. A total of 602 patients in the Philadelphia facilities tested positive for the virus.
Levine said her agency had taken a "deep dive" into the data and the agency was providing assistance to facilities in such areas as infection control.
The Pennsylvania data tracks anecdotal information from other jurisdictions where the incidence of the virus in nursing homes has become increasingly evident. Some state veterans homes have also reported high numbers of Covid-19 patient deaths.
At Pennsylvania veterans homes, which are licensed as nursing homes, active cases have been reported at two facilities.
A study by the U.S. Centers for Disease Control and Prevention concluded nursing home residents were particularly vulnerable due to the age of residents and the confined space coupled with the highly contagious nature of the Covid-19 virus.
In the Philadelphia region deaths among nursing home residents totaled 16 in Chester County at 14 facilities, 24 in Bucks County at 29 facilities and 41 deaths at 34 Delaware County locations.
At the opposite end of the state, Allegheny County, which includes Pittsburgh reported 16 deaths in 18 facilities.
Other Pennsylvania counties with a high number of nursing home deaths include Lancaster with 20, Luzerne with 21 and Berks with 13. Among counties with no reported nursing home deaths were Dauphin and York in the central part of the state.


COVID-19 Cases Associated with Nursing Homes to Date
Facility County Number Of Facilities Number Of Cases Number Of Deaths
ADAMS 1 1 1
ALLEGHENY 18 140 16
BEAVER 2 70 10
BERKS 12 193 13
BUCKS 29 178 24
BUTLER 3 17 2
CARBON 2 12 5
CHESTER 14 105 16
CLARION 1 1 0
CLEARFIELD 1 1 0
COLUMBIA 1 12 0
CUMBERLAND 3 30 2
DAUPHIN 3 28 0
DELAWARE 34 288 41
ERIE 1 1 0
FAYETTE 1 3 1
INDIANA 2 11 1
LACKAWANNA 9 169 12
LANCASTER 17 248 20
LEBANON 1 5 0
LEHIGH 10 125 10
LUZERNE 11 132 21
LYCOMING 1 1 0
MERCER 1 1 0
MONROE 6 67 13
MONTGOMERY 52 551 60
NORTHAMPTON 10 211 9
PHILADELPHIA 41 602 34
PIKE 1 18 1
SUSQUEHANNA 3 25 1
WASHINGTON 1 1 0
WESTMORELAND 4 68 11
YORK 1 1 0
PENNSYLVANIA 297 3316 324

VA Reports 200 Covid-19 Deaths

By Walter F. Roche Jr.

Some 200 veterans under care at US Veterans Administration facilities have died from the coronavirus and, as in the general population, New Orleans has been among the hardest hit.
The VA data show 429 veterans under care in New Orleans are under VA care, 36 being treated as inpatients and 398 as outpatients.
The VA also reported that in the past two days alone, four veterans under care in New Orleans have died from the virus.
The report shows three veterans under care in Detroit died on Wednesday and Thursday. Overall 119 veterans are being treated in that city, 21 as inpatients and 98 as outpatients.
Other VA facilities with high totals include Bronx, N.Y. 258, East Orange, N.J. with 210 cases, Brooklyn, N.Y. with 268 and Chicago (westside) 128.
The New Orleans veterans figures parallel those from the general population which has been attributed, at least in part, to attendance at Mardi Gras events. Louisiana has recently reported 700 covid-19 deaths and 2,054 hospitalized from the virus.
Still other VA treatment center covid-19 case reports show Ann Arbor- 15 inpatient 26 outpatient, Atlanta 17 and 63, Bedford, MA- 21 and 10, Boston- 13 and 24, Northport, N.Y.- 28 and 65, Philadelphia- 13 and 45, Pittsburgh-3 and 11, Richmond- 7 and 42, San Juan- 6 and 42, Tennessee Valley (Nashville)- 4 and 22, St. Louis- 12 and 26, District of Columbia- 20 and 69.
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State Vets Homes Hit Hard

By Walter F. Roche Jr.

In a Florida veterans home nine residents tested positive, one of them died, while on Long Island 40 were sickened and seven died. In Holyoke, Mass. 25 veterans died, all victims of coronavirus.
But they weren't all only just veterans they were residents of state run veterans homes and like elderly residents in nursing homes across the country they are dying in increasing numbers from the ongoing pandemic.
The deaths at the Massachusetts veterans home has prompted state Attorney General Maura Healey to launch an investigation. The home's superintendent was fired.
State veterans homes, which are not part of the U.S. Department of Veterans Affairs, are generally funded by state governments, though Maine's homes are run by a private corporation.
Other hard hit state programs include New Jersey where 10 deaths have been reported at a Paramus facility. A second Massachusetts veterans home has had three deaths and Oregon has had three deaths.
Still other state veterans health facilities reporting either covid-19 infections or covid deaths or both include Oregon, Maine, Washington, California and Alabama.
Experts attribute the high incidence of covid-19 in nursing homes to the vulnerability of the residents and the highly contagious nature of the virus.
One recently released study found that the covid-19 incidence was not as severe in other types of facilities for the elderly including an assisted facility.
The study made public today cited statistics from an assisted living facility and a senior independent living center in Seattle.
Citing the "rapid spread and high morbidity" with covid-19, two deaths were reported at the facilities during the study period."
Noting that the results differed markedly from data at skilled nursing facilities in the same area, the study found that the residents of the independent living and assisted living facility "do not live as closely together" and do not require skilled nursing care.
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2 PA Vets Homes Have Covid Cases

By Walter F. Roche Jr.

Two Pennsylvania veterans homes at opposite ends of the state have been hit with coronavirus, but four others have so far avoided the pandemic.
According to a spokeswoman for the state Department of Military and Veterans Affairs, five residents and one staffer at the Southeastern Veterans Center in Chester County have tested positive for Covoid-19.
At the Southwestern Veterans Center in Pittsburgh one staffer tested positive, according to Joan Nissley, the agency spokeswoman.
She said there have been no deaths from the virus.
"Our homes have – and will continue – to report positive test results to county, state, and federal public health officials in accordance with CDC guidelines and are ensuring follow-up protocols are accomplished," Nissley said.
Veterans nursing homes in other states have been much harder hit where deaths have been reported at two facilities. Some 25 deaths were recorded at a veterans home in Holyoke, while five were reported at the soldiers home in Chelsea.
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NO Covid-19 Data on Troubled City Home

By Walter F. Roche Jr.

Philadelphia health department officials are refusing to release information on the number of Covid-19 cases at the city owned 402-bed nursing home, a facility with a long list of complaints and deficiencies.
Requests for data on the number of coronavirus cases and any subsequent deaths at the Philadelphia Nursing Home were denied this week with health department officials citing a 65-year-old law, the Disease Prevention and Control Law of 1955.
The refusals continued even after Philadelphia Health Commissioner Thomas Farley voluntarily released data on the number of coronavirus cases in the city prison system.
"Those are two different situations," health department spokesman James Garrow wrote in response to the second request. "We’ve stated in the past that we are not releasing information on the disease or any cases that may happen in nursing homes."
A review of state Health Department inspection reports on the city facility show a history of multiple complaints and deficiencies including the most recent in which a wheelchair bound patient suffered serious injuries, including multiple jaw fractures, in an altercation with a roommate.
The facility was cited for failing to immediately report the incident to the Pennsylvania Department of Aging and local police.
Though the incident occurred on Aug. 10 of last year, it didn't become public until state health department surveyors visited the facility on Jan. 23 of this year.
In a plan of correction nursing home officials promised a re-education program for staffers and an auditing program to monitor compliance.
The reports show four complaints were filed against the home since January but state surveyors concluded there were no deficiencies.
But multiple deficiencies were found in an annual license inspection at the facility in a report dated Oct. 29 of last year.
Violations included mishandling of drugs, food and other sanitary violations. Records showed a refrigerator storing drugs was out of proper temperature range on multiple occasions.
The records showed a female patient continued to receive a drug which emergency physicians at a local hospital had warned the nursing home to discontinue.
After her second trip to the emergency room for a bleeding incident, the hospital sent back a plea.
"Please stop taking your blood thinner medications. This was supposed to be discontinued on your last discharge," a hospital physician wrote.
"The facility failed to provide resident with treatment and care in accordance with professional standards and practice," according to the state inspection report.
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Law, Rules Ignored in Mass Transfer

By Walter F. Roche Jr.

Some 300 Massachusetts nursing home patients were being rushed to new facilities without notice despite state and federal requirements that so-called involuntary transfers from nursing homes be limited to specific circumstances and that patients be given notice of their right to an appeal.
So far the mass transfers have been announced for two nursing homes, one in Worcester, the other in Wilmington. But state officials have made it clear they are intent on expanding the program to provide some 1,000 beds for patients recovering from Covid-19.
Massachusetts regulations regarding so called involuntary transfers and discharges state, "A facility may not discharge or transfer a resident "unless the resident or appropriate representative consented in writing to the discharge or transfer."
Federal regulations set only six justifications such as the patient no longer requires the level of care provided or the facility cannot provide the necessary level of care. In addition if the patient files an appeal the transfer must be put on hold.
The transfer of 147 patients at Beaumont at University Place in Worcester was first disclosed a week ago and by early this week Beaumont patients were already being transferred to other nursing homes owned by Salmon Health Care, the owner of Beaumont.
The transfers were interrupted only when it was discovered that several of the current residents already were infected with Covid-19.
Beaumont patients and their representatives only learned of the imminent transfers a week ago in a facebook post by the Salmon's, chief executive officer, Matthew Salmon.
Interviews with relatives of the Beaumont patients show none were informed individually for the transfer nor were they given a medical justification, as required.
An additional 142 patients at the Advinia Care in Wilmington also have been targeted for transfer to other homes owned by the home's parent, Pointe Group Care. That move was also put on hold today after nearly half the patients also tested positive for covid-19 despite showing no symptoms.
Questions posed to both companies about compliance with the state and federal involuntary transfer requirements went unanswered.
Massachusetts officials, including aides to Baker, also did not respond to a series of questions about involuntary transfer rules.
The rushed transfers and the manner in which they were disclosed has prompted protests from the families of current and former patients at the two facilities.
Rev. Megan Leary, who had two grandparents at the facility for several years said the way the transfers were implemented was "unethical at best."
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2nd Mass. Home Getting 142 Covid-19 Victims

By Walter F. Roche Jr.

Massachusetts officials have designated a second nursing home to serve exclusively as a treatment center for coronavirus victims, forcing the relocation of some 142 current patients at the Wilmington facility.
The selection of Advinia Care was disclosed this week by the nursing home's parent company, Pointe Group Care. Campaign finance records show officers and employees of Pointe Group have donated $4,500 to Massachsuetts Gov. Charles Baker's campaign committee.
The other nursing home selected for the care of covid-19 victims in Massachusetts, Beaumont Nursing and Rehabilitation in Worcester, is owned by the Salmon Health and Retirement. Members of the Salmon family and employees of its nursing homes have donated over $20,000 to the campaign committees of Baker and Lt.Gov. Karyn Polito.
State officials have defended the unusual arrangements contending it is necessary to treat covid-19 patients separately to avoid having additional patients infected. The patients will be sent to the nursing homes upon their release from area hospitals.
Relatives of current and former patients at Beaumont have protested the action contending the shift in location will be especially disruptive for a frail population, many suffering from dementia.
Rev. Megan Leary, whose grandparents lived at Beaumont for several years, said she was particularly troubled by the fact that the transfers were announced at the last minute by Matthew Salmon, the company's chief executive, on a facebook page.
Calling that move "unethical at best," Leary said there was apparently no effort to contact patients or their family members individually.
In a related development, the transfer of the Beaumont patients has been delayed because several of the current patients turned out to be already infected with covid-19. The current patients are being transferred to other Salmon facilities.
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Cadden, Chin Remain in Michigan

By Walter F. Roche Jr.

Two former Massachusetts pharmacists remain in a Michigan lockup, but a key hearing on their second degree murder charges has been delayed yet again.
Court records show Barry Cadden and Glenn Chin's hearing on whether the should be bound over for a jury trial has been set for May 21. The two are charged with 11 counts of second degree murder for their roles at a now defunct company that caused a deadly 2012 fungal meningitis outbreak.
The hearing had originally been set for this week in Howell, Mich. before Livingston County District Court Judge Shauna Murphy.
Under the revised schedule Murphy is due to issue a ruling on June 11. Further delays, however, likely will depend on the ongoing coronavirus pandemic.
The two were charged by then Michigan Attorney General Bill Schuette with second degree murder in the deaths of 11 Michigan patients who died in the outbreak.
Cadden and Chin already have been convicted of federal racketeering and mail fraud charges. Cadden has already begun serving a nine year sentence, while Chin got an eight year sentence. The two were brought to Michigan from separate prisons in Pennsylvania last year and have remained in the Livingston County Jail ever since.
County officials recently announced a ban on visitors at the jail due to the the coronavirus pandemic.
Chin's federal sentence is due to end on Jan. 1,2025. Cadden is due for release April 4, 2025. If convicted on the Michigan charges, they will likely face a life term.
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