Of all the ways Angie White could’ve imagined losing her 88-year-old grandfather, she didn’t expect this.
Her grandfather, Richard “Dick” Stoy, died of complications from COVID-19 on April 27 at Conestoga View Nursing & Rehabilitation in Lancaster Township, just a week after testing positive.
“Plan for his death,” nursing home staff told Stoy’s daughter, Cindy Rosado, after his diagnosis. It was a rapid decline, White said, for a man who was energetic and healthy during a visit with his great-grandchildren just a few months ago.
“I can’t believe my grandfather would be here,” White said.
The township has seen more deaths than any other of Lancaster County’s 60 municipalities, according to county data.
More than 51% of the county’s deaths — 88 of 170 on Wednesday — were residents of three nursing homes in the small but highly populated municipality, according to the county coroner: 52 at Conestoga View, 20 at Hamilton Arms Center and 16 at ManorCare Health Services — Lancaster.
In addition to the vulnerable population in nursing homes, ManorCare resident Robert Merrill, 71, said he has noticed poor adherence to infection control by some staff in the weeks since the outbreak hit the facility.
Merrill, a two-year resident of the nursing home on Abbeyville Road, said he has trouble understanding aides there because of a language barrier. He also said they sometimes remove their masks when speaking with him.
In other instances, Merrill said some staffers have entered his room, used a protective gown near his door while assisting him, and left the gown in the room — unwashed between uses.
Julie Beckert, a spokeswoman with HCR ManorCare, said employees are trained on how and when to clean and conserve personal protective equipment, or PPE.
“If the employee is working on a specific unit, the PPE can be reused on that unit when following our CDC recommended conservation guidelines,” she stated.
Currently, the Centers for Disease Control and Prevention does not have a clear recommendation on washing gowns between uses. The risk of contamination by health care personnel — either from multiple employees wearing the same gown with a single patient or one employee wearing the same gown with multiple patients — is “unclear,” the CDC states on its website.
Merrill said a ManorCare administrator told him employees were set to be trained on the proper use of personal protective equipment because of infection control issues.
“It’s six weeks too late,” Merrill recalls telling the administrator.
Beckert did not directly respond to a question on whether the training occurred.
Two associations representing Pennsylvania nursing homes and similar facilities — LeadingAge PA and Pennsylvania Health Care Association — have been warning for years that underfunding of the Medicaid program that covers many residents severely challenged the industry. In recent weeks as the pandemic gathered strength here, they repeatedly and publicly asked for more help from the state, expressing concern about inadequate supplies of personal protective equipment more than a month ago and saying they critically need increased funding and testing.
Lancaster Township and county officials have told LNP | LancasterOnline that help — for things such as acquiring personal protective equipment — has been offered through emergency management channels but much of the assistance thus far has come through the Pennsylvania Department of Health.
“We have been concerned about nursing homes since the beginning of this,” county Commissioner Josh Parsons said. The county provided some personal protective equipment to nursing homes until the state Department of Health recently took over those operations, he said.
However, county officials, including directors for the Office of Aging and Emergency Management, have “reach(ed) out to nursing homes for suggestions on any other ways we can help them,” Parsons said.
Commissioner Craig Lehman said the county continues to offer disinfecting services and provide some personal protective equipment to both licensed and unlicensed facilities.
Lancaster Township reached out to area nursing homes for any assistance in obtaining personal protective equipment, township supervisors Chairman Steve Elliott said.
“They responded that they have their own channels to meet their needs,” he said.
The state Department of Health refuses to answer questions about cases, deaths or its response at specific nursing homes, including Lancaster County facilities.
Department spokesman Nate Wardle wrote, “We are constantly reviewing and considering what information to release publicly, while also protecting the privacy and confidentiality of Pennsylvanians.”
In a rare exception to its policy, the department confirmed Wednesday that it has installed a temporary manager at Brighton Rehabilitation and Wellness Center in Beaver County, where, according to Associated Press reports, at least 58 people have died of COVID-19. No such manager has been installed at any Lancaster County nursing home, Wardle said.
However, the department generally reports being in at least daily contact with homes that have cases, issuing and updating guidance, providing education and consultants as needed and distributing some personal protective equipment.
State Secretary of Health Dr. Rachel Levine said Thursday that it is “working intensively” with all homes that have outbreaks.
Republican state Sen. Scott Martin of Martic Township said he was not aware of the exact number of cases at the facilities in Lancaster Township where the death rate continues to rise rapidly, but had been following earlier reports that showed at least 39 deaths at Conestoga View.
Martin and Republican state Sen. Ryan Aument of Landisville are spearheading an effort in Harrisburg to allocate $200 million of the $3.9 billion Pennsylvania received as part of the federal coronavirus aid package to long-term care facilities. Nearly $95 million was allocated for Lancaster County to address any coronavirus-related expenses, excluding revenue losses.
“These facilities absolutely need help or more resources,” Martin said, noting Lancaster County’s large senior population.
Martin visited ManorCare and Willow Valley Communities on Thursday to deliver personal protective equipment with Operation Emerald — an initiative to support first responders from the nonprofit Emerald Foundation — but did not go inside. He said he quickly could see the difference in approaches between the two facilities. While pulling up to Willow Valley in a car, his temperature was taken. No such policy was enforced at ManorCare.
Democratic state Rep. Mike Sturla of Lancaster city, who represents the areas where ManorCare and Conestoga View are located, said neither home or any health care association has reached out to his office for aid, but was not aware of the high number of cases in the homes. The high number of deaths at the three Lancaster Township nursing homes illustrate a need for better reimbursement rates for these facilities, Sturla said.
Staff writer Gillian McGoldrick contributed to this report.
This story has been updated to more accurately represent comments from Martin and Sturla.