By Laura Strickler and Stephanie Gosk -
NBC News
In December 2019, Sharon Farrell flew in from Florida to visit her brother Stephen at a New Jersey nursing home, where she said she found "disgusting" conditions.
"I told the nurse, 'I'm going to call the state - I'm paying $ 9,000 a month, and I wouldn't let my dog live like this."
Farrell said that four months later, as COVID-19 was spreading rapidly, he repeatedly called the center to ask how his brother was doing.
When he finally got in touch with someone they told him he was fine.
However, within a few days he had died.
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It has been 19 months since the discovery of 17 bodies in a small morgue at the Andover Subacute II nursing home in Sussex County, New Jersey, in April 2020. The federal government fined homeowners $ 221,115 for not having a "Substantial compliance," and the attorney general's office began an investigation.
But the owners are still in business.
They have changed the names of Andover and its sister center and installed new signs on the façade.
As of Friday, there were 25 Andover residents with coronavirus, according to state data.
And owners continue to be paid by Medicare and Medicaid, the taxpayer-funded programs that pay most of the costs of America's nursing home operators, even though one of the owners, Louis Schwartz, helped run a chain called Skyline Healthcare, which collapsed in 2019 amid allegations of negligence and financial mismanagement, which the chain denied.
"The individuals who ran Skyline should never be running a nursing home again, and yet here we are," said David Grabowski, professor of health policy at Harvard Medical School, recalling that the pandemic uncovered a sector that was already in crisis, lacking resources and regulation.
"Different names, same practices," Grabowski said.
"We have to make sure there are no such back doors, that nursing homes cannot just rename the building and continue to operate as is," he added.
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Some relatives of those killed in Andover say they are frustrated, and some are suing over the center's alleged lack of preparation to deal with COVID-19 and mixing infected residents with healthy ones.
Farrell joined a lawsuit with other families, but said, “I don't give a damn about the class action lawsuit.
I want these guys to go out of business. "
Before COVID-19
At its peak, Skyline Healthcare had more than 100 facilities and oversaw the care of more than 7,000 elderly residents.
But from 2017 to 2019, the chain began a slow-motion meltdown, and more than a dozen Skyline-operated nursing homes closed their doors, throwing residents, providers, employees and state regulators into chaos.
Many households were left without money.
Others were closed due to negligence, documented in government records.
At an Arkansas nursing home, regulators identified worms in a resident's catheter, according to an inspection.
Fourteen residences were forced to close permanently, displacing more than 900 residents to new facilities, sometimes hours away.
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Skyline's principal owner, Joseph Schwartz, and his son Louis did not return multiple messages and emails requesting comment in 2019. They have denied allegations of negligence.
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The Schwartz family has not left the nursing home business.
Although Skyline has disappeared, Joseph Schwartz is still listed as the owner or co-owner of four facilities, according to federal nursing home ownership data.
Louis Schwartz and Chaim Scheinbaum have interests in at least seven nursing homes between them, including the facility formerly known as Andover Subacute II.
In January 2020, New York health authorities recommended not allowing Scheinbaum to take over a nursing home in upstate New York, citing an "ongoing investigation" and noting that they disapproved of its "character and competence." , according to a document from the Department of Health.
Scheinbaum did not respond when asked to comment on the recommendation.
A year before the coronavirus outbreak, an Andover resident with dementia left the center through two broken doors and was found at 4:30 a.m. sitting in the snow with severe frostbite, according to a federal inspection.
Terri Thompson, her daughter, sued the center, alleging violations of the minimum standard of care.
The lawsuit is pending and the owners have denied the claims.
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Dante Maglioli said that in early 2020, his father, Joseph, complained about the quality of care at Andover.
The family spoke of transferring him to another center.
When the pandemic began to spread, he heard his sister and father talking on the phone.
His father said he wasn't sure Andover could cope with the new and deadly disease.
And then, Maglioli said, "my sister did not speak to my father again," who died on April 9, 2020.
Schwartz and Scheinbaum did not respond when asked to comment on conditions at Andover before the pandemic.
When the pandemic hit, nursing homes in New York and New Jersey, including Andover, took the worst of it.
Eighty-three of the 539 residents of the residence, or nearly one in six, died of coronavirus in the first four months of the pandemic.
Farrell's brother was among the victims.
The Andover Subacute I and II Center was renamed Woodland Behavioral and Nursing Center at Andover.NBC News
Preston Nicolai, then a 20-year-old maintenance worker at the facility, said it was "horrible."
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"Sometimes we lost 10 to 12 people a night," he recalled.
Before the bodies began to pile up in Andover, he was told to move residents from room to room, although the center did not know who had COVID-19 and who did not.
"I think this helped spread the cases throughout the building," he said.
Nicolai said he was told to stack the bodies on top of each other in a small room as the center struggled to cope with the wave of deaths.
On Easter Sunday, April 12, Nicolai said, he went to work and found the body of a woman in an outside maintenance shed, along with shovels, rakes and a lawn mower.
He said there was no more room for corpses inside the nursing home.
“I was morally devastated.
I felt really bad putting someone's loved one in the shed, ”she said.
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He moved the body back into the center, but he cannot get rid of the images.
"I've had really bad dreams, and I don't have the money to pay for a therapist," she said.
They don't even know what they don't know
Documents just obtained through an open records request by our sister network NBC News reveal how the center struggled to cope with the outbreak in April 2020.
Emails from Andover staff members to Sussex County officials document repeated requests for personal protective equipment (PPE) such as masks and gloves, some of which were delivered to the facility.
A summary of an early morning inspection on April 12 written by Kyle Wilson, a registered nurse, and addressed to the Andover Township Police Chief outlines conditions within the facility days before it was posted. the first story about the bodies in the little morgue.
Wilson works part-time at the police department, according to a central operator.
He did not return a call seeking comment.
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Wilson wrote that protective equipment released to the facility by the Sussex County Sheriff's Office was missing.
An Andover employee said the facility was "aware of a batch of PPE 'donated by the Sheriff's office' but could not account for its whereabouts or the existing inventory of PPE at the facility, if such inventory exists."
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Wilson wrote: "Staff were observed to touch PPE (face shield, gown, mask) and face with bare hands."
She wrote that she “confronted [the nurse on duty] with this observed behavior.
She assured me that there was no problem because she was 'not in a room.'
Wilson wrote that there was no evidence of COVID-19 at the center and that staff had not segregated patients suspected of being infected.
He wrote: “In my opinion, acquiring PPE alone will not solve the rate of spread at this center.
Staff are undoubtedly contaminated throughout their shift.
Although the staff are tangibly scared, there is no culture of safety at this facility.
They have not been taught.
They don't even know what they don't know.
Two days later, a Sussex County Federal Department of Health and Human Services Administrator Carol Novrit emailed county officials to say that Andover staff members had told her that residents “ they were not being fed ”, that they had“ open wounds ”and that the deaths of both residents and staff members were not being reported to public health officials.
He wrote that the staff told him that "now there is no infection control."
Schwartz and Scheinbaum did not respond when asked to comment on documents obtained by NBC News.
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Federal inspection reports conducted in mid-April 2020 revealed similar observations, noting that residents with symptoms were intermingled with asymptomatic ones.
Impossible to know
Owner representatives said that at the time it was "often impossible to tell who had coronavirus and who did not due to lack of testing capabilities."
In a statement, the owners of Andover, now known as Woodland Behavioral, said that “the safety and health of our residents has always been the highest priority for Woodland Behavioral,” adding: “The COVID-19 pandemic brought challenges. unprecedented, and our heroic staff dealt with them to the best of their ability.
We continue to thank them for all they did (and continue to do) to protect our residents. "
Representatives for Scheinbaum and Schwartz said they asked multiple government agencies for help, including two verbal requests to the National Guard on April 11 and 15, but were told by military officials they could not assist them.
A spokesman for the New Jersey National Guard refuted his claim.
"The National Guard does not have any information indicating that the Andover subacute center has made a request for assistance, much less that it has been rejected."
The spokesperson said that early in the pandemic, the Guard "supported all the mission requests that we received."
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The National Guard did respond to a request for emergency assistance that Sussex County officials sent to the governor on May 6.
Two days later, 22 members of the Guard went to Andover and performed non-medical tasks, such as cleaning the facilities.
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Homeowners say problems identified in the spring 2020 federal inspections have been resolved with state and federal regulators.
A spokesperson for an industry trade group, the American Health Care Association, said it is "misleading" to focus on the "bad actors" and not the challenges facing nursing homes.
"The real problem is the chronic shortage of Medicaid funding, which barely covers 70-80% of the cost of nursing home care," said spokeswoman Beth Martino.
"This leaves facilities with difficulty investing in improvements, or even keeping their doors open," he added.
The investigation continues
Preston Nicolai said he was fired four months after the overloaded morgue was discovered, accused of improperly disposing of medical waste.
He believes the owners were looking for an excuse to get rid of him after what he saw and the attorney general's office has not contacted him.
However, Sharon Farrell contacted her this April.
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When asked when the attorney general's office would end the investigation, a spokesperson said: "As is our usual practice, we will not provide updates on the investigation or release any additional information unless and until we file an action or close the matter." .
The spokesperson said the Andover investigation is part of a larger investigation of "facilities with a high number of COVID-19-related deaths and a below-average record in terms of health inspections, staffing and quality of care. attention".
The class action lawsuit filed by some relatives of the deceased, including Maglioli and Farrell, recently obtained a legal ruling that allows the lawsuit to remain in state court rather than federal court, according to the families' attorney, Daniel. Leave.
Marchese said that's good for plaintiffs, who can plead their case to a local jury rather than being referred to a federal compensation program established through the PREP Act, which protects companies from some forms of liability after natural disasters such as the coronavirus pandemic.
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Maglioli concluded: “I believe that these gentlemen, their corporation, whatever it is, have to pay the price.
And I don't mean to pay for it in a financial way. "
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