Tom Canavan lived alone in his Rutland home, defiantly independent, until Sept. 24.
It was only when Canavan’s memory started faltering and he wandered from the house that his family persuaded the 94-year-old to move into Rutland Healthcare & Rehabilitation Center, where his wife Mary spent her final years.
His children dropped him off at the door, barred from entering due to Covid restrictions. They would see him again only twice, for 15-minute visits through a plexiglass shield.
In the weeks he spent at the elder care facility, his daughter Debbie Holmes recalled watching in horror as Covid ravaged the facility, infecting 26 residents and 15 staff.
She recalled the numbed disbelief she felt when she got the call that her father tested positive. “It was just surreal for us,” she said. “Why did it have to be right there, on our father’s floor?”
Canavan died of the virus on Nov. 22.
As the number of coronavirus cases in Vermont surges, nursing homes continue to bear the brunt of the impact. About 53% of the Covid deaths in Vermont have been at elder care facilities, according to data from the New York Times.
Genesis HealthCare has been at the center of that death toll. Rutland Health & Rehab is the second Genesis-owned facility in Vermont to fall victim to a major Covid outbreak. The virus swept through Burlington Health & Rehab this spring, infecting 39 people. Eleven residents ultimately died.
In both instances, Vermont Department of Health officials said the facilities had cooperated with state testing and had adequate safeguards in place. But the latest outbreak has highlighted and exacerbated the weaknesses of the Genesis facilities, which have struggled with limited staffing, reduced occupancy and financial losses.
VTDigger is underwritten by:
“Covid-19 is a complex virus,” said Genesis spokesperson Lori Mayer, adding that administrators “may never know” how the virus first took hold at the facility. “Our thoughts and prayers go out to those impacted by COVID-19 during this difficult time, especially the families of the five residents who passed away,” she said.
Holmes said she didn’t blame Rutland Health & Rehab or its workers. “They did the best they could.”
Elizabeth Herriman, whose mother, Mary “Pat” Brown died on Nov. 20, also praised staff. Unable to deliver flowers or food to workers, she and her siblings put a homemade thank you sign up outside the facility.
A weakened facility
Genesis has suffered financially during Covid. The corporation lost $62 million in the third quarter of 2020, according to the latest earnings report. By August, the company reported Covid cases in 241 of 361 facilities.
Occupancy plummeted at facilities around the country. Many homes, which already struggled to recruit employees, lost staff.
Genesis has since sold off nursing homes nationally to cut losses. Officials filed an application to sell five of its nine Vermont facilities — in Burlington, Springfield, Berlin, St. Johnsbury and Bennington.
Some of those nursing homes have a spotty track record in Vermont. The state filed suits against three of the facilities, including Burlington Health & Rehab, Berlin Health & Rehab and St. Johnsbury Health & Rehab. The federal Centers for Medicare & Medicaid Services has cited some of the homes for violations.
Rutland Health & Rehab was not among those who were cited for violations, nor will it be affected by the sale.
The facility did not report a Covid case in the spring, but wasn’t so lucky this fall.
In early October, families were told that a traveling nurse had tested positive for the virus, according to Holmes. The facility went into lockdown for two weeks, but appeared to have halted the spread.
No one else got sick until Nov. 8, when the facility reported its first positive case. This time, the virus spread quickly, primarily among residents on the third floor, the memory care unit.
It’s especially hard to slow the spread of the virus among residents who suffer memory loss, said Mayer. She cited research from the University of Exeter in England that shows dementia patients are among the most vulnerable to infection. Residents may not understand the reasons for the safety precautions, or may wander between rooms, making “restrictions are very difficult to enforce,” she said.
Herriman said she explained the virus to her mother, Brown, a 79-year-old who suffered from dementia. Brown quickly forgot. “They had no idea they have to fight anything,” Herriman said.
Facility staff did what they could to combat the virus. Unlike during the Burlington Health & Rehab outbreak in April, Rutland had enough personal protective gear for staff, Mayer said. The nursing home was conducting testing three times a week, and updated families daily with a 9 a.m. Zoom call.
VTDigger is underwritten by:
Still, cases ticked upward. Brown, a mother of six and a long-time nurse, tested positive on Nov. 13 — Friday the 13th, her daughter noted. She contracted pneumonia and died a week later.
She was one of the five residents who have fallen victim to the virus at the facility, according to Mayer. Among them was 83-year-old John Zawistowski, a former marble worker who could identify the make and model of cars at first glance, according to his 86-year-old brother Hank. “He could tell ‘em from a mile away,” the elder Zawistowski said.
Canavan also tested positive on Nov. 13. He was a World War II vet and Rutland native, who spent a 35-year career working at the Howe Scale Company. He loved to garden, and hold afternoon parties for neighbors and his four kids — the simple things in life, Holmes said.
Holmes had visited her father often when he lived at home, but had trouble contacting him once he entered Rutland Health & Rehab. Canavan didn’t have a cellphone, and each resident was allowed just one 30-minute Zoom call a week, she said. The third floor had just one phone for residents to share, a portable receiver for the facility’s fax machine.
During one video call, Canavan was unshaven and appeared not to have bathed for days.
Unable to visit, Holmes felt helpless. She was wracked with guilt that her father wasn’t living with her. “We had no idea what was going on,” Holmes said. “We were just at their mercy.”
Crippled by Covid
The virus has left the nursing home with challenges of its own.
The 123-bed facility is less than half full, with 60 residents, according to Mayer. With 41 cases, 43% of residents and 18% of staff have tested positive.
Rutland Health & Rehab has reported a “severe need of staffing support,” according to a local posting by Derek Pitts, an Emergency Preparedness Coordinator for the state health department. The facility needed help from nurses and non-health professionals alike, to provide meal delivery, activities and games for residents in quarantine, and Covid screening for staff.
“The shift is whenever you can provide time during waking hours,” Pitts wrote.
Two registered nurses from the Medical Reserve Corps agreed to volunteer and a third will arrive next week, Mayer said. Genesis had recruited staff from other facilities, and Rutland Regional Medical Center staff had also stepped up to fill shifts, said hospital spokesperson Gerianne Smart.
The staff are tested before they start work, and screened daily, Mayer said.
Even with the precautions in place, Herriman predicted the virus will continue to spread. “These places are warm, it’s close quarters, people have roommates,” she said. There will be more cases, and likely, more deaths.
Her family has turned to advocating for Vermonters to help prevent community spread in the first place.
“Maybe just maybe it will spark even one person to do better, and try harder to follow guidelines for their loved ones and community,” she and her five siblings wrote in an email to Gov. Phil Scott. “This is what would give our family comfort.”
Don't miss a thing. Sign up here to get VTDigger's weekly email on Vermont hospitals, health care trends, insurance and state health care policy.