Washington: The coronavirus has preyed on residents of nursing homes in New Jersey with lethal force, claiming more than 4,850 lives. Deaths at long-term care facilities now account for half of the state’s COVID-19 fatalities, well over the national rate.
As of Sunday, 15 nursing homes had reported 30 or more deaths apiece, including four with more than 50 deaths, state records show.
But nowhere has the devastation been starker than at the New Jersey Veterans Home at Paramus, a state-run home for former members of the US military.
The home is built on the idea that those who served in the military are entitled to dignified care in their twilight years.
Instead, in what some people have called a betrayal of this fundamental pact, the Paramus home is the site of one of the biggest coronavirus outbreaks in the country.
The virus has swept through the facility, which in late March had 314 residents, infecting 60% of its patients. As of Sunday, 72 deaths there had been linked to the virus.
Growing list
The list of the dead is almost certain to grow: Of the remaining 211 veterans and their spouses, 120 had either tested positive for the virus or were awaiting results. About 1 in 5 staff members has contracted the virus, and one employee has died.
“The whole place is sick now,” said Mitchell Haber, whose 91-year-old father, Arnold, an Army veteran, died last month at the home, which is about 19km northwest of New York City.
“What they should really do is raze it and put a park there,” he said. “It’s like a mass shooting.”
About 56km south, in Edison, New Jersey, another state-run home for veterans has had 55 virus-related deaths.
The official who oversaw both homes for the state’s Department of Military and Veterans Affairs, Mark Piterski, resigned last month after announcing that he intended to run for Congress.
Staffing levels
He and Gov. Philip D. Murphy have said that he was not asked to step down. Piterski, a retired Army brigadier general, said he had struggled to maintain staffing levels at the outset of the outbreak, when 100 employees a day were calling out sick. He said he had asked for help repeatedly, telling officials, “I need nurses - yesterday.”
What has happened in Paramus is not just a failure by state regulators. The home also gets funding from the federal Department of Veterans Affairs, making it subject to additional regulatory oversight.
Two congressmen and the New Jersey commander of the Veterans of Foreign Wars are demanding a federal inquiry.
Christina Noel, a VA spokeswoman, said in a statement that the agency conducted annual inspections of state-run homes to ensure that they met its standards of care.
“If a state-run home doesn’t meet these standards, then the department will not pay for veterans to receive care there,” Noel said.
Evaluation team
Murphy has hired a team to evaluate what went wrong at Paramus and other long-term care centres in New Jersey, most of which are privately owned.
And the state’s attorney general, Gurbir S. Grewal, has opened an investigation into nursing homes with high fatality rates. The inquiry could lead to criminal charges.
“For many of these facilities, this was the equivalent of a 500-year flood,” Grewal said of the pandemic at a recent news briefing. “But that doesn’t mean that we shouldn’t examine how folks responded when those floodwaters started rising.
“And it also doesn’t mean that we shouldn’t examine how they operated before that flood,” he added. “If they cut corners. If they, or anyone, for that matter, ignored red flags or warnings. If they lied to regulators or others. If they put profits over patients.”
Nationwide crisis
The Paramus home is in Bergen County, the area of New Jersey that the virus hit first and hardest. The facility’s problems are part of a nationwide crisis at nursing homes, which, according to an analysis by The New York Times, are linked to at least 25,600 deaths, more than a third of the country’s virus-related fatalities.
But the virus’ path of destruction through veterans’ homes has exposed a painful vulnerability with national implications. On Tuesday, amid continuing outrage over a Massachusetts home for veterans where at least 70 deaths have been linked to the virus, a group of US senators called for an inquiry into state-run facilities.
Kryn Westhoven, a spokesman for New Jersey’s Veterans Affairs Department, said the homes’ proximity to virus hot spots and the frailty of their residents had contributed to the spread.
“The population is vulnerable,” Westhoven said. “Older. Dealing with underlying health conditions.”
But families of veterans who either died at the Paramus home or are residents there have questioned how things went so wrong, so quickly and why they were not told earlier about the severity of the problem.
“They really kind of held the truth from everyone,” said Stephen Mastropietro, whose 91-year-old father, Thomas, died at the home last month after testing positive for the virus. He had moved there in February.
Mastropietro said he was haunted by his decision not to move his father, who had dementia, out of the facility in late March.
“They said that they had a case, but in another part of the hospital,” he said. “Then 20-something people died that week.”
Friendly and caring
Many relatives described an atmosphere that was friendly and caring before the pandemic. The director shared his cellphone number, visitors gave nicknames to employees and bingo games were sacrosanct.
The home earned average ratings last year on a federal scorecard, with the exception of a below-average mark for food storage.
Waiting lists were common at the Paramus home, which opened in 1986 to provide additional housing for an aging World War II population. One of three military nursing homes run by the state, it admits only those who have been honourably discharged, their spouses and Gold Star parents whose children were killed during active military duty.
In late March, as the virus hit and employees began to get sick, relatives who had been barred from visiting said the telephones at nursing stations rang off the hook.
New Jersey did not require nursing home staff members to wear masks until March 30, and relatives said their loved ones were routinely brought to sit in common areas at the start of the outbreak. By April 9, there had been 10 virus-linked deaths.
Little or no information about the virus was shared, relatives said, until news of the first wave of deaths prompted Murphy to dispatch 40 Army National Guard medics to the home.
‘Catastrophic failure’
Rep. Bill Pascrell Jr., a Democrat who represents parts of northern New Jersey, has a brother-in-law who is a resident at the Paramus home and has tested positive for the virus. Pascrell called the virus’ ability to spread through the facility unchecked a “catastrophic failure.”
“This is not only a tragedy,” he said. “This is an urgent message to all of us. These veterans fought on the field for this country.”
Since April, dozens of nurses from the federal Department of Veterans Affairs have been on site to help staff members. A team of doctors from nearby hospitals similarly besieged with virus patients was recently invited to inspect the home and to share what they had learned about infection control.
“If we can save one veteran from what they’ve learned,” said Rep. Josh Gottheimer, a Democrat who represents Paramus, “that would be a huge help.”
Dr. Adam Jarrett was among those who toured the home. He said it was “clean and organized.”
“We have consistently called for new heights of collaboration and cooperation of the acute-care organizations,” Jarrett, the chief medical officer of Holy Name Medical Center in Teaneck, said. “We should have been there to assist sooner.”
Piterski, who intends to challenge Gottheimer as an independent, said calls from Gottheimer and Pascrell for an inquiry in early April had delayed the arrival of additional nurses and had hurt the remaining workers’ morale.
“They kicked my workers when they were down and when they were pulling double and triple shifts,” Piterski said. The home, he said, serves a vulnerable population, and 175 residents die there of natural causes every year.
