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Saying Sagepoint Nursing and Rehabilitation Center jeopardized the health and safety of its residents, the Maryland Department of Health is fining the Charles County facility $10,000 a day dating to March 30 for “widespread deficiencies” in testing, providing its staff with protective equipment and isolating those who tested positive for the coronavirus.
Sagepoint, which has more deaths than any other nursing home in Maryland, came under scrutiny as officials sought to control the spread of the virus through such facilities, sites of nearly three in five COVID-19 deaths in the state. According to Maryland data, at least 34 residents and one staff member at the home in La Plata have died of the respiratory disease and 97 residents and 32 employees have tested positive for the coronavirus.
“Your facility failed to implement an effective infection control program,” said a letter to Sagepoint dated Wednesday and signed by Dr. Patricia Tomsko Nay, executive director of the health department’s Office of Health Care Quality.
The fine is the first civil penalty the state has imposed on a senior living facility since the coronavirus began its spread.
“Based on the seriousness of these findings, it is imperative that you immediately determine the measures that are necessary to correct these deficient practices, what systemic changes you will develop to ensure that this does not happen again, and what quality improvement process will be implemented to oversee the system,” Nay wrote.
[ Map: Nursing home coronavirus cases, deaths in Maryland ]
The violations were so serious that inspectors considered two residents in “immediate jeopardy,” health department spokesman Charles Gischlar said in an email late Thursday night.
“An immediate jeopardy is when a facility’s noncompliance with regulations has caused or is likely to cause serious harm or death to a resident,” Gischlar said. “This is the most serious type of deficiency and carries the most serious sanctions.”
Sagepoint was required to immediately rectify those issues, and state surveyors who returned to the facility found the residents no longer under “urgent” risk Gischlar said.
Sagepoint officials said in a statement they “strongly disagree with the findings contained in the letter, and we will be disputing them directly to the Office of Health Care Quality." The statement also noted that the agency told them that all of its concerns had been successfully resolved.
But Gischlar said Office of Health Care Quality will issue a full report to Sagepoint identifying “multiple systemic weaknesses in infection control.” The facility then has to submit a plan within 10 days for how it will correct the problems, which will be reviewed by the agency, he said. Inspectors will make unannounced visits to assess whether the plan is fully implemented, he said.
The citations caught some Charles County officials by surprise because they said they were led to believe Sagepoint was getting the problem under control.
State Del. C T. Wilson, a Democrat who represents the county, said he had asked Sagepoint officials about reports that staff did not have adequate protective gear. He said he was told that wasn’t true.
“It kind of looks like it was,” Wilson said. “I’m beyond furious. These are all very serious violations. This is so crushing to see.”
Reuben B. Collins II, the president of the Board of Charles County Commissioners, said he, too, was under the impression from regular briefings by Dr. Howard Haft, a physician assigned by the Maryland Department of Health to oversee the county’s response to the coronavirus crisis, that “things were for the most part under control.”
[ Coronavirus in Maryland: Everything you need to know ]
A YouTube video of Haft’s April 21 briefing to the council shows council members asking him about testing, data and devices for family members to communicate with residents of nursing homes now that in-person visits were not allowed. After a council member, Thomasina O. Coates, asks “what aggressive process are you putting in place to combat what’s already happening,” apparently in reference to Sagepoint’s number of cases and deaths, Haft details what he and other health officials have done.
"I reviewed the process that was in place there,” said Haft, going on to mention testing for all staff and residents and separating residents according to their test results.
“All of those things were put into place and documented,” he said.
He said he asked specialists in infection control at the department to conduct a “more granular” review as well.
“They reported back there was complete compliance there," Haft said.
Haft could not be reached for comment Thursday.
According to Nay’s letter, the state began its survey April 21 and continued through May 6 ″to determine if your facility was in compliance with State regulations.
[ How to add your voice to our coverage of COVID-19 in Maryland ]
“This survey found that your facility was not in substantial compliance with the State regulations," the letter said. "In fact, conditions at your facility posed immediate and serious jeopardy to the health and safety of your residents.”
The letter accuses the facility of failing to obtain lab results in a timely manner, use appropriate hand hygiene and personal protective equipment, and group together those with known or suspected cases of COVID-19.
Previously, the facility has said it “fought hard” to test all residents but received “little support from any local or state agencies.” It attributed its high death rate to the age and medical vulnerability of its residents, who on average are 89 years old.
Asked for an earlier Sun article about staff complaints that they did not have adequate personal protective equipment and had to arrange for their own coronavirus tests, Sagepoint spokeswoman Joyce Riggs said the facility “always had and issued the appropriate PPE to follow the CDC guidelines at each stage however acquiring PPE through all supply chain sources has been and continues to be challenging.
“There were not enough test kits available to universally test staff initially,” Riggs said. “Staff who needed to be tested due to symptoms or exposure were directed to follow up with their primary care provider for screening and testing.”
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For Tammy Semega of La Plata, the news of the state’s crackdown on the facility comes at a bitter moment: Her father, who tested positive for the virus in April, died there Wednesday.
“They need to be closed down,” Semega said. “They don’t deserve to be taking care of our elderly.
“Look at the numbers," she said. “They did not run this right.”
Semega said she had called and filed multiple complaints about Sagepoint, because employees had been saying they were short-staffed and did not have enough protective equipment. She said her father had lost more than 30 pounds because he wasn’t eating and it seemed there wasn’t enough staff to make sure that he did, Semega said.
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She was told April 10 that her father, Michael Fanase, a 91-year-old who had fought in World War II, tested positive for the coronavirus, although he appeared to have only minor symptoms. A second test was negative but because he had a slight fever, he was moved to an area for those who tested positive, she said.
While the state findings echo some of what she and other family members have been saying, that offers little comfort, she said.
“I won’t feel vindicated until their doors are closed,” she said.