Problem-plagued Annandale Healthcare Center accepts new patients, prepares for Phase 2

Someone’s mother lives in this room at the Annandale Healthcare Center.

Updated Aug. 16: The Annandale Healthcare Center (AHC), the nursing home with the most COVID-19 cases and deaths in Virginia, is still on lockdown but plans to enter Phase 2 by the end of August. 

The Virginia Department Health (VDH) lists the AHC as having had 156 cases and 55 deaths, although there have been additional cases and deaths since that those numbers were reported. AHC advised patients Aug. 8 via robocall that another resident and a staff member tested positive. 

COVID prevention failures

The VDH just released a new report on the AHC based on COVID-19 surveys conducted July 22-23. It states: “Based on observations, staff, and resident review interviews and facility documentation, the facility staff failed to ensure infection control measures were consistently implemented to prevent the development of transmission of a communicable disease (COVID-19).”

Among findings in the report: 

• “Staff failed to follow the facility’s screening process to include temperature checks and questions related to COVID-19.” 
• Staff entering the facility and waiting to be checked in failed to position themselves six feet apart despite markings on the floor directing people where to stand.
• Staff ignored signs by the elevator stating “no more than two people per ride.” An employee with a resident in a wheelchair told an inspector “you can ride with us; we don’t count two persons per ride when we have a resident with us.” 
• The receptionist let a milk delivery person into the kitchen twice without proper screening. 
• A housekeeper was observed removing trash from resident rooms using her bare hands then took the bagged trash to the biohazard room and didn’t wash her hands.  

Patients at the Annandale Healthcare Center are not allowed on this outdoor deck.

Meanwhile, the resident who reached out to the Annandale Blog, whom we’re calling “Angela” to protect her privacy, has observes staff failing to follow safe health procedures to prevent the spread of the virus. She also reports a long list of deficiencies that is making the AHC an unpleasant living environment.

New patients admitted

While visitors are banned and residents aren’t allowed out, the facility has been accepting new patients since July 1. The VDH report notes that the AHC is certified for 222 beds but has 131 residents.

A woman whose aunt was at Manor Care at Fair Oaks moved her into the AHC in early August. The aunt had tested positive for COVID early in the pandemic but was asymptomatic. She had to have three negative tests before being admitted to the AHC. 

The niece was unhappy with Manor Care. She said staff members dropped her aunt several times and weren’t responsive when she needed assistance getting to the bathroom. Manor Care at Fair Oaks had 136 COVID cases and 13 deaths, according to the VDH. 

Related story: The Annandale Healthcare Center during COVID lockdown: ‘worse than prison’

The niece had heard about the problems at AHC, but felt “they’re under more scrutiny now and they need to step up their game.” Despite some problems on moving day – including a long delay and some fumbles getting her out of the car and into the building – the niece says her aunt is happy with her new home. 

Ready for Phase 2?

The VDH doesn’t disclose what phase various facilities are in and views its recommendations on phases for long-term facilities as guidelines, not hard-and-fast requirements, says Brenden Rivenbark, senior policy analyst in the office of Virginia’s health commissioner. 

“Ultimately right now, these restrictions and guidance are at the discretion of the facility,” Rivenbark says.

Under the VDH guidelines for Phase 1, visitors aren’t allowed except for patients in a compassionate care or hospice situation, he says. 

Related story: Virginia nursing home with the biggest COVID outbreak is in Annandale

“In order to move to Phase 2 Annandale must go through two additional rounds of full-facility testing. The issue is that testing is taking a really long time,” says Beth DeFalco, a spokesperson for CommuniCare, AHC’s parent company. 

“We are pushing ahead to get to Phase 2, but until the testing speeds up, we can’t move into that phase,” DeFalco says. 

AHC advised residents that the next building-wide COVID test is scheduled for Aug. 24. 

A typical room, with insufficient room to use a wheelchair.

DeFalco insists that the deficiencies cited in a May report by the VDH are being addressed. She sent the Annandale Blog a July 23 report drafted by the Infection Prevention and Control Team at the Veterans Health Administration calling the AHC a “very clean, well-maintained facility.” 

Despite those claims, residents received a robocall from AHC stating a health inspector found staff weren’t washing their hands after disposing human diapers in the trash room, as well as not practicing social distancing in the break room and nurse stations. 

Residents confined indoors

Under Phase 2, visitors are still prohibited but group activities are allowed for 10 or fewer people with social distancing. 

Residents can be taken outdoors on the facility’s property during phases 1 and 2, “if there’s a safe place with PPE for staff to accompany them,” Rivenbark says. 

At the AHC, however, residents aren’t allowed on the rooftop deck or outside at all. 

Angela, who’s been at AHC for five years, hasn’t been outdoors since the pandemic started in March.

“We have a beautiful patio upstairs, but we can’t sit there, even two at a time for 10 minutes,” Angela says. “If they are allowing new residents, why can’t they let us sit outside on our deck?”

Meanwhile, as AHC prepares for Phase 2, the facility is hoping to bring residents to the parking lot for photo shoots with classic cars. 

Health protocols not followed 

Months after AHC was cited by VDH inspectors for not following COVID safety rules, Angela says many employees still aren’t wearing masks, face shields, gloves, or hair coverings – except when they’re expecting a visit from public health officials. She says some staff members who deliver meals to residents’ rooms don’t wear gloves as they take food off the trays. 

Angela is wary of leaving her room because the halls are often too narrow and too crowded to permit social distancing. 

“If you’ve got staff not social distancing when they’re working here, you know they’re not doing it when they leave,” Angela says. “You know they’re going to bring it back. Common sense tells you that.” 

Clarification sought 

Rep. Gerry Connolly reached out to the VDH in July asking for an investigation of the AHC, citing the reports of inadequate health measures in the Annandale Blog, other news articles, and the VDH itself. He also asked for clarification of the data reported by the VDH Long-Term Care Task Force that categorizes the AHC as “outbreak pending closure” despite more recent cases and deaths. 

In response, Rivenbark said the VDH data reflects “two focused infection control surveys at Annandale Healthcare Center based on findings observed via data submitted by Annandale to CMS [Centers for Medicare & Medicaid Services]. The complete report on findings based on those surveys is being developed.”

Related story: Public health officials cite deficiencies at Annandale Healthcare Center

“Our epidemiology teams work with facilities to confirm identified cases and report those data through the Virginia Electronic Disease Surveillance System,” Revenbark says. “Outbreaks are listed as ‘pending closure’ when more than 28 days have passed since the onset of the cases.” 

A typical bathroom in a patient’s room.

Even though positive cases were identified during a June 29 point prevalence survey, Rivenbark says, it could still be listed as “outbreak pending closure” as of July 15 if the onset of the identified positive cases was confirmed to be 28 days or more prior to July 15. 

While CommuniCare, claims the VDH data is incorrect and overstates the number of COVID deaths, Rivenbark says the VDH data is more accurate than other self-reported data systems. 

Resident fears for her health

Angela is worried that lax health measures at AHC will result in more cases and deaths. 

She says housekeepers that had tested positive and had quarantined at home have returned to AHC and are cleaning rooms of residents who tested negative. 

Angela is particularly upset that AHC has been slow in sending COVID patients to the hospital. 

“It blows my mind that 11 residents died here and they never sent them to the hospital,” she says. “If that isn’t gross negligence, then what is?”

A previous Annandale Blog story noted that Chris Duncan had to insist that his COVID-stricken mother be taken to the hospital. After she died, it took him weeks to get AHC staff to release her medical records. They finally agreed to hand over the records but they are charging him 25 cents a page. 

Substandard living conditions

Aside from the restrictions due to the pandemic, the conditions inside the AHC are unhealthy, unsafe, and unpleasant – and have been so for years, Angela says. 

“So far, for breakfast, I have gotten a rotten banana every day, an untoasted English muffin, and unfried turkey sausage link,” she says. She has been served meatballs and hamburgers that are raw inside and ham too tough to cut. At one point she saw a bug trapped under the plastic wrap on a Boston cream pie. 

A banana for breakfast.

Vending machines, along with the physical therapy room and hair salon, are off limits because residents with COVID were moved nearby. 

She says residents with disabilities are in rooms that are too small to maneuver a wheelchair and don’t have accessibility features in the bathroom.

Among other failings at the AHC cited by Angela: 

• Bathroom tiles falling off the wall, with what looks like black mold underneath.
• Water-stained ceiling tiles in her room. 
• Water on the floor from leaky pipes
• Black flies congregating on the curtains around the beds. 
• Only 36 inches of space between roommates’ beds. 
• Windows are locked, so there is no way to get fresh air. 
• Black gunk on the air conditioner vents. 
• Holes in the bed sheets and sheets so thin, they are transparent. 
• Light switches and electric outlets too hard to reach. 

The center doesn’t send doctors to check on patients, Angela says. “They just walk in at night to see if you’re still there. They don’t ask how you’re doing or what you need.” 

Staff failed to fulfill requests for over-the-counter medications like Aleve or Advil, she says. Physical therapy consisted of helping patients walk down the hall three times a week. “That lasted about three or four weeks and that’s it.” 

“A monkey could run this place better,” Angela says. “These people don’t have a clue.”

Angela moved in to the AHC in 2015 because she had a blood clot in her leg and couldn’t feel the floor or walk. After being bedridden for a long time, the feeling started coming back, and she is now able to walk using a walker. 

She feels like she could live on her own and would like to move out of the AHC, but with a lockdown in force, no one is allowed to come in and help her move. 

She worries they will take revenge if she complains too much, but “if they kick me out, I’ll say thank you.”