Official reports of 8 more nursing home deaths fell through the cracks

State Health Officer Ayne Amjad said officials were aware of multiple deaths of residents at a Princeton nursing home but were hindered in publicly reporting the deaths because of staffing issues at the facility and at the local health department.

Ayne Amjad

“We need the proper documentation,” Amjad said in a Sunday telephone interview. “We have to be sensitive when announcing it publicly, especially when it relates to covid.”

Amjad continued, “We are working on clarifying the processes at a local level so that delays do not happen.”

The state Department of Health and Human Resources on Sunday morning reported the deaths of eight residents of the Princeton Health Care Center. That was on top of three deaths previously reported at the facility.

DHHR said the deaths occurred over the course of the last few weeks but were not reported in an official capacity due to personnel changes at the Mercer County Health Department.

Those who died include an 80-year old woman, an 87-year old woman, an 86-year old woman, a 79-year old woman, a 91-year old man, a 78-year old woman, an 89-year old woman and a 76-year old man.

Bill Crouch

“We are deeply saddened by the passing of these eight West Virginians,” said DHHR Secretary Bill Crouch. “Our condolences are extended to these families during their time of grief.”

The nursing home has been dealing with an outbreak for weeks. Right now there are  34 active resident cases and 21 active employee cases. The facility has gone through round after round of testing.

Amjad said officials were aware of deaths from the nursing home, but steps in officially reporting the deaths were delayed by several factors.

“If any piece is missing in that puzzle, that’s why. Everything has to be accounted for, documented. It can’t just be word of mouth. You cannot make a mistake with saying something,” Amjad said.

So one factor is that DHHR tries to be particularly careful about reporting deaths after early missteps.

Early on in West Virginia’s coronavirus response, in March, the state reported two deaths on two different occasions that turned out to not be true.

“Two different places, two different counties. And in both situations, just to tell it like it is, we weren’t right,” Gov. Jim Justice angrily said at the time.

Those mistakes began at the local level and then were passed along to DHHR. Officials at DHHR said they would work harder to verify deaths through two confirmations.

So the state requires a death certificate as well as a death report that includes additional information about the circumstances.

“To be accurate and sensitive to families, the state requires a death certificate and death report in order to classify a death as covid or probable covid related before including it in our dashboard,” Amjad said.

In Mercer County, there have been extenuating circumstances with officials who could make sure that reporting is done.

Dr. Charles J. Mirabile, medical director at Princeton Health Care Center, was diagnosed with covid-19 as the virus spread through the nursing home, the Bluefield Daily Telegraph reported. He was recently transported to J.W. Ruby Memorial Hospital in Morgantown, where he is on a ventilator.

Medical needs of residents are being met right now by Dr. Ryan Runyon, the facility’s associate medical director.

The other issue was the mass exodus of leaders with the Mercer County Health Department.

Earlier this month, Mercer health department administrator Susan Kadar turned in a retirement letter, and health officer Kathleen Wides also resigned. In reaction, health board chairman Randy Stevens also resigned.

In its own announcement of the eight nursing home deaths, the local health department cited the departures and confusion over reporting procedures.

“The delayed reporting of these deaths was influenced by two factors: First, the sudden vacancy of the medical director position at PHCC, and second, a misinterpretation of standing COVID-19 state procedures pertaining to the need for verification of death certificates prior to reporting,” the local health department stated.

Death reporting procedures are being updated “based on the new clarification of directives to ensure there will be no delay in future reporting,” stated Dr. Randy Maxwell, chairman for the county health department.

Amjad has been filling in for the past couple of weeks as the health officer for Mercer County while also carrying on her relatively new duties as the state health officer.

Amjad went in person to the Princeton nursing home last Sunday.

The prior Friday and Saturday, she had spoken on the telephone with Mirabile, the facility’s medical director who wasn’t yet hospitalized, to try to get a feel for the situation.

“I wanted to talk to him before showing up there,” Amjad said.

The two decided additional blood work needed to be ordered for residents.

But by the time she arrived, Mirabile was out. Amjad said she spent about 3 hours with administrator Stephanie Compton and registered nurse Tabitha Billings, an infection control specialist.

Meanwhile, blood work results returned, showing that some residents were dehydrated or had abnormal lab results. As a result, 16 residents went to local hospitals that Sunday night.

“We wanted to make sure they were stable and safe,” Amjad said.

Crouch, the DHHR secretary, publicly announced the 16 hospitalizations that Monday during a regular briefing about West Virginia’s coronavirus response.

“So we have some real concerns. We have been in constant contact with the administration down there, with the CEO,” Crouch said that day.

Even at that time, Crouch described the local health department being in disarray and said the state was trying to get a better grasp on any fatalities.

“We have three reported deaths, but again those deaths are reported through the local health department. We are trying to confirm additional deaths through the health department,” Crouch said on August 3.

This Saturday, August 8, Amjad called the local health department herself to push the official paperwork through.

On Sunday morning, DHHR was finally able to provide public information about the deaths.

Amjad, during a Sunday telephone interview, said several steps have been taken to try to help the Princeton nursing home.

In addition to multiple rounds of testing, the National Guard has been on site to help the facility check its air system, aiming to suppress the spread of droplets. Plastic sheeting was placed between doors.

“We were trying to find ways to mitigate the spread,” Amjad said.

Amjad said the nursing home’s situation seems to be improving.

“They have a lot of hard workers who are doing their best,” she said.

“It’s emotionally tolling on them too. Some of their residents they’ve been with them a long time. It’s emotionally draining for them. We’ve been trying to help them and trying to encourage them.”

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