Long before the anonymous tip that led to the discovery of 17 bodies in a makeshift morgue at Andover Subacute and Rehabilitation Center, there were problems at the state’s largest nursing home.
There weren’t enough supplies. Staffing was short. Protective equipment was in short supply.
And as the coronavirus outbreak began to engulf the facility in Sussex County, two nurses, one former and one current, recalled how they would move the sick from room to room with no masks, deal with filthy floors and corridors and handle beds that were not disinfected even after residents died in them.
“It was a horror house,” said one nurse, who said she tested positive for COVID-19 and spoke on the condition of anonymity, for fear of losing her job.
The coronavirus crisis has ravaged nursing homes across the state. Nearly 30% of New Jersey’s COVID-19 related deaths were in long term care facilities or nursing homes, according to Monday’s state department of health statistics. As of Monday afternoon, a total 45 people had died at Andover, with 190 positive cases of COVID-19, according to DOH numbers.
Neither nurse was at Andover Subacute when the makeshift morgue was discovered on April 13. One had already left and one was out on disability. But both said they were working when more and more patients became ill and started to die.
Trying to care for more and more ailing patients without even the most basic protective gear, some nursing home workers would fall ill themselves, fighting an uphill battle against a lethal disease as it ravaged residents who they tried to keep safe.
At the same time, they said there was a stunning lack of transparency and information, even among staff, as the crisis escalated.
“Early on, they said they were preparing,” said the current nurse. “But they never disclosed an exact number to us. Everything was kept kind of hush hush amongst management.
According to the nurses, the situation was already out of control in the weeks leading up to the Easter weekend when 15 residents died.
Andover Subacute and Rehab is owned in part by Chaim “Mutty” Scheinbaum through Lakewood-based Alliance Healthcare Holdings. Scheinbaum also has ownership stakes in nursing homes in Pennsauken and Cinnaminson in New Jersey, and two other nursing homes in Pennsylvania.
In a statement released by Scheinbaum responding to questions from NJ Advance Media, the 37-year old CEO of Alliance said across the country, the virus has hit nursing home patients and their health care professionals the hardest.
“With one of the largest nursing home populations in the state, Andover Subacute II is on the front lines of this crisis, cooperating with public health officials to prioritize patient safety,” he said.
Andover has two separate buildings: Andover I, a smaller facility that serves those with less serious medical issues, and Andover II, a larger unit with many dementia and Alzeimer’s residents, and others suffering from schizophrenia and other mental problems.
BRINGING BODY BAGS
Andover Subactute has been in the spotlight since the discovery that the nursing home was holding 17 bodies in a makeshift morgue April 13, the day after Easter Sunday.
The facility’s existing morgue was little more than a small holding room with a window and an air conditioner, meant to hold two gurneys.
“They’re calling it a morgue,” one of the two nurses said. “It was nothing more than what we called a holding room. Where a patient expired that’s where they went before the funeral home picked them up. It’s disgraceful.”
The township police had been asked to supply 25 body bags on Easter and found five bodies being stored in a room in Andover II, Police Chief Eric Danielson had said. The day after, police found 12 more bodies being stored on site, officials said.
Even before the pandemic hit the nursing home, supplies were scarce, said employees. They would ask for supplies and were told they weren’t coming since the bills were not being paid, said one nurse.
And when the nursing home received a shipment of protective gear from the Sussex County Sheriff’s Office, the home’s administration made it clear that it was not available tor everyone, said one nurse.
The first shipment of protective gear from the Sheriff’s Office arrived at the center April 1, according to a statement from the Sussex County Department of Health and Human Services.
“It was kept under lock and key,” said the nurse. “It was not distributed to the nurses, short of the isolation wing. It was kept under lock and key. We were told ‘Go figure it out. If you want your own PPE, you have to get it.’”
After nurses approached the home’s administrator, demanding answers as to how they could get protective equipment, an employee responsible for ordering supplies allegedly chastised the group, telling them to watch the news to see how scarce protective gear had become, the current nurse said.
Eventually, by early April, staff were given one mask each, said the current nurse. The employees were told to wash and spray the mask with Lysol before reusing it.
Although Scheinbaum would not address the question of whether employees were initially denied protective gear, he acknowledged the lack of protective gear at the facility.
“Like virtually every other healthcare facility across the region, Andover Subacute II has faced challenges due to a general lack of PPE, as well as staffing complications caused by front line workers becoming ill,” said Scheinbaum.
At the same time as nurses were struggling to keep themselves safe while treating sick residents, they were being told to swab their patients as part of the tests for the coronavirus, said the two employees. The testing, which requires healthcare workers to get close to a patient and swab their nasal cavity, was ordered without even the basic training required, they said.
The lack of protective gear and training led to a backlog of residents that needed to be swabbed, said the former nurse. One man died before he could be swabbed for COVID-19, said the former nurse.
“There was no swabs available and he expired before that swab could be done,” the nurse said.
As the outbreak snowballed, nurses were moving patients from one wing to another, sometimes transferring residents who were on the ground floor to the second floor, and from the third floor back down to the ground floor, said both the current and former nurses. They did this with no protective gear, said the current nurse.
“Talk about cross contamination? Oh my god. Oh my god,” said the current nurse.
As workers scrambled to move sick patients from one area of the hospital to the other, they struggled with waning staff, said both employees. For the 11 p.m. to 7 a.m. shift, there was one nurse covering two wings of the facility, with more than 50 residents in each, one nurse said.
While Scheinbaum did not address staffing for specific shifts, he said that the illness affecting employees has caused the facility to operate with a smaller staff than usual.
“While Andover Subacute II has a full complement of licensed and qualified staff, unfortunately some of its front line workers have been impacted while fighting this pandemic and are unable to return to work at this time,” he said in the statement. “The facility is working with the Department to find replacements for those people who have become ill, has already retained a licensed nursing home administrator consultant along with a certified infectious disease consultant, and is otherwise working to ensure that the facility has qualified professionals to deal with this unprecedented health emergency.”
Scheinbaum said that staff was given updates regularly, but did not specify if staff were notified of new positive cases of COVID-19 as they were reported.
“We communicate regularly with our staff directors in daily meetings and conference calls to provide the latest updates on what is happening across our facility,” his statement said.
Separately, both employees said it was extremely difficult to get information to residents’ families.
“We had families calling continuously,” said the current nurse. “They didn’t want anything disclosed to families. They weren’t sharing the details with us staff. It just goes on and on.”
At least three relatives of residents previously told NJ Advance Media that it was almost impossible to reach anybody at the home. Francesca Veen said it took her four hours to get through to the home to check on her grandmother.
The facility has been barred by the state Department of Health from admitting any new patients, and the state ordered Andover to retain an infection control expert and key consultants.
One of the two nurses, though, said somebody needs to be held accountable.
“The owners, the administration. It was horrible. It was downright criminal how they went about everything,” said the nurse.
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Rodrigo Torrejon may be reached at firstname.lastname@example.org.