Copyright © 2020 Albuquerque Journal
In a notice posted March 30 on the website for La Vida Llena, a large Albuquerque retirement community, executive director Linda Givens detailed some changes wrought by COVID-19.
The retirement community would be postponing all group activities, she wrote. It had also closed La Vida Llena’s on-site fitness centers and hair salon. The facility had delayed closing its on-campus amenities past the dates the governor ordered similar facilities closed statewide.
At the time, its dining rooms remained open.
“Management recognizes that these are drastic measures, but we think if we limit the time of closeness to mealtime, we can be OK for now,” Givens wrote in a post that has since been removed from the website.
“Be assured we will adjust in whatever area if it is required. We appreciate your cooperation and taking social responsibility so that we can all be safe.
“We do not want the virus in our community.”
A day later, Givens announced the first known coronavirus case among La Vida Llena residents.
And a day after that it closed its dining rooms.
By the end of the week, on-site testing exposed an outbreak.
To date, 33 staff people have tested positive and 31 residents have had positive tests – 28 from the health care unit, including at least 16 who have died, and three in the independent living area. Nobody has tested positive in the other units, according to La Vida Llena’s numbers.
The health care unit, which had 43 residents as of April 1, currently has 24.
Deaths linked to La Vida Llena account for about one in six of all statewide deaths in coronavirus patients.
The virus’ surge through the facility has prompted staff to publicly raise concerns citing inadequate preparation and mitigation, and triggered an investigation by the office of New Mexico Attorney General Hector Balderas, who has described various “deficiencies” in the facility’s coronavirus response.
While more than 10% of its employees have been infected with COVID-19 and the virus has inundated the health care unit, La Vida Llena notes that the vast majority of the residents on its large campus have tested negative.
“We have and will continue to do everything possible to protect our residents and employees – and to do what we can to work with the various federal, state and local agencies who have helped guide our response,” the facility said in a written statement.
Nursing homes around the country have struggled to combat coronavirus, including in New Mexico where the state reported five new deaths at one facility in Farmington.
PPE not used
The New Mexico Department of Health has been retesting at La Vida Llena and is working with the state Aging and Long-Term Services Department on “active and ongoing day surveillance” at the facility, according to a DOH spokesman. He said the facility has been cooperative and is ensuring compliance with state and federal guidelines for COVID-19 management.
But Balderas said earlier this month his agents interviewed staff, contract workers, residents and their families and the investigation’s preliminary findings show a host of problems with how the facility handled the virus.
He reported in a letter to New Mexico Health Secretary Kathy Kunkel that the facility failed to use personal protective equipment, or PPE, and that staff were even discouraged from using it as late as early April.
“One wonders if this crisis could have been prevented or mitigated had LVL chosen a divergent, more cautious course of action,” Balderas wrote.
In an interview with the Journal, Allen Gonzales, who worked at La Vida Llena’s on-site salon, said that Givens herself on April 1 stopped to question him after she saw him wearing a mask while he helped clean the building.
“I said, ‘I’m wearing it just to protect us,'” Gonzales told the Journal. “She goes, ‘You really don’t need to be doing that – wearing that mask – all you’re going to do is scare and get the residents worried that something bad is going on.'”
La Vida Llena’s management declined a Journal interview request but answered questions via email.
The facility said there was an effort to preserve supplies prior to the outbreak but that employees “were not actively discouraged from wearing masks.” All employees are required to wear masks now, the facility said, and everyone had received masks – including some sewn by residents – as of April 3 or their next working shift.
Balderas’ letter said his office’s early investigative findings are that the facility did not adequately communicate to residents, who felt they had to rely on outside news outlets for crucial information, and medical personnel, who treated patients without being told they had tested positive or been exposed to COVID-19.
“This practice, coupled with the habit … of discouraging PPE use, needlessly put many additional staff members at risk of contracting the virus,” he wrote.
His office also noted the facility’s noncompliance with public health orders.
The facility contends Balderas’ findings are incomplete because they are based on 32 interviews out of 448 residents and 302 staff.
“None of those interviews have included La Vida Llena management or supervisors,” a La Vida Llena representative wrote to the Journal. “We understand why investigators at this early stage might have incomplete information about La Vida Llena based on such a tiny sample size.”
‘This is not right’
An upscale retirement community, La Vida Llena offers a range of housing situations, including independent living, assisted living, health care and memory care units.
All of the deaths at La Vida Llena have been tied to the health care unit, which the facility says is home to the frailest residents with the most underlying health conditions.
But La Vida Llena’s first known case was in an independent living resident. Givens had reported the case in a website post dated March 31, saying the resident was hospitalized and had been exposed to the virus by a “private caregiver.” The resident had tested positive three days prior.
By April 3, state officials reported more than 20 coronavirus cases, including two deaths, linked to the facility.
Like Balderas, employees have questioned whether management took appropriate measures to stop the spread.
“They weren’t doing what they were supposed to do, which is why they’re in the shape they are in now,” said Penni Johnston, who has worked nearly three years as a cosmetologist at La Vida Llena but recently filed for unemployment after she said she was reassigned to cleaning and organizational jobs.
Johnston said she raised concerns about how long La Vida Llena kept its on-site salons open.
She said the facility did not close them until March 25 – and then asked staff to continue performing services in patient rooms, something La Vida Llena said was offered only temporarily.
Gov. Michelle Lujan Grisham’s administration ordered all nonessential businesses, including salons, to close effective March 24.
One of Johnston’s salon colleagues ultimately tested positive for COVID-19, she said.
“I kept telling my boss, ‘This is not right. You’re bringing us in and out and in and out of here every day,'” she said. “We’re risking our lives and more so than that the residents’ (lives). … We were all worried.”
She said the management was “very secretive” about the situation and employees learned more from news media reports.
A hospice provider with clients who live at La Vida Llena – four of whom have tested positive for COVID-19, including one who died – said the facility recently prohibited one of his nurses from entering. He said it has been difficult and frustrating for his staff to get health updates for clients inside the facility, getting three returned calls out of 37 attempts between mid-March and mid-April.
“I’m very concerned with the quality of care that’s being provided and making sure my patients are comfortable at end of life,” said the provider. La Vida Llena said it is “particularly sensitive” to outside caregivers, but that “it is our policy to work cooperatively with hospice providers and to allow hospice providers access to our residents at the end of life, following recommendations from the DOH.”
La Vida Llena took a phased approach to shutting down its community.
On March 14, it quarantined its health care areas, limiting entrance to staff and “essential health care providers” and doing regular temperature checks, a representative told the Journal. However, if residents needed help eating, they were taken to the health care dining room, where they sat two residents per table. The facility said it expanded meal time to allow for two separate seatings.
La Vida Llena banned visitors except at its assisted living facilities on March 16 and began delivering meals to those residents’ rooms.
By March 18, it banned visitors at the independent living areas, except for “essential” providers who help residents with chores like shopping, laundry and bathing.
“These visitors were required to check in through the main entrance and follow protocol,” the facility told the Journal.
But one employee told the Journal the policy did not keep people out. Even after the restrictions, the employee said she reported to supervisors that visitors were coming in via the building’s many other doors.
In La Vida Llena’s first coronavirus case, Givens noted the resident had been exposed by a non-employee “care provider” and that other independent living residents had also been exposed by a non-employee provider.
“The problems we have had are from external providers coming into the building and they or their client not following the recommended protocol,” Givens posted in a March 31 update.
Dining, fitness open
While La Vida Llena announced restrictions about who could enter the facility in mid-March, it took longer to shut down areas where residents congregated or interacted with others.
A statewide public health order, effective March 19, forced gyms to close and restaurants to stop dine-in service, but La Vida Llena did not close its on-site fitness centers or communal dining rooms until more than a week later.
“We are … aware that gyms have been closed citywide. We have made a decision to leave our Fitness Centers open with some requests and limitations,” Givens wrote in a post dated March 23, telling residents to wipe down equipment before and after use and that only two to four people could exercise at the same time.
La Vida Llena did not close its community dining rooms until April 1 – following instructions from the city’s Environmental Health Department.
The facility’s management told the Journal that the independent living dining room stayed open until April because it is “not considered a restaurant” per the state’s guidelines, but that staff limited the number of people sitting at each table.
While La Vida Llena started limiting attendance for group activities on March 20, it did not cancel group activities until March 30.
Several people with ties to the facility say it moved too slowly given the nature of the threat.
Coronavirus has wreaked havoc at nursing homes and similar facilities around the country. The disease in late February tore through a Seattle-area nursing home in a high-profile outbreak that has now been linked to 43 deaths, according to the Seattle Times. Nursing homes and other long-term care facilities in the U.S. have seen over 36,500 coronavirus-related cases in residents and staff, and over 7,000 people have died, the New York Times reported last week.
Anita Summers, whose 87-year-old mother is an independent-living resident at La Vida Llena, said she began calling the leadership in mid-March raising concerns.
Summers said in an interview last week that she thinks Givens waited too long to restrict residents’ activity and gatherings and failed to communicate the seriousness of the situation to people living on the campus.
“I don’t know the legality of it. I don’t know the recommendations. I don’t know what (executive director Givens) was and wasn’t required to do,” Summers said. “Even if I didn’t know about the horrible way they handled it with staff, I think she had a moral obligation to do something a lot sooner.”