NEW HOPE, Minn. — Gabriela Sikich got a call from the St. Therese nursing home on April 9, telling her that her mother was sick, but that she didn't exhibit all the symptoms of COVID-19 and seemed fine.
A few days later, Sikich got another call. Her mother, 89-year-old Jutta Prisler, hadn't improved, and a test revealed that she was positive for COVID-19. Two days later, on April 14, her mother was dead.
"I'm really angry at the fact that they did not take the time or the protocol that they needed to, which I thought was to test her right away," Sikich said. "The saddest thing is we couldn't say goodbye, that we couldn't hold their hands and say goodbye."
Prisler is one at least 47 St. Therese residents who have died from coronavirus complications.
The day Prisler died, inspectors from the Minnesota Department of Health visited the home as it was in the midst of an outbreak among employees and staff. They found infection control violations that “had the potential to affect all residents, staff and visitors residing in the facility," according to a report released Friday by the health department.
Since the inspection, at least 22 other residents died from COVID-19, state death certificate data shows.
"Hadn't really had any" training'
The health department report said staff told investigators that they didn’t have the proper training to prevent infection from spreading in the home. The nursing home administrator denied that allegation.
During the visit, a physical therapy assistant was seen coming out of a COVID-positive resident’s room in a short-sleeved gown and not wearing eye-protection, carrying a trash bag full of fluids and food, according to the report.
That violated posted warnings saying employees must wear protective equipment including eye-protectors when entering COVID-positive patient rooms – and must remove and bag protective gowns just before leaving the room so as not to spread the virus to common areas.
Despite that warning, she removed the potentially contaminated clothing she was wearing out in a hallway and placed it in a plastic bag that she threw away in a cart meant for non-COVID materials, the report said.
When an investigator spoke with the physical therapy assistant, she said she didn’t know why the resident had been isolated, and that she had been called to the floor to work as a nurse assistant as many staff were out ill due to a COVID-19 outbreak.
She said she hadn’t “really had any training on isolation precautions to be used when someone is suspected to have COVID-19,” according to the report. A nurse later told an investigator that infection control training had not been done for non-nursing staff and didn’t know who was supposed to do that.
The home administrator later told the investigator that staff such as the physical therapy assistant had been trained, but “acknowledged not all staff had been observed for return demonstrations due to the sheer volume of staff employed.”
Also on April 14, a nursing assistant walked out of a COVID-positive patient’s room carrying a gown that was not bagged that he threw into a bin labeled “soiled linen,” according to the health department report.
The assistant, still wearing the same gown he used in the COVID-positive patient’s room, went into another patient’s room to wash his forearms.
When an investigator confronted the nursing assistant, the assistant said, “That is what we told to do” and that he had been trained a few days prior.
In a statement, St. Therese CEO and President Rode, said the home is following the guidance of the CDC and health department and equipping more staff with personal protective equipment.
"We have addressed the issue, which was relatively low-level," she said of the infection control violations. "That there was just one in a detailed inspection of a 258-bed skilled nursing home battling an invisible and sometimes fatal virus is a credit to our committed staff, which is working very hard under trying conditions to protect and care for our residents."
Sikich said she's angry with St. Therese for not doing enough to prevent the death of her mother and so many others.
"Shame on them," she said. "Forty seven residents died in two weeks, they did not have the proper controls in place."
This is the third time in four years St. Therese has been cited for having inadequate infection control practices. In 2016, a nurse failed to wash her hands and correctly use gloves before treating a resident.
In 2017, inspectors found that staff failed to take the necessary safety precautions and failed to report an influenza outbreak in the home.
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The state of Minnesota has set up a hotline for general questions about coronavirus at 651-201-3920 or 1-800-657-3903, available 7 a.m. to 7 p.m.
There is also a data portal online at mn.gov/covid19.