Candace Falk got the call from the assisted-living facility in Hugo on May 14: Her 83-year-old mother had tested positive for the coronavirus.
She was assured that her mother, Gladys, was not showing symptoms and that staff at the senior home would provide the family with regular updates on her condition.
Instead, it was the last time that Falk would hear from the facility, Encore at Hugo, until two weeks later when a nurse found her mother in a laundry basket, bruised and disoriented. Her health had deteriorated so rapidly that she would need end-of-life care, the nurse said.
Days later, her mother died of COVID-19.
“There was almost no communication until it was too late,” Falk said. “It was my worst nightmare.”
Her experience highlights the crisis still unfolding in Minnesota’s senior care communities, which remain the center of the COVID-19 pandemic with 1,172 reported deaths since mid-March. The total number of long-term care facilities with at least one known case of the virus has nearly tripled since May 10, according to state health data.
As lawmakers reconvene this week for a special session, elder care advocates and families are renewing their push for new consumer safeguards to protect thousands of seniors who live in lightly regulated assisted- living facilities, citing an urgent need to prepare for the duration of this pandemic and future virus outbreaks.
Advocates and some DFL lawmakers are supporting a far-reaching bill, introduced Monday, that would increase state oversight of assisted- living homes and upgrade many long-standing practices that they contend have contributed to the large death toll in these homes.
The proposed safeguards require facilities to draw up detailed plans for responding to acute respiratory viruses like COVID-19. And they must take other steps such as installing cameras in residents’ rooms, on request, to enable family members to better monitor their care.
The bill would prohibit evictions from assisted-living homes during public health emergencies, a response to rising complaints of arbitrary discharges during the pandemic. It also calls for a statewide task force to come up with ways to minimize deaths in long-term care facilities resulting from respiratory viruses while protecting the rights of residents.
“Especially during a time of a pandemic, families need to have some certainty that their loved ones are cared for,” said Rep. Ginny Klevorn, DFL-Plymouth, author of the legislation in the House and member of a long-term care committee. “They are at their most vulnerable and we want to make sure that all citizens of Minnesota are cared for.”
Many of Minnesota’s 1,700 senior care communities were caught unprepared by the pandemic.
Some providers were so short on emergency supplies that they had to put out calls for homemade masks and converted graduation gowns and rain ponchos to use as protective gear. Other homes ran dangerously short on staff as workers fell sick or stayed home to avoid getting infected.
Widespread testing in such facilities was not rolled out until late May. On top of that, government guidance on when and how much to disclose on COVID-19 outbreaks kept changing, which sowed confusion and anxiety.
“COVID-19 exposed systemic shortcomings and a surprising lack of infection control protocols and supplies that should have been in place a long time ago,” said Kristine Sundberg, executive director of Elder Voice Family Advocates, the main group backing the consumer protection bill.
Problems have been especially acute in many smaller assisted-living facilities, which resemble apartment buildings with services. Some of these homes have only one or two spare rooms, making it impossible to isolate infected residents on separate floors or wings. People share hallways, bathrooms and dining rooms.
About 40 residents of an assisted-living facility in Wayzata were evacuated in April after COVID-19 swept through the home, infecting a majority of its residents and staff members and killing two residents.
Minnesota Department of Health officials, who regulate senior homes, have cited encouraging data showing that cases and deaths from the coronavirus have declined significantly in long-term care facilities. Last week, the state recorded 13 deaths from COVID-19 in long-term care — the lowest level since early April and down from a grim high of 151 deaths in the third week of May.
Even so, the virus is far from contained. A total of 324 assisted-living facilities reported cases of COVID-19 among its residents and staff as of July 7, up from 292 in such facilities two weeks earlier, state records show.
In Hugo, several families who had loved ones at the Encore facility said they were caught in an information vacuum, with no one returning their calls as COVID-19 swept through the small single-story facility in May.
At least nine residents died and a total of 18 staffers and residents were sickened by the virus, state records show.
Former caregivers who worked at the facility described a chaotic atmosphere in which residents were allowed to wander the halls without masks even after the infection had spread. Supplies were in such short supply that one employee used her own money to buy thermometers for checking residents. At times, they said, there was just one staffer on site to care for up to two dozen residents, many of them sickened by the virus.
“It’s such a small community that I could not even picture how they could separate people” infected with the virus, Falk said. “My fear was that if [COVID-19] ever got in there, it would infect everyone.”
Administrators at Encore, which operates five assisted-living and memory care facilities, did not respond to repeated messages left since last week. The organization’s website said its residents “enjoy caring support, a comfortable home, a sense of community and convenient amenities.” As of Monday, the website did not mention COVID-19 or any prevention measures.
Rosemary Olson works as a cashier at a grocery store in Hugo; her 95-year-old mother, Marcheta Ross, lived at the Encore facility. She said she had no idea that there had been a large outbreak there until relatives of other seniors at Encore began dropping by her store and expressing grief over the sudden deaths.
Alarmed, Olson began calling the facility multiple times a day but said there was no response. “It was maddening,” she said.
On May 24, her mother died of COVID-19 after seven years at the home. No administrator at the facility, she said, called or wrote to express their condolences.
“I was so angry and so frustrated,” Olson said. “If you’re not telling people that you’re sorry that their loved ones have passed away, then shame on you.”