U.S. Health Secretary says feds investigating Brighton nursing home coronavirus outbreak

U.S. Health and Human Services Secretary Alex Azar questioned Friday whether Pennsylvania officials have been “aggressive enough” in flagging and enforcing violations at Brighton Rehabilitation and Wellness Center, where at least 76 residents have died of covid-19.

Azar discussed the Trump administration’s concerns over the Beaver County nursing home’s coronavirus outbreak — the hardest hit long-term care home in the state and among the worst outbreaks nationwide — during a visit to Heritage Valley Beaver Hospital, located just down the road from the entrance to Brighton.

“We are particularly concerned about the terrible, terrible losses at Brighton Rehabilitation and Wellness Center across the street,” Azar told reporters during a news conference at the hospital. “I wanted to be, frankly, here near Brighton, just so the people of Western Pennsylvania know how seriously the national government is taking this issue. We want the state to take it very seriously also.”

In what Azar described as a “rare” move, the federal government sent investigators to the Beaver County nursing home the week of May 12 to do a review independent of state inspection efforts.

“We are completing our own federal investigation of the conditions and circumstances there and will publicly release our findings soon,” Azar said, “and, if merited, will certainly demand accountability.”

A similar federal investigation was launched at a Kirkland, Wash. nursing home linked to 40 covid-19 deaths, but such efforts are unusual since regulation and enforcement of nursing homes is delegated to states.

The embattled Brighton center has the most coronavirus deaths and cases — including 368 residents and 31 staff members — of any long-term care home in Pennsylvania.

“In this instance, we felt the situation was, frankly, so devastating in terms of the human impact and the pervasiveness that we actually sent federal investigators in,” Azar said. “That work is currently under review at the Centers for Medicaid and Medicare Services.”

He pointed out that public records show Brighton has had several instances “jeopardy” findings and fines regarding unsafe treatment of patients in recent months and years.

“There is a serious question: Has the state been aggressive enough in taking action there?” Azar said.

“The department is committed to ensuring that the health and well being of residents and staff at long-term care facilities is a priority, and we need owners and operators to take that same commitment,” state health department spokesman Nate Wardle said by email.

Other state officials and Brighton nursing home did not immediately return requests for comment Friday afternoon.

In addition to the National Guard deploying support teams at Brighton to improve the situation, the state helped install a temporary manager to take over operations of the nursing home in late April. The manager is Long Hill Co., a Connecticut firm that specializes in managing distressed health care organizations.

At the time, state health officials said they did “not believe that there were any serious red flags about the way Brighton has responded to the covid-19 cases seen at the facility.”

“These situations are not easy for anyone, and we know congregate care settings have been hit particularly hard, as evidenced by the data on our website,” a health department spokesperson said in a statement.

Earlier this month, Levine said that just because a facility has seen an outbreak does not mean that facility has broken any rules, and the outbreak should not be taken as a reflection on the quality of care. She reiterated that nursing homes fall under the Department of Health jurisdiction, but everyday operations fall to each facility.

“We license these facilities, we regulate the facilities, we inspect these facilities,” Levine said. “We support the facilities. But we don’t operate the facilities. Actually, the owners operate these facilities.”

Azar said Friday that “there’s not an excuse for an infection spreading like wildfire throughout a nursing home.”

“That suggests that you’re not engaging in the basic types of infection control, isolation of patients and appropriate use of personal protective equipment,” Azar said.

The Brighton facility has spent the past 28 months on the Center for Medicare and Medicaid Services’ Special Focus Facility Program list, a nationwide list of nursing homes with more — and more serious — problems and inspection deficiencies than the national average.

“We have found generally across the country that nursing homes that have had past fines for patient quality care and safety, who are lower rated in terms of the safety measures, that those are also more likely to be institutions where you will have inadequate infection control,” said Azar, “and as result cause infections, outbreaks of covid and fatalities of our seniors.”

Meanwhile, there are examples of large nursing home chains in the region that have not had a single case of covid-19, Azar said.

“This isn’t happening everywhere,” he said. “I don’t want to hear the response that this is inevitable, that seniors in a health care setting cannot be protected.”

The Trump administration is working with providers to “protect the vulnerable” and potentially save tens of thousands of lives by correcting problems at nursing homes nationwide, but state officials need to step up to ensure changes happen, Azar said.

“We need our governors and our state health commissioners to pay more attention to our nursing homes,” Azar said. “These are our most fragile, vulnerable citizens to severe complications and death from covid-19, and we need to make sure that these nursing homes are actually engaged in appropriate infection control. They need to be testing every single patient that’s a resident of the nursing home, they need to test all staff members every week.

“And we need the states to really follow up on that and make sure that happens.”