Bacon's Rebellion

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The Deadliest Nursing Homes in Virginia

—

by

sherlockj
in ,

M. Norman Oliver M.D., Virginia Health Commissioner

by James C. Sherlock

(updated Jan. 20 at 2 PM)

Today I have assessed the Centers for Medicare/Medicaid Services COVID-19 Nursing Home Dataset to determine the deadliest nursing homes in Virginia measured by COVID death rate of residents from Jan 1, 2020, through Jan. 3, 2021.

The results are profoundly disturbing at several levels. There are 120 columns in that CMS data. I report here only a few data points.

Virginia’s deadliest nursing homes measured by resident COVID deaths per thousand residents since Jan. 1, 2020 as of January 3, 2021 were:

The Woodlands Health and Rehab Center
Clifton Forge
815.8 COVID deaths/1,000 residents
Current occupancy rate 63%.

The Jefferson
Arlington
600 COVID deaths/1,000 residents
Current occupancy rate 32%.

Arleigh Burke Pavilion
McLean
562.5 COVID deaths/1,000 residents
Current occupancy rate 65%.

Bayside of Poquoson Health and Rehab
Poquoson
523.8 COVID deaths/1,000 residents (7 deaths the week of Jan. 3)
Current occupancy rate 70%.

Francis Marion Manor Health & Rehabilitation
Marion
404.3 COVID deaths/1,000 residents (3 deaths the week of Jan. 3)
Current occupancy rate 46%.

Heritage Hall Clintwood
Clintwood
400 COVID deaths/1,000 residents, current occupancy rate 70%.  This facility has the distinction of the highest number of residents confirmed with COVID 19 in the last year in this group of nursing homes – 77 – with 100 beds.

Loudoun Nursing and Rehab Center
Leesburg
391.3 COVID deaths/1,000 residents
Current occupancy rate 35%.

Greensville Health and Rehabilitation Center
Emporia
357.1  COVID deaths/1,000 residents, current occupancy rate 65%. Even at 65% occupancy, this facility reports shortage of nursing staff.

The Virginian
Fairfax
357.1  COVID deaths/1,000 residents (1 death the week of Jan. 3)
Current occupancy rate 59%.

Pulaski Health and Rehab Center
Pulsaski
326.9  COVID deaths/1,000 residents
Current occupancy rate 51%.

Pelican Health Norfolk
Norfolk
307.7  COVID deaths/1,000 residents (4 deaths the week of Jan. 3)
Current occupancy rate 65%. Even at 65% occupancy, this facility reports shortage of nursing staff.

Galax Health and Rehab
Galax
301.6  COVID deaths/1000 residents
Current occupancy rate 53%.

There are 25 more Virginia nursing homes with 200 or more  COVID deaths/1,000 residents. These are, from highest death rate to lowest are:

THE NEWPORT, Newport News
MOUNT VERNON HEALTHCARE CENTER, Alexandria
HERITAGE HALL BIG STONE GAP, Big Stone Gap
SOUTH BOSTON HEALTH & REHAB CENTER, South Boston
NEWPORT NEWS NURSING & REHAB, Newport News
NOVA HEALTH AND REHAB, Weber City
RADFORD HEALTH AND REHAB CENTER, Radford
LEE HEALTH AND REHAB CENTER, Pennington Gap
CHATHAM HEALTH & REHABILITATION CENTER, Chatham
OUR LADY OF THE VALLEY, Roanoke
ASHBY PONDS INC, Ashburn
SKYVIEW SPRINGS REHAB AND NURSING CENTER, Luray
BRANDON OAKS NURSING AND REHABILITATION CENTER, Roanoke
CONSULATE HEALTH CARE OF WOODSTOCK, Woodstock
SEASIDE HHC @ ATLANTIC SHORE, Virginia Beach
BON SECOURS-MARYVIEW NURSING Center, Suffolk
COLISEUM CONVALESCENT AND REHABILITATION CENTER, Hampton
LIFE CARE CENTER OF NEW MARKET, New Market
HILLSVILLE HEALTH & REHAB CENTER, Hillsville
ENVOY OF STAUNTON, LLC, Staunton
ACCORDIUS HEALTH AT NANSEMOND POINTE LLC, Suffolk
LEEWOOD HEALTHCARE CENTER, Annandale
THE LAURELS OF BON AIR, Bon Air
ENVOY AT THE VILLAGE, Fork Union
RALEIGH COURT HEALTH AND REHABILITATION CENTER, Roanoke.

Of those 25, Newport News Nursing & Rehab and Envoy of Staunton, LLC, reported nursing shortages on Jan. 3, 2021.

The highest Jan 3 2021 occupancy rate was 98% at Envoy at the Village, Fork Union; the lowest was 28% at The Newport, Newport News.

By total number of resident COVID deaths, not the rate of deaths, the top six are:

  • South Boston Health & Rehab Center, 39 deaths
  • Heritage Hall, Bill Stone Gap, 34 deaths
  • The Woodlands Health and Rehab Center, Clifton Forge 31 deaths
  • Friendship Health and Rehab Center, 29 deaths
  • Heritage Hall Clintwood, 28 deaths
  • Annandale Healthcare Center, 28 deaths

First observation – as far as I can tell this information is unavailable in the very useful CMS data format through the Virginia Department of Health website.

Second observation – all of these facilities are still open.

Third observation, Virginia is right in the middle of the rankings of the states and D.C. nursing home COVID deaths per 1000 residents at 58.5.

That value varies from New Jersey’s 124.2 and Massachusetts’ 121.7 to Vermont’s 13.1 and Alaska’s 12.0.  Since that figure strips out the variables in resident populations it is a valid comparison.

Perhaps the Health Commissioner can tell us:

  • whether any nursing home has been shut down by the Virginia Department of Health or local health authorities since the onslaught of COVID. If not why not?
  • when each of these nursing homes was last inspected?
  • when this vital consumer information will be available on the VDH website in this usable, nationally comparable format?

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Comments

32 responses to “The Deadliest Nursing Homes in Virginia”

  1. Steve Haner Avatar
    Steve Haner

    https://leg1.state.va.us/cgi-bin/legp504.exe?202+sum+HB5059

    Remember this was the one industry, the only industry, to receive COVID liability protection from the General Assembly in the midst of this crisis. See bill above.

    1. V N Avatar
      V N

      and not the schools …

  2. Steve Haner Avatar
    Steve Haner

    https://leg1.state.va.us/cgi-bin/legp504.exe?202+sum+HB5059

    Remember this was the one industry, the only industry, to receive COVID liability protection from the General Assembly in the midst of this crisis. See bill above.

    1. V N Avatar
      V N

      and not the schools …

  3. sherlockj Avatar
    sherlockj

    Thanks, Steve, I did not remember that. Coin-operated General Assembly at work.

    School Boards, schools and businesses other than nursing homes of course remain liable. They need to step up their campaign donations.

  4. sherlockj Avatar
    sherlockj

    Thanks, Steve, I did not remember that. Coin-operated General Assembly at work.

    School Boards, schools and businesses other than nursing homes of course remain liable. They need to step up their campaign donations.

  5. Policy Student Avatar
    Policy Student

    This information is concerning; thank you for sharing. For what it’s worth, at least one rehab facility that I know of is exclusively serving covid-positive hospital transfers. It frees up hospital ICU beds, while nursing very ill patients. Higher death rates could be explained, at that particular facility.

  6. Policy Student Avatar
    Policy Student

    This information is concerning; thank you for sharing. For what it’s worth, at least one rehab facility that I know of is exclusively serving covid-positive hospital transfers. It frees up hospital ICU beds, while nursing very ill patients. Higher death rates could be explained, at that particular facility.

  7. James A. Bacon Avatar
    James A. Bacon

    Where are the contact tracers? Where are the case investigators? I thought they were supposed to be focusing on nursing homes. What have they learned? Who is in charge? Anybody?

    1. sherlockj Avatar
      sherlockj

      Directly the job go the VDH Office of Licensure and Certification – the one that is so profoundly understaffed. As we have described here, it is the Governor’s fault that they are understaffed. He has had four years to fix the problem since the 2017 IG report that identified the shortfalls.

  8. James A. Bacon Avatar
    James A. Bacon

    Where are the contact tracers? Where are the case investigators? I thought they were supposed to be focusing on nursing homes. What have they learned? Who is in charge? Anybody?

    1. sherlockj Avatar
      sherlockj

      Directly the job go the VDH Office of Licensure and Certification – the one that is so profoundly understaffed. As we have described here, it is the Governor’s fault that they are understaffed. He has had four years to fix the problem since the 2017 IG report that identified the shortfalls.

  9. Dick Hall-Sizemore Avatar
    Dick Hall-Sizemore

    Thanks for digging this data up, Jim. That is a valuable contribution and is information that VDH and the mainstream media should have made available.

    I was surprised that the nursing homes with the highest death rates were not concentrated in rural areas, but, rather evenly distributed between rural and urban areas. I was particularly surprised at the number of nursing homes in Northern Virginia that made the top 12, four. I would have thought that in a high income area such as NOVA, nursing homes would have had higher rates and, therefore, higher staff to patient ratios.

    1. sherlockj Avatar
      sherlockj

      I was surprised by the same phenomenon. The urban and suburban nursing homes are close to the best hospitals. Logically they should have suffered a lower percentage of deaths per case (1) if they were paying attention – meaning properly staffed and managed – and sought hospitalization for their patients at appropriate times.

      What limited VDH data that are available do not align with and are in some cases show higher numbers of deaths than the CMS data, but I am using the CMS data because it is the national standard and it has calculated such data as COVID deaths/1,000 residents, which I think is the fairest way to compare nursing homes.

      The explanation on the VDH website for the differences follow:

      Comparison of VDH Data to CMS Nursing Home Data:

      “On June 4, 2020, CMS posted its first report outlining COVID-19 data reported by nursing homes. Nursing facilities report these data to the CDC’s National Healthcare Safety Network (NHSN). The public is able to view facility-specific data about COVID-19 cases, deaths, and more. Due to different reporting requirements and case classifications, timelines, and other factors, the CMS data will likely be inconsistent with data reported by VDH.”

      “The VDH surveillance case definitions are specific, especially for cases that are considered ‘probable.’ The NHSN definitions for residents and staff are not based on epidemiological linkages or other detailed information that public health collects, such as laboratory results based on symptoms and possible exposures by being in a facility. Because the NHSN definition for suspected cases is broader and focuses solely on the signs and symptoms suggestive of COVID-19, there will be differences between what is being counted at the state versus what is being reported to NHSN.”

      That may be true if a bit self-serving. But in the case of gross results it is not dispositive. The CMS numbers are bad enough to make the point that there was no oversight here in Virginia.

    2. idiocracy Avatar
      idiocracy

      “High-income” in NOVA only applies to white collar workers.

      For the blue collar service sector employees in NOVA, they live 15 to a house to make ends meet.

      1. Matt Adams Avatar
        Matt Adams

        They also go to StonSprings with their perpetual 4 minute ER wait time to die.

      2. Dick Hall-Sizemore Avatar
        Dick Hall-Sizemore

        The white collar workers are those most likely to have relatives in nursing homes.

  10. Dick Hall-Sizemore Avatar
    Dick Hall-Sizemore

    Thanks for digging this data up, Jim. That is a valuable contribution and is information that VDH and the mainstream media should have made available.

    I was surprised that the nursing homes with the highest death rates were not concentrated in rural areas, but, rather evenly distributed between rural and urban areas. I was particularly surprised at the number of nursing homes in Northern Virginia that made the top 12, four. I would have thought that in a high income area such as NOVA, nursing homes would have had higher rates and, therefore, higher staff to patient ratios.

    1. sherlockj Avatar
      sherlockj

      I was surprised by the same phenomenon. The urban and suburban nursing homes are close to the best hospitals. Logically they should have suffered a lower percentage of deaths per case (1) if they were paying attention – meaning properly staffed and managed – and sought hospitalization for their patients at appropriate times.

      What limited VDH data that are available do not align with and are in some cases show higher numbers of deaths than the CMS data, but I am using the CMS data because it is the national standard and it has calculated such data as COVID deaths/1,000 residents, which I think is the fairest way to compare nursing homes.

      The explanation on the VDH website for the differences follow:

      Comparison of VDH Data to CMS Nursing Home Data:

      “On June 4, 2020, CMS posted its first report outlining COVID-19 data reported by nursing homes. Nursing facilities report these data to the CDC’s National Healthcare Safety Network (NHSN). The public is able to view facility-specific data about COVID-19 cases, deaths, and more. Due to different reporting requirements and case classifications, timelines, and other factors, the CMS data will likely be inconsistent with data reported by VDH.”

      “The VDH surveillance case definitions are specific, especially for cases that are considered ‘probable.’ The NHSN definitions for residents and staff are not based on epidemiological linkages or other detailed information that public health collects, such as laboratory results based on symptoms and possible exposures by being in a facility. Because the NHSN definition for suspected cases is broader and focuses solely on the signs and symptoms suggestive of COVID-19, there will be differences between what is being counted at the state versus what is being reported to NHSN.”

      That may be true if a bit self-serving. But in the case of gross results it is not dispositive. The CMS numbers are bad enough to make the point that there was no oversight here in Virginia.

    2. idiocracy Avatar
      idiocracy

      “High-income” in NOVA only applies to white collar workers.

      For the blue collar service sector employees in NOVA, they live 15 to a house to make ends meet.

      1. Matt Adams Avatar
        Matt Adams

        They also go to StonSprings with their perpetual 4 minute ER wait time to die.

      2. Dick Hall-Sizemore Avatar
        Dick Hall-Sizemore

        The white collar workers are those most likely to have relatives in nursing homes.

  11. TBill Avatar
    TBill

    On that “Top 10 list” The Virginian is the one I am familiar with, important to me as a partner for music performances for the residents, in pre-COVID times of course. It’s a nice place from my perspective.

    Appreciate the article.

  12. TBill Avatar
    TBill

    On that “Top 10 list” The Virginian is the one I am familiar with, important to me as a partner for music performances for the residents, in pre-COVID times of course. It’s a nice place from my perspective.

    Appreciate the article.

  13. Acbar Avatar
    Acbar

    Thanks again, Steve, for your insight re GA liability action.

    But another reaction: I live near the Arleigh Burke Pavillion, which is the extended care facility within Vinson Hall, a popular military (primarily Navy) retirement home, whose residents include many widowers and widows who continue to drive their own cars, remain active in the community, shop for themselves at the shopping center across the street, visit family living nearby, and otherwise defy the risks and expectations for people their age. Vinson Hall also encourages the community to come into the facility; it’s where the neighborhood civic association meets and the local precinct votes . . . until this past year, anyway. Of course the high death rate at the Pavillion is alarming and could reflect mismanagement. Yet I wonder if the covid data aren’t skewed in this case by the relative lack of isolation generally at Vinson Hall and the concentration of its most vulnerable and worst outcomes in the Pavillion statistic. I’d be interested in the data for Vinson Hall as a whole: how that ranks among comparables.

  14. Acbar Avatar
    Acbar

    Thanks again, Steve, for your insight re GA liability action.

    But another reaction: I live near the Arleigh Burke Pavillion, which is the extended care facility within Vinson Hall, a popular military (primarily Navy) retirement home, whose residents include many widowers and widows who continue to drive their own cars, remain active in the community, shop for themselves at the shopping center across the street, visit family living nearby, and otherwise defy the risks and expectations for people their age. Vinson Hall also encourages the community to come into the facility; it’s where the neighborhood civic association meets and the local precinct votes . . . until this past year, anyway. Of course the high death rate at the Pavillion is alarming and could reflect mismanagement. Yet I wonder if the covid data aren’t skewed in this case by the relative lack of isolation generally at Vinson Hall and the concentration of its most vulnerable and worst outcomes in the Pavillion statistic. I’d be interested in the data for Vinson Hall as a whole: how that ranks among comparables.

  15. James A. Bacon Avatar
    James A. Bacon

    Posted on behalf of Amy Hewitt, vice president of strategy and communications for the Virginia Health Care Association:

    We’ve read with interest some of the recent posts on the Bacon’s Rebellion blog about nursing home care.

    Every death from COVID-19 is tragic and the suffering in our long term care facilities—both from the virus itself and the isolation caused by the necessary restrictions on visitation by loved ones and activities—is devastating to see. The untold story of the pandemic, however, is the heroic work of the front line caregivers who show up to work every day to care for our seniors, even when testing and PPE were difficult to obtain initially, and today when they willingly comply with federally-required twice a week testing because of the high overall positivity rates across the state. They have helped over 11,000 patients and residents recover from COVID-19.

    It is disappointing to see inflammatory statistics about deaths per 1,000 residents when the average Virginia nursing home has only 120 beds. We understand the need to normalize data for comparisons, but we believe this just confuses the public.

    As we have shared previously, community spread is the driving factor in nursing facility outbreaks. As experts have repeatedly noted, COVID-19 cases in a surrounding community is a top factor in outbreaks in nursing homes. University of Chicago’s Tamara Konetzka, a nationally recognized expert on long-term care, said, “Trying to protect nursing home residents without controlling community spread is a losing battle.” Dr. David Grabowski, professor of Health Care Policy, Harvard Medical School stated, “The strongest predictor of whether or not we’ll see cases in [a particular setting] is community spread.”

    As you know, nursing home residents are typically older adults with multiple chronic conditions, making them most vulnerable to COVID-19. While mortality rates decreased compared to the spring due to a better understanding of the virus, better treatments, and government resources to help reduce spread, as industry leaders predicted, the rising number of new COVID cases in facilities are resulting an increasing number of deaths.

    The COVID-19 vaccines will literally be a lifesaver for residents and expedite the reopening of long term care facilities to family members and loved ones. Nearly all nursing homes in Virginia have had their first vaccine clinics while second clinics are underway or scheduled.

    1. sherlockj Avatar
      sherlockj

      “Inflammatory statistics”? “Confuses the public”? Seriously? That is your position Ms. Hewitt?

      I have two questions that you can certainly answer.

      1. Was any Virginia nursing home shut down by the state or federal governments for cause in the past year? If so, which one/ones and what was the reason for each shutdown. Readers are particularly interested in The Woodlands Health and Rehab Center, Clifton Forge. 815.8 COVID deaths/1,000 residents. Translated, that means 82% of the residents of that nursing home in the past 9 months died of COVID. It’s is still open with a fresh supply of patients. Why?
      2. Does your organization support fully funding the publicly stated personnel requirements of the Office of Licensure and Certification of the VDH so that it has a chance of carrying out it’s inspection mission efficiently and effectively?

      Looking forward to your response and best regards

  16. James A. Bacon Avatar
    James A. Bacon

    Posted on behalf of Amy Hewitt, vice president of strategy and communications for the Virginia Health Care Association:

    We’ve read with interest some of the recent posts on the Bacon’s Rebellion blog about nursing home care.

    Every death from COVID-19 is tragic and the suffering in our long term care facilities—both from the virus itself and the isolation caused by the necessary restrictions on visitation by loved ones and activities—is devastating to see. The untold story of the pandemic, however, is the heroic work of the front line caregivers who show up to work every day to care for our seniors, even when testing and PPE were difficult to obtain initially, and today when they willingly comply with federally-required twice a week testing because of the high overall positivity rates across the state. They have helped over 11,000 patients and residents recover from COVID-19.

    It is disappointing to see inflammatory statistics about deaths per 1,000 residents when the average Virginia nursing home has only 120 beds. We understand the need to normalize data for comparisons, but we believe this just confuses the public.

    As we have shared previously, community spread is the driving factor in nursing facility outbreaks. As experts have repeatedly noted, COVID-19 cases in a surrounding community is a top factor in outbreaks in nursing homes. University of Chicago’s Tamara Konetzka, a nationally recognized expert on long-term care, said, “Trying to protect nursing home residents without controlling community spread is a losing battle.” Dr. David Grabowski, professor of Health Care Policy, Harvard Medical School stated, “The strongest predictor of whether or not we’ll see cases in [a particular setting] is community spread.”

    As you know, nursing home residents are typically older adults with multiple chronic conditions, making them most vulnerable to COVID-19. While mortality rates decreased compared to the spring due to a better understanding of the virus, better treatments, and government resources to help reduce spread, as industry leaders predicted, the rising number of new COVID cases in facilities are resulting an increasing number of deaths.

    The COVID-19 vaccines will literally be a lifesaver for residents and expedite the reopening of long term care facilities to family members and loved ones. Nearly all nursing homes in Virginia have had their first vaccine clinics while second clinics are underway or scheduled.

    1. sherlockj Avatar
      sherlockj

      “Inflammatory statistics”? “Confuses the public”? Seriously? That is your position Ms. Hewitt?

      I have two questions that you can certainly answer.

      1. Was any Virginia nursing home shut down by the state or federal governments for cause in the past year? If so, which one/ones and what was the reason for each shutdown. Readers are particularly interested in The Woodlands Health and Rehab Center, Clifton Forge. 815.8 COVID deaths/1,000 residents. Translated, that means 82% of the residents of that nursing home in the past 9 months died of COVID. It’s is still open with a fresh supply of patients. Why?
      2. Does your organization support fully funding the publicly stated personnel requirements of the Office of Licensure and Certification of the VDH so that it has a chance of carrying out it’s inspection mission efficiently and effectively?

      Looking forward to your response and best regards

  17. cjbova Avatar
    cjbova

    Yes, the vaccines will save lives, and yes, frontline care workers often do heroic jobs. But nursing home owners are responsible for sufficient supplies and adequate staffing and training of that staffing. And not all of the owners do a heroic job.

    The Commonwealth has failed in its responsibility to conduct enough VDH inspections to ensure the safety of residents as shown in the CMS Nursing Home compare reports.

    Eight nursing homes listed in the piece above have not had a VDH health inspection since 2018.

    Twelve had more than the Virginia average of 12 citations for deficiencies on their last inspection: 2 @20, 1 @19, 2@ 18, 2@ 17,1@ 16,1@ 15, 2@ 14 and 1@13. The national average is 8.3.

    The most recent VDH health inspection for any of these nursing homes were two in February, 2020. (One of them had 20 citations and a 2-star below average health rating.) If nothing else, there should have been emergency orders to at least inspect for infection control measures.

    Ms. Hewitt didn’t say whether the Virginia Health Care Association and its members are insisting on more VDH inspectors to see every facility is brought up to safe levels of care.

  18. cjbova Avatar
    cjbova

    Yes, the vaccines will save lives, and yes, frontline care workers often do heroic jobs. But nursing home owners are responsible for sufficient supplies and adequate staffing and training of that staffing. And not all of the owners do a heroic job.

    The Commonwealth has failed in its responsibility to conduct enough VDH inspections to ensure the safety of residents as shown in the CMS Nursing Home compare reports.

    Eight nursing homes listed in the piece above have not had a VDH health inspection since 2018.

    Twelve had more than the Virginia average of 12 citations for deficiencies on their last inspection: 2 @20, 1 @19, 2@ 18, 2@ 17,1@ 16,1@ 15, 2@ 14 and 1@13. The national average is 8.3.

    The most recent VDH health inspection for any of these nursing homes were two in February, 2020. (One of them had 20 citations and a 2-star below average health rating.) If nothing else, there should have been emergency orders to at least inspect for infection control measures.

    Ms. Hewitt didn’t say whether the Virginia Health Care Association and its members are insisting on more VDH inspectors to see every facility is brought up to safe levels of care.

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