At least 14 patients have died. Dozens more are still hospitalized. And residents who’ve already been sent back to a Gallatin nursing home have turned up with new cases of COVID-19. A WPLN News investigation finds that the facility downplayed the outbreak to first responders. But the nursing home administrator now says there was no stopping the coronavirus.
The Gallatin Center for Rehabilitation and Healing says all employees were notified within hours of a staffer testing positive of COVID-19. This was March 21, a full week before a mass evacuation began.
But COVID was not a concern expressed in the 911 calls made on behalf of patients being sent to the hospital with trouble breathing. WPLN News obtained the recordings through an open records request.
“Do you know if she’s been in contact with someone who tested positive for the coronavirus?” the dispatcher asked on Wednesday, March 25.
“No,” the nurse responded, after a pause.
Staffers never warned dispatchers, who even asked specific screening questions so first responders could take precautions and wear protective gear.
Another patient needed to go to the hospital the next day, after several employees had already tested positive and multiple patients were being tested.
“Do you know if she’s been around anybody who has traveled to the airport or on an airplane or been confirmed with coronavirus?”
“No,” the caller said, cutting off the question.
And on Friday, just hours before a mass evacuation would begin, another patient was short of breath and unconscious.
“Do you know if he’s been in contact with someone who tested positive for the coronavirus?” the dispatcher asked.
“We don’t know. We have no clue,” the caller said.
That weekend, every patient and staff member would be tested. Nearly 100 residents turned up positive and 33 staff members, most of whom had no symptoms.
A Deadly Front In The War On Coronavirus
Nursing homes are quickly becoming the deadliest battleground in this pandemic. Nearly every resident is in poor health already. And even on a good day, infection control is difficult with so many elderly people living in tight quarters.
The guidance from federal regulators changes by the week, but the nursing home with the first deadly outbreak, in Washington State, was faulted by regulators for not moving rapidly enough to identify and manage ill residents.
In Gallatin, federal surveyors tell WPLN News they have completed their review but won’t release their list of deficiencies until later this month.
Patient families expect flaws to be identified.
“I think a lot of it could have been prevented,” says Tammy Howell. Her mother lives at the Gallatin nursing home and is now nearly three weeks into her stay at Sumner Regional Medical Center, which took nearly all the COVID-positive patients. She must test negative twice before returning to the facility.
Howell and other family members say the nursing home dismissed ailments that turned out to be COVID.
“Don’t tell me that you’ve got a couple of cases and tell me my mom doesn’t, and she has some of the symptoms, just because you want to cover your butt,” she says.
Even now, Howell says the hospital is giving her more information than the nursing home.
The home has already been put on notice that some families intend to file lawsuits. They accuse the facility of making nurses work even though they weren’t feeling well and failing to make everyone wear masks and gloves.
Local officials have been displeased with the response as well and have been happy to express their concerns.
“We were being told at first that basically they had this situation under control,” Sumner County Mayor Anthony Holt says. “And it wasn’t under control. It was completely out of control.”
Holt says the nursing home continued to ignore the advice of local officials who wanted patients to stay in area hospitals longer. They’d been transported to neighboring counties so Sumner Regional could focus on the COVID-positive patients. After everyone was moved out and the facility was deep-cleaned, the nursing home started moving people back immediately — which was the plan all along.
But Sumner County emergency management chief Greg Miller doubted the facility had enough nurses who hadn’t been exposed.
“We thought they were rushing the decision to move them back in,” he says. “We just weren’t getting many answers.”
In the following days, at least three more residents fell ill and were moved to the hospital. Though on those 911 calls, staffers were more direct with dispatchers.
“Have you obviously been in contact with anyone who has tested positive for the coronavirus?” one asks a caller from the nursing home April 6.
“Oh yeah, everybody here has,” she says with a laugh. “I’m sorry. I just have to say that and laugh because that’s all I can do.”
‘You Cannot Stop It’
The nursing home’s administrator is also being more open about the experience. In an interview with WPLN News, Dawn Cochran acknowledges she was overrun, even though she didn’t think so at first.
“Once you get one sick patient, it’s a tidal wave. You cannot stop it,” she says now.
Cochran says she was doing everything the Centers for Medicare and Medicaid Services recommended, often ahead of schedule, like screening employees for symptoms.
In recent years, though, CMS has cited the 200-bed Gallatin nursing home for deficiencies in infection control. They’re small lapses — people sticking their hands in the community ice machine or poor management of bed linens. But they’ve resulted in below average ratings.
Cochran has a long career as a nursing home administrator but has only been in the Gallatin facility since early March. She says she can only speak for the time since she took over. As for the 911 calls without disclosing COVID concerns, she says nurses were genuinely confused.
“What appears to be COVID-like symptoms wasn’t in two residents we had tested,” she says. “So we just don’t always know.”
Cochran says she has cooperated with state health officials from the beginning and saw them as a partner in planning the evacuation.
Even as they await the federal findings, state officials have already said they find the nursing home’s response to be “perfectly adequate.”
“I’m hoping everybody can learn from it,” Cochran says. “But at the same time, I don’t know what we could have done better at the time — I don’t.”
At least nine other Tennessee nursing homes also have multiple confirmed cases, as of Sunday. Whether those get out of hand will shed light on whether an outbreak is really inevitable.