Public Health Officials Contradict Nursing Home Director's Claims

EVANSTON, IL — The director of the nursing home that has accounted for more than half of COVID-19 deaths in Evanston claimed he had been forbidden from comprehensive testing for the new coronavirus. But according to state public health officials, there was never any such ban on testing.

Phil Hemmer, executive director of Three Crowns Park, has said facility administrators had urged public health officials to authorize testing of asymptomatic people since mid-March.

"The trigger for this terrible disease is its ability to spread unknowingly by infected individuals who show no symptoms," he told residents Monday. "Unfortunately, until recently testing had been limited to those with symptoms, allowing many infected individuals without symptoms to infect others."

Last month, Hemmer said Three Crowns Park had hired a private lab to test all independent living residents, and on April 24 he announced that the facility planned to start testing all staff members. But he did not specify whether he or other administrators turned down an opportunity to test all staff members earlier. The facility has 178 residents and 180 staff.

"Federal and state government reversed their opposition to comprehensive testing of nursing homes," Hemmer said in an April 28 letter to residents and their families. "This is a fundamentally key element in protecting our residents, but until last week it was prohibited."

A representative of the Illinois Department of Public Health disputed Hemmer's characterization.

"IDPH never prohibited comprehensive testing at nursing homes," a spokesperson told Patch. "Previously, when both PPE and testing supplies were scarce, an individual being clinically compatible and epidemiologically linked were sufficient for isolation and quarantine. Symptomatic staff were restricted and isolated at home, and infection control and environmental cleaning measures were implemented."

Ike Ogbo, director of Evanston's health department, said the city followed guidelines set by state public health officials with regard to coronavirus testing at Three Crowns Park, but he declined to answer questions about his department's knowledge of testing decisions at the facility.

"As a result of our appeals, the governments's testing policy recently changed," Hemmer said Monday in a letter notifying residents and families that 11 of the facility's 130 staff members and an additional resident had tested positive for the coronavirus. "Those who test positive are home with pay until they are cleared to return. Gratefully, two staff members have recovered from the virus and returned to work."

Hemmer said previously all staff members wear appropriate personal protective equipment when working, undergo daily monitoring for fever and other symptoms and are physically distanced from one another when possible. Three Crowns Park officials have hired four staffing agencies, invited retired staff members to return, increased hourly pay and offered bonuses to work with residents with COVID-19, Hemmer said in letters to residents.

Records obtained by Patch show two letters were sent to local legislators on April 9 concerning the worsening situation at Three Crowns Park. By that point, the firm Haymarket Public Strategies was providing communication assistance to the nursing home.

That day, Ogbo said that was the third time that IDPH State Epidemiologist Craig Conover had visited the facility to provide guidance since the ourbreak began.

"As a State certified Health Department, we must comply with the stipulated IDPH guidelines that mass testing is not recommended when a resident is positive for COVID-19 at a long term care facility," Ogbo told Mayor Steve Hagerty in an April 9 email, which the mayor passed on to staff and local lawmakers notifying them it was the city's top concern.

Ogbo went on to provide recommendations for Three Crowns Park administrators, including providing better hazard pay to staff, using temporary staffing agencies and contacting nursing schools. He also said the city had provided a significant amount of its supply of personal protective equipment to Three Crowns Park. As of that day, he said the city had given a total of 7,200 pieces of PPE. In total, as of a month later, the city had distributed 19,000 pieces of equipment to 23 non-city entities, including long-term care facilities, according to a spokesperson.

"The City only has a limited supply of PPE reserved for our first responders. As it shows, we have shared a sizable amount with Three Crowns. I have continued to press the need for Three Crowns to aggressively engage their vendors for PPE and not rely on the City's limited supply," Ogbo said. He explained he has also requested that state public health officials assign an on-site monitor to the facility to make sure it is following IDPH guidance and necessary infectious disease control measures.

Also on April 9, Hemmer sent a letter to the same local legislators titled "Three Crowns is facing a terrible calamity." He said the facility had an immediate need for immediate on-site testing for all residents and staff members.

"None of our residents are being tested for the virus at Three Crowns Park. None of medical staff or assistance have been tested at this highest at-risk center," Hemmer said. The executive director also said the pandemic and shortages of PPE had caused the facility to lose staff. He asked for five nurses and five certified nursing assistants to help.

To get through the end of April, Hemmer said at the time, the facility needed an extra 140,000 pieces of PPE, including 10,000 more N95 medical-grade masks.

On April 17, Hemmer said a letter to Hagerty and Ogbo that IDPH officials had offered to provide "the testing we asked for" that day.

"However, we still have the other two critical prerequisites that need to be in place before IDPH begins testing of staff and residents: crisis staffing and enough personal protection equipment," Hemmer said. He noted the facility did not have enough PPE "if we start testing" and because he expected to "lose more staff after testing."

On April 22, Hemmer sent an email to IDPH Assistant Director Evonda Thomas-Smith, who departed abruptly as Evanston's health director last year before receiving an $80,000 cash payment, titled, "Employee Testing and Crisis Staffing for Three Crowns Park."

Hemmer said the facility had ordered testing supplies through IDPH and was told they would arrive that day. He recounted efforts to bring in additional staff, but said it still was not enough.

"We need State of Illinois crisis staffing to replace staff members who test positive and we need additional PPE to protect residents and staff," he said.

Later that day, Hagerty asked Ogbo: "Did IDPH backpedal and decide to test everyone at [Three Crowns Park]? If so is this a one-off or a change in policy?"

"The IDPH recommendation that discourages mass testing is still in effect," Ogbo responded. "Testing everyone at [Three Crowns Park] is basically just a one-off direction from IDPH."

Hemmer said Thursday in an email in response to written questions from Evanston Patch that in "mid-April Three Crowns retained a private lab to conduct testing." He declined to clarify the date of the contract or whether the facility was prohibited from hiring one earlier.

"At no time did we turn down any opportunity to test," Hemmer told Patch.

Businesses willing to pay private labs had been able to test asymptomatic workers for weeks by the time Hemmer's testing began. Hemmer declined to say why staff were not tested alongside residents by the private lab.

The Evanston Health and Human Services Department has declined to provide information about which nursing homes have requested PPE and how much they have received, citing unspecified privacy concerns.

According to IDPH data released last Friday, there were 24 confirmed cases of COVID-19 among Three Crowns Park residents and staff. Six residents have died. Among all Evanston residents, there were 409 confirmed cases and 11 deaths as of Wednesday, according to the city's website. No information regarding how many of those people have recovered has yet been released by the health department.

Related:

Retirement Home Staff Tested After 6 Residents Die Of Coronavirus
Fourth Coronavirus Death Reported At Three Crowns Park
Third Resident Of Evanston Retirement Home Dies Of Coronavirus
Nursing Home Strike Called Off, Workers Will Not Walk Out Friday

Staff at two other Evanston nursing homes were planning to go on strike Friday before a tentative deal was reached with less than 48 hours to before it was set to begin. Workers at Aperion Care Evanston, 1300 Oak Ave., which has reported 29 coronavirus cases and one death, and the Grove of Evanston, which has reported 21 cases and two deaths, are represented by the union SEIU Healthcare.

Nursing home employees have complained for weeks of widespread shortages of personal protective equipment, staffing shortfalls, being unable to take time off when they have symptoms, receiving inadequate training and a lack of transparency from facility operators.

In response to the threatened strike, 21 Democratic state senators sent a letter to IDPH to ask about PPE requests at the 64 unionized nursing homes set to strike. The letter's signatories include former SEIU Healthcare organizer Sen. Ram Villivalam and Sen. Laura Fine, of Glenview, whose 9th District includes Evanston.

"When our nursing home staffs aren't afforded adequate PPE, that puts worker and resident lives in danger," Fine said in a statement. "PPE is scarce right now, but our front-line workers need these supplies in order to continue caring for those who need it the most.”