Carney’s fault because he put the most voracious fox in charge of the hen house. An appointment that could only be read as giving nursing homes carte blanche to ignore regulations, to ignore best practices, to ignore making residents’ well-being a priority.
But, I’m getting ahead of myself. Let me tell you the story. Back in the late 1990’s Sen. Robert Marshall created a task force to address longstanding problems in Delaware’s nursing homes. Largely powered by grassroots tales of abuse and neglect in Delaware’s long-term care facilities, and informed by Sen. Marshall’s viewing the problem through the lens of his father’s own experiences, Marshall convened a series of public hearings up and down the state, provided phone access (I was on the other end of the phone) for people to tell their stories, and ultimately brought all the players together at Buena Vista to develop a legislative strategy to address the multiple issues.
As part of the review, we read every single nursing home inspection report that had been filed during the previous five years. It was clear that a few facilities caused the majority of the problems.
The results of the process were perhaps the most progressive set of nursing home reforms in the country, including the creation of the Division of Long-Term Care Residents Protection, the mandating of staffing minimums and staffing minimums by shift, stronger sanctions for nursing homes that chronically fail to meet requirements, and much more. Those reforms were opposed vociferously and continuously by Yrene Waldron, who had been an administrator at one of Delaware’s worst for-profit nursing homes, and who became, of course, the chief lobbyist for the nursing homes as Director of the Delaware Health Care Facilities Association. Which reminds me, when I mentioned that there were a few facilities causing the majority of problems, one of those problem facilities had been run by Yrene Waldron, and most of the problems took place when she was the facility’s director.
She pissed in the ear of then-DHSS Secretary Gregg Sylvester, who became a one-man rain delay against the reform efforts. To their credit, the Carper Administration, specifically Jeff Bullock, sidelined Sylvester, and made staff attorney Tom McGonigle their point person on the reforms. Tom ultimately wrote much of the legislation that enabled the reforms. He was a hero, IMO. The Carper Administration then appointed the perfect person to run the new division, Mary McDonough. McDonough, along with Barb Webb and a small but mighty staff, prioritized the safety and well-being of nursing home residents over the profit motive of the for-profit corporations. They were great. The industry was not happy.
Everything was fine until Mary deservedly was nominated and confirmed to be a Family Court Commissioner. By this time, Ruth Ann Minner had become governor, and Vince Meconi, of all people, had been appointed as DHSS Secretary. Vince named a profoundly-undistinguished aparatchik he had met back when he worked on one of Carper’s campaigns to be the new director. Her name was Carol Ellis. Yrene Waldron then moved the headquarters of the Delaware Health Care Facilities Association into the same building that housed the Division (it’s along the Brandywine River). She and Carol Ellis formed a common bond over the abominable premise that the nursing homes were the true victims, not the residents receiving sub-standard care. I cannot overstate the degree to which Waldron played the victim when it came to the ‘mistreatment’ of nursing homes. It got so bad that Carol Ellis publicly stated during a review of her agency that she would not enforce the minimum staffing-by-shift standards because she didn’t believe in them, even though those standards were the law and not subject to her discretion. The staffing-by-shift requirements of course did not mandate the same number of workers overnight as during the day. But they are essential. In addition to dementia patients, who do not have the same body clocks as those w/o dementia, you need nurses and orderlies to answer call bells and address patient needs. Under Carol Ellis, that did not happen. You could have a patient in distress pounding on a call bell and, thanks to Carol and Yrene, nobody would come.
You may be saying to yourself, some 600 words in, “This is all well and good, Steve, but how is the pandemic afflicting our nursing facilities John Carney’s fault?”
Fair question. Here’s the answer. Upon last year’s retirement of Mary Peterson, who had been the most recent Division Director, John Carney and DHSS Secretary Kara Walker appointed the single person in the State of Delaware least willing or interested in protecting the welfare of nursing home residents. Read for yourself:
NEW CASTLE (Sept. 3, 2019) – Department of Health and Social Services (DHSS) Secretary Dr. Kara Walker announced the appointment of Yrene Waldron, former Executive Director of the Delaware Health Care Facilities Association, to lead the Division of Health Care Quality. She will begin her duties Sept. 16.
“I am thrilled that Yrene is joining our Department as director of the Division of Health Care Quality (the new name of the Division),” Secretary Walker said. “As the former director of the Delaware Health Care Facilities Association, she brings extensive experience working with health care system and their staffs to her new role. She understands how the health care system works, the important role it plays in caring for and keeping Delawareans safe, and the role our Division of Health Care Quality which promotes quality care and the enforcement of state and federal laws and regulations.”
This appointment is unfathomable unless the Carney Administration has no regard for nursing home residents, which is quite possible. The results have been both disastrous and predictable:
The Division of Public Health said 247 of the 388 coronavirus-related deaths in the state have involved nursing home residents, equivalent to about 64 percent. That’s despite the fact just 990 of the 9,773 positive cases, or 10 percent, have involved residents.
Preliminary data from the federal Centers for Medicare & Medicaid Services indicates only four states (New Jersey, Connecticut, Massachusetts and Rhode Island) have a higher rate of COVID-19 in nursing homes than Delaware. About 19.2 percent of residents in the First State have contracted the virus, per the data.
It is no surprise that, with Waldron in charge, Delaware nursing homes have dragged their feet on testing:
Many long-term care facilities in Delaware have not begun conducting universal testing for COVID-19 under a plan outlined by the governor earlier this month, according to state officials.
Where there is testing, the results are totally screwed up:
“It’s just human error,” said Yrene Waldron, director of the state’s Division of Health Care Quality. “Human error because these facilities are 24/7 facilities, they are working extremely hard — they always have — but now even more so.”
You see? Even in her alleged role as the Division Director, Waldron still runs interference for the nursing homes, as if they, and they alone, are blameless. And, of course, this most secretive of states was hiding the results from the public:
Until recently, the state was not releasing data about the number of long-term care workers who have been infected with or died from the virus, despite multiple requests for this information by Delaware Online/The News Journal.
Of course, the nursing homes respond to the crisis in typical fashion: They’re asking John Carney to grant them immunity from their negligence:
Cheryl Heiks, executive director of the Delaware Health Care Facilities Association, said in a statement that long-term care providers are asking the state for immunity “in light of the unprecedented events these last few months.”
“Many of our seniors and their families rely on long-term care facilities in Delaware and the fear is lawsuits may cripple this industry, resulting in dire consequences for those that need this care,” she said.
Cheryl, the willful negligence of your clients caused numerous deaths that were avoidable. Your roster of miscreants deserves no forgiveness or immunity for their actions and omissions.
The nursing homes are a major part of this problem, and having this voracious fox in charge of the hen house has led only to a huge pile of feathers and bones in the wake of the pandemic. The Carney Administration made the nursing home issues far worse by placing someone in charge who was expressly committed to protecting the business of nursing facilities over the safety of the residents the nursing homes allegedly serve.
Governor Carney, while you can’t make this right, you can install someone, anyone, as Division Director who is capable and who cares about the residents. Getting rid of Yrene Waldron is the first step in restoring public confidence in Delaware’s nursing homes. Can you please, at least, do that?