All residents of Flagstone Senior Living’s Memory Care Unit have been transferred to COVID-19 units at outside facilities so the residents can receive 24/7 care and Flagstone can professionally clean and disinfect the Memory Care Unit, also known as The Atrium.
“Through this time, through the whole outbreak, we were working alongside the health department, who was giving us advice from the State of Oregon, and we were working on placement, getting people, our residents, to the appropriate COVID units, so they could have some extra care during this time,” said Tammy Doss, regional director of operations for Milestone Retirement Communities, which operates Flagstone Senior Living. Doss has been on-site at the Flagstone facility in The Dalles since the first week of the outbreak.
“The state helped assist with the outbreak at the Flagstone facilities by working with residents, families and the facilities to relocate COVID-19 positive residents to the state’s contracted surge capacity facilities. By doing this, the individuals who decided to move could recover from COVID-19 elsewhere and, in turn, help reduce workload for staff at the facilities as they are managing the outbreak,” said Elisa Williams, communications officer with the Oregon Department of Human Services (ODHS)’s office of Aging and People with Disabilities.
Between Sept. 29 and Oct. 5, seven residents had been sent to one of ODHS’s COVID-19 surge facilities, Pacific Health and Rehabilitation in Tigard, in order to comply with that state recommendation and ease the load at Flagstone.
By that Friday, Oct. 9, all remaining 10 residents from the Memory Care Unit had been transferred to the Emerson House in Portland, another ODHS surge facility.
“Pacific Rehab did not have the capacity to transfer all of our residents into their unit, and through our collaboration with the State and County Health Department, Emerson House became available, and we were able to use them,” said Rosalyn Watson, executive vice president of clinical and compliance for Milestone.
Now that all residents have been transferred out of the facility, the Memory Care Unit will be professionally cleaned and disinfected.
“We needed it to sit 48 hours vacant, nobody in or out, and then we are professionally cleaning it today (Monday, Oct. 12) ... and then we’ll go from there,” said Caryl Ridgeway, chief operations officer for Milestone.
ODHS issued an executive order for Flagstone Retirement and Assisted Living on Sept. 14, and issued a second executive order specific to the Memory Care Unit on Sept. 22 — meaning that Flagstone would need to comply with additional infection control requirements, such as posting signs, taking measures to separate infected residents from uninfected residents, and retraining staff on infection control. Additionally, Aging and People with Disabilities staff would begin weekly on-site reviews of facilities and provide additional oversight at the facility.
Staff voice concerns
Staff and residents were tested weekly for COVID-19, and any employee who tested positive was sent home on a mandatory 14-day quarantine. In total, 15 staff members were put on mandatory quarantine — and though these were not all during the same week, the remaining staff severely felt the absence of their colleagues.
Multiple employees who worked during the first days of the Flagstone outbreak have publicly spoken out about negative conditions they experienced at Flagstone, primarily as a result of being overworked and understaffed to the point where residents suffered from neglect, despite local staff’s best efforts to keep up with residents’ needs.
Employees also expressed frustration about corporate’s response and a lack of clear communication from the corporate level, and they said that when they voiced concerns about management of the outbreak, they were either ignored or directly retaliated against.
One employee, who asked to remain anonymous, said that she got a panicked phone call from former-Executive Director Sharla Mosqueda the evening of Sunday, Sept. 20, telling her that her COVID-19 test had come back negative and asking her to come into work the next day.
“The 21st, 22nd and 23rd of September were probably the worst three days of my life that I have had so far,” she said, describing 14- to 16-hour days doing her regular work as a medical technician on the Assisted Living side of Flagstone while also doing jobs outside her regular duties, such as answering call lights and helping to bring meals down to Memory Care. Other coworkers worked up to 36 hours straight, and drove to a colleague’s house down the street to shower because they didn’t have time to go home on their breaks.
“I was like, whoa, I have slept like maybe six hours in the last week. Yeah, I have nothing left to give. I am hearing people screaming, I’m hearing people that are struggling to breathe ... I just, I need therapy after this.”
Despite the rest of her workload, she was put in charge of caring for the one resident in the Memory Care Unit who hadn’t tested positive for COVID-19. The woman was “locked up by herself,” she said, with a wall of plastic between her, her apartment, and an apartment that’s located directly across the hall.
“She literally told me, ‘I don’t know when was the last time that I ate’ ... that, out of everything, strikes a nerve with me the most,” she said.
That apartment across the hall had been housed by a COVID-positive resident, who was among of the first seven residents to be transferred out go the Memory Care Unit. However, between the time when the COVID-positive resident was transferred and staff got around to cleaning the room of contaminants, someone left the apartment door open.
“This woman, for days and days and days, had the opportunity, being left alone, not having her medications, she had the opportunity to go into that apartment and do whatever she wanted ...” in a room that still had many of the other resident’s possessions, along with COVID-contaminated linens, clothing, and soiled bed pads. “It was just sitting there to be rifled through by a (COVID) negative resident.”
That last resident eventually tested positive for COVID-19.
“I just want to do everything that I can to make sure that my grandma doesn’t get put in that situation, that my wife’s grandma doesn’t get put in that situation, that your grandma doesn’t get put in that situation. It’s just, it’s wrong.”
When she did speak out to her supervisors, she said her concerns were ignored, and eventually, she was removed from the work schedule and placed on a mandatory quarantine for entering the Memory Care Unit. She said she does not expect that she’ll be allowed back to work after her quarantine ends.
When asked to respond to employees’ reports of potential negligence at the facility during the outbreak, Ridgeway responded, “The state has been there, and they would have made Roz (Watson) or I aware immediately if there was something that was concerning to them regarding neglect of a resident.”
Referring specifically to former Flagstone staff member Scott Scrimshaw’s account of the “crisis” in the Memory Care Unit, published in the Oct. 7 edition of the Columbia Gorge News, Ridgeway said, “I think the majority of what we read in the article was a disgruntled employee.”
As of press time, two anonymous Flagstone employees have corroborated Scrimshaw’s account of the conditions in the Memory Care Unit during the first week of the outbreak.
While Flagstone was graded positively in ODHS’s recent weekly onsite reviews, the reviews did identify areas where Flagstone’s facilities needed improvement and infection control protocols needed to be reviewed. Specific needs were additional staff for resident care, improved disinfectant processes for PPE, and better practices to ensure frequent communication with residents’ families.
“The facilities are being given ongoing technical assistance to make corrections in procedures,” said Williams. “In the (last week of September), ODHS staff was on site four times to provide technical assistance with infection control — some of these were daylong sessions.”
Said Watson, “It’s important to understand that never did we fail to meet the care needs of our residents. As Caryl (Ridgeway) pointed out, we have employees that, certainly, as we move through COVID and the management of an outbreak in our communities, we understand that, certainly, it’s exhaustive. There have been occasions that it’s been chaotic. But we continue to meet the care needs of our residents.
“I would like to point out that as we go through this pandemic, employees express their stress in different ways. And I think that there have been occasions … that they’ve been able to express their stress. But again, the care of our residents was our priority. And we never failed to care for our residents.”
In total, the North Central Public Health District has connected 48 cases of COVID-19 to the outbreak at Flagstone, including residents, employees, and members of their household. Of these 48 cases, 11 people died — all of them residents of the Memory Care Unit.
“COVID-19 is just a horrific pandemic ... Our thoughts and prayers go out to our families who lost their loved ones. It’s a difficult time for all. And our focus continues to be on the care and services for residents,” said Watson.
“What’s important to remember is these (cases) are people’s lives,” said Ridgeway, “And not just the care staff that are giving the care, but they were close to those residents that have passed away. And it’s very hard as somebody who’s been in the industry and caring for seniors, watching them leave when you have that attachment to them. So we’re just very sympathetic to that. And very appreciative of everything that our staff have done at this community and all of our communities during this pandemic. It is not — it has not been easy.”