As COVID-19 spread across Texas in March, it became clear that the virus would batter the state’s 1,200 or so nursing homes, where some of the most vulnerable Texans were crammed together in largely understaffed, unprotected facilities. Five months later, nearly 9,000 nursing home residents have tested positive for COVID-19 and 1,100 have died from the pandemic.
What wasn’t clear, however, is which facilities had been exposed to the virus. Texas officials refused to release the information, even though doing so would have helped family members make crucial decisions for their loved ones, says Amanda Fredriksen, the associate state director of AARP Texas. Residents and their families “need to know what they’re facing, and not all facilities are doing a good job communicating what’s going on in the facility,” she says.
Data released at the end of July by Texas health officials finally provides a glimpse into infections, deaths, and recoveries at individual Texas nursing homes. The data also reveals that facilities run by Creative Solutions in Healthcare, a Fort Worth-based company with a poor record of infection control that owns and operates 64 nursing homes across the state, are COVID-19 hotspots.
Following a yearlong investigation into for-profit nursing homes, the Observer and Type Investigations found that Creative Solutions has consistently operated its facilities with below recommended staffing levels, leading to death and injuries. Now, data released by the Texas Health and Human Services Commission (HHSC) reveals that residents inside Creative Solutions nursing homes are more likely to be affected by the virus than nursing homes in the state overall.
Before the data was released, advocates and family members had to rely on journalists, press releases, and messages from facility operators to determine the scope of outbreaks at nursing homes. The homes weren’t required to tell family members if a resident had been in contact with an infected person until April 19. And HHSC refused to release even basic information about coronavirus infections in nursing homes until May 15, two months after the virus started sweeping the nation. Even then, the agency only provided information by region, making it impossible to drill down into outbreaks at specific facilities.
For months, the agency fought open records requests for site-specific data, appealing to Attorney General Ken Paxton that it should be allowed to withhold the information on the grounds that it represented “protected health information.” Paxton’s office, which arbitrates disputes between requesters and government agencies, rejected the argument.
Of the 1,220 facilities tracked by HHSC, the two with the highest number of COVID-19 cases among residents are both owned by Creative Solutions: River City Care Center in San Antonio and Mountain View Health and Rehabilitation in El Paso. The 92-bed River City Care Center has the most in the state with 157 cases. While county officials sent residents from other nursing homes who had tested positive for COVID-19 to River City Care Center in an attempt to consolidate infected residents in one place and avoid spreading the virus, conditions within the facility may have led to a higher number of COVID-19 deaths since. Some Bexar County officials opposed sending coronavirus patients to River City in the first place, calling the site “horrible” due to its spotty inspection record. A San Antonio Express-News article published in November reported instances of abuse and neglect, including the choking death of one resident. A news report indicates high temperatures inside the facility, along with residents possibly being given incorrect medication, may have been a factor in six coronavirus-related deaths. As of July 30, seven COVID-19 deaths have been reported at the facility.
COVID-19 cases have cropped up at other Creative Solutions facilities elsewhere in San Antonio. At The Rio at Mission Trails, 67 residents have been infected and four have died; Huebner Creek Health & Rehabilitation Center had 54 cases and 3 deaths; Buena Vida Nursing and Rehab recorded five infections and one death. Some of those facilities had employees that worked at more than one of the homes—a practice that has been identified as a factor in the virus’s spread nationwide.
The nursing home with the second-most infected residents in Texas is another Creative Solutions facility: the 139-bed Mountain View Health and Rehabilitation in El Paso, where 117 people tested positive for the virus and 16 have died. The facility has been under fire for months by workers who have complained to state regulators, saying the facility has denied them access to personal protective equipment. The company allegedly hid masks from workers and failed to provide gowns, shoe, and hair coverings that could have prevented spreading the virus.
The state health agency launched an investigation into the outbreak at Mountain View and four other Creative Solutions nursing homes in El Paso. Between them, they’ve tallied 228 infections and 31 deaths. State officials said on Thursday that investigations into all of the facilities except Mountain View have been concluded, but they had not provided findings of those investigations to the Observer by Monday.
Altogether, Creative Solutions nursing homes in Texas have recorded 601 COVID infections among residents and 77 deaths since the beginning of the pandemic. On average, the company’s facilities had 10 infected residents, higher than the state average of seven. Creative Solutions homes also had more residents die on average than the rest of the state: 1.24 deaths per facility at Creative Solutions compared to 0.93 statewide.
The company did not return a call for comment for this story.
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