Families question lack of visitations at veterans home

Primary issues at the Delaware Veterans Home in Milford include outdoor visitation that, according to concerned family members, met guidelines but was prohibited during its reopening amid COVID-19, as well as staffing turnover and a lack of communication from the DVH administration. Submitted photo

MILFORD — Established in 2007, the Delaware Veterans Home is a long-term care facility for veterans. Its stated mission is “to provide outstanding long-term care services to Delaware veterans that uphold dignity and respect while sustaining and improving their quality of life.”

However, at present, all is not peaceful among those with loved ones at the four-unit, 150-bed facility in Milford, which functions as a division of the Department of State. Its policies are administered by the Delaware Commission of Veterans Affairs, which also oversees its operations.

Some family members of loved ones at DVH have spoken out, with questions, concerns and accusations regarding the administration and operation of the facility, which is directed by Tina Foskey, DVH’s contracted administrator.

“It’s a mess down there. They don’t seem to have their act together,” said Dover resident Steve Lepage, whose 85-year-old father — like Mr. Lepage, a U.S. Air Force veteran — has been a resident at the Delaware Veterans Home since June 2015.

Primary issues include outdoor visitation at DVH that, according to concerned family members, met guidelines but was prohibited during its reopening amid COVID-19, as well as staffing turnover and a lack of communication from the DVH administration.

“I can tell you that a number of our resident families contact DVH on a regular basis, sometimes daily and sometimes multiple times a day,” said Kristopher Knight, Delaware chief deputy secretary of state. “Often, they want to speak directly to the director, who obviously has a very busy job. We also send out a weekly update to all families. We try to be responsive, even if the requests are inaccurate or accusatory, because we understand the frustration families endure during difficult times.

“Sometimes, we are asked to do things we cannot do for legal reasons. Sometimes, we cannot provide the individual attention that family members want directly from the nursing home director. But we try to respond within reason without sacrificing care to our residents,” he said.

For several months during the coronavirus crisis, U.S. Army veteran Gene Thornton battled with DVH administration and other state entities in efforts to visit her husband, Lt. Col. Donovan Jagger, in person outdoors. Lt. Col. Jagger had dementia and passed away Aug. 24. However, Ms. Thornton continues her fight to remedy the plight she says exists at the veterans home.

“I have an interest in making the world a better place, after I leave it. And right now, that veterans home requires some attention,” she said.

During the pandemic, except for an allowed visit on Aug. 19, Ms. Thornton’s only contact with her husband, whom she notes was very hard of hearing, was via videochats. That August visit was allowed as “compassionate care,” an accomodation typically given to family of loved ones who are near the end-of-life stage.

According to Ms. Thornton, the Delaware Veterans Home met state criteria, which allowed outside visitation beginning in June with the Centers for Medicare & Medicare Services’ defined guidelines for reopening of nursing homes. That criteria, issued in mid-May, required no new-onset COVID-19 cases, adequate staffing and supplies of personal protective equipment. However, such outdoor visitation at DVH was not allowed while her husband was alive, Ms. Thornton said.

“What we family members want to know is, why weren’t we allowed to visit outside since the first of June?” said Ms. Thornton. “I kept saying that I wanted to see my husband … why can’t we visit outside? There is a big porch. Yet, we just found when the state of Delaware announced that indoor visitation could resume in nursing homes on the eighth of September, the statement said outdoor visitation has been authorized since the first of June. I would like to know — we would like to know — what has Miss Foskey requested and when did she request it?”

Regulations change often during pandemic

Mr. Knight explained that the coronavirus pandemic left many regulations in flux.

“We know that some DVH resident family members and staff aren’t happy with some of the decisions that have been made at the home during the pandemic,” he said. “We know some have been in contact with the press, the governor’s office, legislators and other advocates, which is their right. They have targeted the home administrator with all kinds of accusations, some of which are untrue and unfair.

“The reality is that DVH is a highly regulated health care facility and the rules governing the home have been in an almost constant state of change over the last seven months,” he added. “Some staff and families don’t like that — they want things to be stable and predictable. A lot of times, we agree with them, but we don’t have the authority to ignore rules from state and federal authorities like (the Department of Health and Social Services) and the Centers for Medicare & Medicaid Services.”

Ms. Thornton said she is bitter and harbors a sense of guilt for not being with her husband in his final weeks and months.

“I was my husband’s medical power of attorney. I’m not just some snoopy wife. I’m not just a wife, and my husband can speak for himself. My husband could not speak for himself. I was his advocate. And sure, (with) COVID, we’re going to have things that are going to be different. I understand that. I am not asking to go in without a mask,” she said. “Why couldn’t I have done that all along? Why couldn’t I have seen my husband all along or at least since the first part of June? He might be alive today if I had.”

Families feel guilt after not visiting

Mr. Lepage shares in that heartbreak.

“I feel really bad for Gene Thornton. I mean, if she would have had at least the window visits since June, maybe she wouldn’t feel so guilty. She really feels guilty, like she let her husband down,” he said. “And I kept telling her, it’s not your fault. It’s the people that are running this place. It’s their fault for not being proactive and seeing a sense of urgency for getting families reunited. That is what hurts me.”

He said he hopes to get some explanation soon.

“Someone has to explain: Why we were denied at least window visits back in June? How is the virus going to travel through a door or window? We are outside, and they are inside. Why wasn’t this allowed?” Mr. Lepage said. “Why did family members, such as Gene Thornton, have to deal with their husband’s passing, having lost all that time and only being able to see them as death was knocking at the door?”

Mr. Knight said safety was a priority.

“All our decisions are based on resident safety,” he said. “Everyone agrees that keeping loved ones apart is not something we want or like to do. It’s a terrible trade-off for safety. That said, even as we answer this question, there are indications of a resurgence of COVID cases in Delaware’s long-term facilities. We don’t want that at DVH.”

Mr. Knight added that the Delaware Veterans Home was one of the first nursing homes in Delaware to stop allowing visitation because of COVID-19.

“That is one of the reasons we have had no COVID deaths (there). When our outdoor visitation plan was approved, I believe we were in the first third of facilities with an approved plan from the state. It’s easy to second-guess, but better safe than sorry in this pandemic. If we had had multiple deaths at the facility, you would be asking much different questions.”

Additionally, Mr. Lepage claims family did not get answers from DVH or leadership concerning visitation and testing of the facility.

“It appears the facility took nearly 90 days to get universal testing done after it was announced by the governor on May 5 that there would be universal testing of staff and residents. On July 6, we received a consent form for family members for testing. Why did it take so long for testing? Visitation is based on the outcome of this testing,” he said.

In addition to numerous chain emails, Ms. Thornton said she spoke with Secretary of State Jeff Bullock and “told him months ago that Ms. Foskey was not responding to family requests for information.”

“The data she provides to the CMS is inaccurate,” said Ms. Thornton. “Every time she sent a family newsletter out, I asked her questions about it and she never responded to me. Then, I approached Courtney Stewart, who is deputy secretary of state, and I let her know there was a problem. And Courtney Stewart responded to one of my emails; thereafter, (she) never opened them … never opened another email.”

Ms. Thornton added that she was disappointed in the demeanor of the administration.

“If you’re going to not speak to family members, not respond to their requests, make errors, and when family members point them out to you, not even take the time to correct the errors, and be rude to family members, that is not the right attitude,” she said.

“She (Ms. Foskey) is a contractor. I have asked to see her contract. I can’t find it on (any) website. I’ll bet you she is in violation of her contract.”

‘Government unresponsive’

Reached Friday afternoon at the Delaware Veterans Home, Ms. Foskey declined comment, saying she is “not at liberty to speak” on those matters, adding, “that is why we have our community relations.”

Ms. Thornton says she and others with concerns about their loved ones at DVH are getting the runaround treatment.

“It is not good when the government is unresponsive to the people,” said Ms. Thornton. “As far as I am concerned, the story has moved from the Delaware Veterans Home to the secretary of state’s office. They are aware of this. They have allowed her (Ms. Foskey) to fire merit employees, and they are aware that merit employees are quitting and citing the hostile work environment. They are aware of that. They just ignore you.”

Mr. Lepage said he wants the governor’s office to look into the facility.

“We have asked for the governor’s office to investigate the issues going on down there,” he said. “There appears to be violations of the state’s Respectful Workplace Policy, which should be alarming to the governor and secretary of state’s office. However, it does not appear they are looking into any of the things we have heard of. There have been forced firings, resignations. Good people are leaving the facility due to the toxic work environment.”

According to Mr. Knight, state personnel rules “don’t allow us to discuss those matters unless an employee formally waives their right to privacy.”

“I can say that all professional employees at DVH have responsibilities for which there is zero tolerance if standards aren’t followed. But employees who are let go also have rights to appeal, including to the courts, and we fully support those rights,” he said.

“We know there is always room for improvement at DVH. While our staff has done a terrific job during the pandemic, we’re still working to implement changes needed to address deficiencies noted in past federal and state surveys,” said Mr. Knight. “Just like in any organization, some of our staff are resistant to those changes, and some will choose to leave. While we don’t like that, we cannot ignore our deficiencies, especially when our regulators require better compliance. We will also look at whether to recommend if DVH would be a better fit in the Department of Health and Social Services, which runs other long-term facilities in Delaware.”

Upcoming renovation to facility questioned

Since the COVID-19 lockdown, Mr. Lepage said his dad’s weight has dropped from 160 pounds in mid-March to a present weight of about 125 pounds. His dad also has open wounds on his buttocks.

“Everyone in my dad’s chain that I communicated with, the social worker, the unit manager, the nurse … they were all forced to resign or were fired. I had no one at the time to speak to. … They were good people,” said Mr. Lepage. “After a while you build a rapport and a certain level of confidence in the people that you are talking to that cared for your mother or father. Well, all of that was gone.”

Up until September, when weekly window visits started, Mr. Lepage said he was afforded one visit, on Aug. 1. “(It was) a compassion care visit; they thought he was going to die,” Mr. Lepage said.

Other than that, it was virtual visits, which Mr. Lepage said were difficult, because his father, in addition to dementia, has glaucoma and hearing loss.

Mr. Lepage had Sunday window visits twice this month. He prepares a home-cooked meal with his dad’s favorites and drops it off around 11:30 a.m. At the window, they are connected via telephone.

Mr. Lepage also questions the timing of a proposed bathing suite renovation project in the Red Unit, where his father currently resides.

This project, announced by Ms. Foskey in a Sept. 10 release, entails renovation of the current bathing suite and removal of a nurse’s station. Construction is slated to begin in November but is subject to change.

“This construction necessitates that we move the residents currently residing on the Red Unit to the Green Unit or to the Gold Unit. During this process we encourage your input regarding where your loved one will move. We will make every effort to accommodate the wishes of both the resident and the family,” Ms. Foskey stated in the release. “It is anticipated that the moves will be initiated the middle of October. As we work towards finalizing room assignments, we will be sending additional correspondence (with) room numbers, room telephone numbers and nursing staff contact information.”

Mr. Lepage said his father should not be moved to another room.

“From what I understand, there is nothing wrong with the wing. It is just a renovation project,” he said. “And there is a thing called transfer trauma, especially where you (have) a dementia patient. Like in the case of my father, he has got Lewy body dementia. He has hallucinations; he thinks he is not in his room.

“If they move my dad … his anxiety level is going to go up. He is going to think he is not in the right place, and I am not there to be able to ease him into it. Transfer trauma, I have researched (it). It can have devastating effects for a person who has dementia,” said Mr. Lepage. “With all this stuff that we’ve got going on with the lockdown and everything, one has to ask, ‘Is this really a necessary thing, especially if everything is working? Couldn’t this be put off?’ We don’t even have visitation. Now, you’re going to allow construction workers?

“I’m fed up,” said Mr. Lepage. “I think there needs to be an investigation down here.”

Mr. Knight says he stands by the decisions made at the veterans home.

“From the very outset of the pandemic, we made resident safety our top priority,” he said. “Today, we have a five-star rating from CMS and no resident fatalities related to COVID-19. We don’t need to tell you how that compares to long-term care facilities statewide, where the virus has taken a deadly toll.

“But this level of safety has come at a cost to our residents and families, especially when it comes to visitation. We all agree that has been a terrible trade-off. We are now allowing outside visitation and hope soon to allow inside visits, done safely under plans approved by DHSS. When our plan for outside visitation was approved a few weeks ago, only about a third of long-term care facilities in Delaware had approved plans.”

Helpful Coronavirus links

Delaware Division of Health Coronavirus Page
CDC: About the Coronavirus Disease 2019
CDC: What to do if You Are Sick
Johns Hopkins Coronavirus Resource Center
AP News Coronavirus Coverage
Reopening Delaware: Resources for Businesses
Delaware Phase 2 guidance

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