By Carl Blankenship
carl.blankenship@salisburypost.com

SALISBURY – A second lawsuit filed Tuesday against the Citadel makes new allegations about conditions inside the nursing home as it seeks “a comprehensive review of the facility’s polices” by a judge.

The Citadel is a site of a COVID-19 outbreak that represents a significant chunk of Rowan County’s cases and is the hardest hit nursing home in the state by the coronavirus-caused disease. Its former residents represent a majority — 17 of 22 — of those who have died in Rowan County after testing positive. Tuesday’s suit was filed by local law firm Wallace and Graham as well as Raleigh firm Gugenheim Law, which specializes in prosecuting claims against nursing homes.

Wallace and Graham also filed a suit last week in which it sought damages in the case of Marjorie Garvin, who was a resident at the facility and died Monday after previously testing positive for COVID-19. The law firm says it plans to dismiss Garvin’s initial suit “to allow the family to grieve and to get her estate in order.”

The new suit filed by Wallace and Graham seeks an injunction “to force compliance with regulations and North Carolina law.” It does not seek monetary damages. It includes 14 affidavits, including sworn statements from anonymous staff.

Claims made in the newest lawsuit include:

• The Citadel admitted new residents despite the outbreak and at least one person who was recently admitted died within two weeks coming to the facility.
• The facility “failed to direct or require nurses and employees to wear masks, gowns or face shields throughout the month of March 2020.”
• Employees who wanted to wear masks around residents in March were told to remove them to prevent “mask fear” until early April. 
• On April 11, an Accordius Health employee came from another facility and found N-95 masks that were not given to staff.
• Nurses were not required to change their gloves from room to room or patient to patient.
• Staff members were not given instructions for COVID-19 patient care as late as mid-April.
• The facility did not “timely implement a COVID-19 management plan.”
• The facility allowed residents to leave their rooms and walk the halls at the home after beginning an isolation protocol, including those who had “recently shown symptoms.”
• The facility failed to tell staff that residents tested positive for the virus and certified nursing assistants learned about cases at the facility from word of mouth and news outlets.
• As late as April 6, there was a sign on the door to the facility stating “ATTENTION ALL VISITORS: There are no cases of Coronavirus in this facility. However, we are not accepting visitors into the building at this time.” The complaint includes a scanned image of the sign.
• Accordius did not pay for testing staff and did not test all patients and new residents
• The Citadel allowed employees with COVID-19 symptoms to return to work after taking sick days or reported symptoms and were not tested.
• The facility asked employees with symptoms and pending test results to work while tests were pending and was “not accepting call-outs without a doctor’s note.”
• The facility allowed staff to return to work after testing positive and not quarantining for 14 days.
• Staff were required to work double and extra shifts in April. One employee oversaw 52 residents during a shift and the nursing director worked a 24-hour shift.
• The facility did not have a plan to prevent understaffing, resulting in issues for residents that included delivery of medications, assistance traveling to restrooms and changing soiled clothes. The lawsuit says equipment was reused in “an unsanitary manner.”
• Visitors bought supplies, including gloves and disposable masks, because the company did not. The lawsuit says one or more employees brought their own supplies.
• COVID-19 positive patients shared restrooms with residents who were not infected.

Accordius COO Kim Morrow said in an email the company had not been served with the lawsuit and that, “It is unfortunate that there has been so much misinformation put out by a source clearly not familiar with the facts of what has been going inside this building.”

“The negative press this law firm is trying to create for the sake of building their own reputation only hurts the patients and staff they claim they are trying to protect,” Morrow said. “I only wish that those individuals responsible for such reckless and selfish behavior would put those efforts to helping our facility care for our residents as so many people from the community already have, rather than trying to capitalize on this pandemic for personal gain and recognition.”

Morrow said the facility has been doing “everything we can in lockstep with the CDC guidelines, the local department of health and local hospitals.”

But a large part of the complaint outlines communication failures from management at the facility, claiming the Citadel lied about test results, including whether the facility had results and telling loved ones a patient who had tested positive was COVID-19 negative. 

The lawsuit claims management failed to inform loved ones until residents became too sick to communicate.

“In at least one instance, a patient died at the Citadel and was left in the room until the next morning,” the lawsuit alleges. “In at least two instances, the power of attorney holders were not timely told of their loved ones’ deaths and were not timely told whether the deceased were positive for COVID-19. One man did not even learn his loved one was ill until after she had died and her body had been sent to the funeral home.”

One certified nursing assistant described going to get tested four days after she started experiencing symptoms. She was advised to self-quarantine for two weeks. She described coworkers being asked to return to work after only a week of quarantine and a nurse from a staffing agency who came into work after testing positive.

The woman said there was a protocol to isolate patients for five days, but there was an instance where a patient was returned to the facility from Rowan Medical Center and placed in isolation for a single night. The same nurses assistant said she talked to a patient who was told she had tested negative when she had, in fact, tested positive. 

The nursing assistant told the patient she had tested positive “because I thought she had a right to know,” according to the lawsuit.