This story has been updated.

The nursing home where health officials identified 14 cases of the novel coronavirus was given a one-star rating from and cited for abuse.

An 11-page report on the Southeast Nursing and Rehabilitation Center by the Department of Health and Human Services in late October 2019, detailed various violations, including a lack of proper sanitary measures, food safety issues, mechanical and electrical failures, pest control issues, and an overall lack of professional standards and adequate training. In two separate citations, it was reported that nurses would perform perineal care on multiple patients without changing gloves and then would touch clean towels with those same soiled gloves. Following these procedures and discarding gloves, nurses would fail to wash and sanitize their hands.

“Based on observation, interview, and record review, the facility failed to maintain an
infection control program designed to provide a safe, sanitary, and comfortable
environment and to help prevent the development and transmission of communicable diseases,” the report stated.

Southeast Nursing and Rehabilitation Center was given 17 health citations in October, 10 more than the average for a nursing home in Texas. It was the third inspection the nursing home has undergone during 2019. In March 2019, it was fined more than $62,000 for citations stemming from neglect. In April 2019, the nursing home was cited for failing to maintain the personal hygiene of four residents.

At the bottom of that April report, DHHS noted: “When germs and bacteria spread, vulnerable nursing home residents can be affected in a negative way. This is especially important because these residents are most likely to have medical conditions that, along with poor hygiene, can wreck (sic) havoc on their health.”

As of Wednesday evening, eight residents, one of whom died Tuesday, and six staff members tested positive for coronavirus. Another 74 residents were awaiting expedited test results.

Southeast Nursing and Rehabilitation Center. Credit: Scott Ball / San Antonio Report

The Metropolitan Health District, the San Antonio Fire Department (SAFD), and the nursing home’s management company, Advanced Healthcare Solutions, were working to get tests for the rest of the staff members, Fire Chief Charles Hood said Wednesday during a press conference.

SAFD became aware of the potential for an outbreak at the Southeast San Antonio facility on March 21, when emergency hospital transport requests increased from the nursing home, Hood said. “As soon as we found out there was a threat [of an outbreak] we were out there in about two hours.”

The Southeast Nursing and Rehabilitation Center staff have been given additional personal protective equipment (PPE), and Metro Health staff has gone inside to sterilize the facility located at 4302 E. Southcross.

“We’ll continue to monitor increased transports out of nursing homes in this region, whether it’s a private ambulance company or the San Antonio Fire Department, to look at trigger points [for] where we may need to address those as a potential hotspot,” Hood said. “We are not looking to take over any nursing home in this region, but we do want to take care of our most vulnerable populations.”

Nine days after the first positive COVID-19 case was reported at a nursing home facility in Kirkland, Washington, about three weeks ago, City and Bexar County officials visited all 68 nursing homes in the area to educate them about the potential spread of COVID-19 and train them on proper cleaning and use of PPE, Hood said.

“Resident health and safety is a top priority for Southeast Nursing and Rehab,” stated nursing home officials. “We agree that the spread of this novel virus is a critical issue that requires our immediate attention, which [we] have done for the past three weeks.”

The nursing home, which has approximately 116 beds, is closed to visitors. Family members of residents have been contacted and can interact with residents using video chat, phone calls, text, or social media. “We have reviewed and updated our infection prevention and control plans and our emergency communication plan,” nursing home officials stated.

Jaivon and Tamaya Cuffin visited Jaivon’s grandmother Yolanda at the facility on Wednesday afternoon for her 64th birthday by talking with her through a window in Yolanda’s room. 

They said they were not able to speak with Yolanda by phone and she does not have a cell phone. 

“They don’t even let us talk to her on the phone,” said Tamaya, who is Yolanda’s daughter-in-law.

While they were notified of the first person who tested positive at the facility, they were unaware that 11 more were confirmed until reporters told them.

“I thought it was just one,” Jaivon said. 

“Now we really can’t talk to her,” he said, noting that they can’t see her very well through the window. “She’s feeling all right. … There’s nothing we can do about this.”

As SAFD and Metro Health monitor nursing home transports of patients to and from the hospital, regional medical directors are working on a system to call for instructions on whether to transport a resident to a hospital or not, Hood said.

“Our goal is to transport those that need to be transported, but … if we can keep [people] in the facilities, that’s what we want to do,” he said.

Under a statewide order, visits to nursing and senior living facilities have been prohibited because the virus is most deadly to older people and those with underlying health conditions.

The number of confirmed coronavirus cases in Bexar County rose to 207 on Tuesday, including the residents and staff at the nursing home. Nine people have died in Bexar County from complications associated with the virus.

Senior Reporter Iris Dimmick covers public policy pertaining to social issues, ranging from affordable housing and economic disparity to policing reform and mental health. She was the San Antonio Report's...