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By Thomas Goldsmith 

Gov. Roy Cooper’s administration says it will review the contract management of North Carolina’s four state-owned veterans nursing homes by a private Georgia-based health care conglomerate. Because 36 veterans died of COVID-19 in the homes, Cooper wants to know what’s what before the state grants a second one-year extension of Pruitt’s five-year deal in December.

A statement from Cooper chief spokesman Ford Porter outlined some steps that the state government will take following the COVID-related deaths of 36 veterans in three of the homes — in Fayetteville, where 20 men died; in Salisbury, where 15 died; and in Kinston, where one died.

The N.C. state-owned skilled nursing facilities have operated under the management of Norcross, Ga.-based PruittHealth since 1998 under a contract that most recently pays the company 9.25 percent of the total operating budget of the homes.

“State regulators will continue to work to ensure that Pruitt Health-managed veterans homes comply with applicable infection control regulations and CDC guidance,” Porter said in an email. “The administration is also reviewing this contract to determine if Pruitt is compliant or if any action should be taken.”

Management pact up for renewal in December

The agreement, which brings more than $4 million in annual commissions to PruittHealth, was most recently renewed by the state on January 25. The one-year extension of the five-year, $200 million contract was achieved with a one-page document that simply said the company would continue to manage the homes for some of North Carolina’s most vulnerable veterans for another year, with no changes in provisions.

Renewal Agreement – PruittHealth Veterans Services – NC Inc_

Private managers mum on deaths

A PruittHealth spokeswoman said Tuesday that the company would decline comment. The non-public company has expressed sorrow about the North Carolina veterans’ deaths with COVID but has declined any discussion of how those deaths happened, or whether the company’s performance as managers might have played a role.

Any discussion of the privatization of nursing-home management is taking place amid concentrated work nationally, as well as in North Carolina, to improve the situation of residents of these centers. Because of age, congregate lifestyle and perilous medical conditions, nursing home residents have taken a far disproportionately lethal hit from the novel coronavirus, particularly in its first months.

Several COVID-related actions taken at North Carolina’s four state veterans’ nursing homes — the fourth is in Black Mountain — have also been used at each of the 427 nursing homes across the state, state DHHS officials said.

As part of an “aggressive,” coordinated plan, each nursing home went through a focused COVID-related inspection during the summer to make sure it met infection control guidelines and goals set by the federal Centers for Medicare and Medicaid Services. Under an initiative announced Aug. 7, every nursing-home staff member will also undergo COVID-19 testing every two weeks.

DHHS ramps up testing

“We are using federal CARES dollars that were allocated to the Department of Health and Human Services for testing,” Mandy Cohen, secretary of the department, said after an Aug. 7 press briefing.

“It will be on the nursing homes … they are going to be the ones that will have to get in contact with a testing vendor or figure out whether or not they want to do the testing themselves. We will provide the funding for that.”

State Rep. Grier Martin (D-Wake), a veteran and member of the NC House Homeland Security, Military, and Veterans Affairs Committee, said that the panel was unlikely to meet before a new session of the General Assembly meets in January. Another possible source of oversight, he said, could be the NC Joint Legislative Oversight Committee on Health and Human Services. Rep. Josh Dobson (R-Nebo), one of that body’s chairs, did not return a call for comment.

“I first want to see what steps the executive branch takes and I know the Cooper administration is taking a close look at the deaths and how they should factor in going forward in any renewal of the contract with PruittHealth,” Martin said.

The unfolding of an overwhelming new virus means that methods of prevention and causes of death from COVID-19 can be complex to untangle. But it’s worth noting that many nursing homes have escaped an appearance by the infection in their facilities, including about 275 in North Carolina.

CalVets nursing homes kept COVID-19 at bay

In an example recently pointed out by Politico, the six state-run veterans nursing homes in California experienced two deaths among 875 occupied beds based on the most recent count by the Centers for Medicare and Medicaid Services.

“If you let your guard down, you are in trouble with this virus,” Thomas Bucci, the California Department of Veterans Affairs long-term-care director, told Politico. “We are only as good as our weakest employee who decides they are not going to wear a mask and just gave a resident a bath and breathed all over him.”

The 36 North Carolina men who died, at least one of whom had survived the Pearl Harbor attack, lived in nursing homes to which several merited special acceptance because of their hazardous duty exposed to toxic materials in the Vietnam and Gulf wars.

There’s a fifth state veterans nursing home managed by PruittHealth, the Georgia War Veterans Nursing Home in Milledgeville. On July 31, the Georgia Department of Public Health reported that 15 men had died in the home of COVID-related causes.

Deaths continued at privately managed Georgia center

By Aug. 11, the same health officials revised totals to say that 17 men had died in the Milledgeville center.

The numbers indicated that two veterans had died in 12 recent days in this home for soldiers, the same number who died during the entire pandemic in California’s six state-run nursing homes.

The N.C. Pruitt contract comes up for renewal by the state Department of Administration on Dec. 1. If the company retains the business, as it has for 22 years, it will also take over management duties for two new state veterans homes in planning stages for Raleigh and Kernersville.

Thomas Goldsmith

Thomas Goldsmith worked in daily newspapers for 33 years before joining North Carolina Health News. Goldsmith is a native Tar Heel who attended the UNC-Chapel Hill, and worked at newspapers in Tennessee...