By Thomas Goldsmith

For the first time, a significant public body had a discussion of North Carolina’s deal with the company that runs the NC State Veterans Homes, at which 38 residents contracted COVID-19 and died. In all, 87 veterans were diagnosed as having contracted the virus.

A Tuesday vote by the state’s NC Veterans Affairs Commission to extend the contract of the Georgia-based PruittHealth company means the company will continue to manage the four homes without contract review or a competitive bidding process for another year. Those will come during a full contract review next year, officials said.

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Commission members meeting virtually heard an extensive presentation urging approval for contract renewal by Terry Westbrook, deputy director of the Veterans Division of the state Department of Military and Veterans Affairs.

“Within the Department of Veterans Affairs, our evaluation is that Pruitt Healthcare has continually provided the level of service and quality here that we require for our veterans, and we want to continue,” Westbrook said.

“That quality of care meets all the standards of care that the [U.S.] Department Health and Human Services has dictated.”

Commissioners had no direct discussion of how and why the COVID-19 infections and deaths happened. Nor was there mention of the 10 cases of the disease that the state Department of Health and Human Services list as ongoing at the Pruitt-run veterans nursing homes in Salisbury and Fayetteville.

In an email exchange in the two days after the commission meeting, Westbrook wrote, “There is no indication that Pruitt did anything that caused veteran deaths.”

At Tuesday’s commission meeting, Westbrook’s pitch was so positive that commission member Patrick Smathers asked if he had any criticism of Pruitt.

“I guess I’m really asking about as far as evaluating Pruitt, what would you say?” Smathers said. “Where would they need to improve on it?”

Westbrook hesitated briefly.

“If they don’t have anything, just say it,” Smathers said.

Westbrook said he hated to make the case that the corporation had nothing to improve.

“Everybody can always find things within the organization and improve them,” he said. “I think Pruitt would tell you things that they would like to do a little bit better with their personnel and they’d like to be a little better with their responsiveness and response times.”

However, Westbrook said, PruittHealth doesn’t need to make changes.

“I can tell you that I’m not aware of anything we would ask them to do differently now that would be in the best interest of how we provide service,” he said.

In a follow-up email, Westbrook said that the state will be reviewing veterans nursing home procedures into 2021, with results to be considered during next year’s request for proposals.

“In order to ensure a comprehensive RFP process and that the state has the right vendor, DMVA has renewed the Pruitt contract for one year,” he wrote. “State officials will continue to monitor and enforce state and federal regulations in the veterans homes.”

The extension of the company’s $45-million-plus contract means it will oversee the in-progress state-owned veterans nursing home in Kernersville and one planned for Raleigh, as well as those operating in Kinston, Black Mountain, Salisbury and Fayetteville.

During the commission meeting, Westbrook said that although 38 residents had died with COVID-19 diagnoses, only 13 had had the disease listed as the principal cause of death on death certificates. Others had COVID along with heart disease, cancer and other conditions that pose mortality risk factors for older people and others who contract the coronavirus.

Commission chair Jane E. Campbell then noted that the standard used across government departments relies on counting deaths in which the person was positive for COVID-19, so that the Veterans Affairs Commission should rely on the higher figure.

Commissioners approved the extension by acclamation after hearing that election-year timing caused the discussion of the deal to be delayed.

“When it came time to our last meeting, we did not feel that undertaking the discussion of the renewal of this was something that we wanted to take on at the end of September of an election year,” Campbell said. “And so we specifically talked about scheduling a meeting to have this conversation post Nov. 3.”

On Thursday, Westbrook responded, “There are no political considerations used in DMVA decisions on contract actions and veteran care and there was no delay.”

Campbell answered questions via a Thursday night email.

“My comments were an attempt to clarify that I did not even want the perception that the decision had any political/partisan connections,” she wrote. “This was a vote to make the right decision about providing care for our fellow veterans who are residents at the 4 state veterans homes. However, perceptions can be reality. For that reason when the timing of this meeting was discussed – it made sense to me to wait until after Nov. 3. “

The contract with Pruitt will ultimately be awarded by the Department of Administration’s fiscal management division.

What has Pruitt done to improve the state veterans nursing homes?

Terry Westbrook, deputy director of the Veterans Division of the state Department of Military and Veterans Affairs, told NC Health News that PruittHealth has brought improvements to the veterans nursing homes such as:

  • “A system that provides an additional air filtering system through infrared light to clean over 99% of possible contaminants from the air supply,
  • “A system that can automatically check a person’s temperature when they first enter the building and determine if any additional screening practices need to be executed, and
  • “Increasing the COVID-19 testing through Point of Care testing to continually evaluate the status of residents and staff.”

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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 and at the Raleigh News & Observer.

Goldsmith's specialty is reporting on aging issues and he's won multiple awards for this work.