Rutherford County, NC, Western North Carolina, News,arrests, RC Catalyst, Judicial District 29A Hospital – Foothills Catalyst

Tory Shepherd Named CEO of Rutherford Regional Health System

Advisory: Detention Center Investigation into Inmates’ Overdoses

On August 22, 2022 an investigation revealed that a total of four inmate’s, at the Rutherford County Detention Center, overdosed on some type of narcotic. Three of the inmates were administered Narcan by officers and were transported to Rutherford Regional Medical Center where they were treated and released back into the custody of the Rutherford County Detention Center. The fourth inmate was administered Narcan on a precautionary status and remained at the Rutherford County Detention Center.

This investigation is still active and being conducted by investigators of the Rutherford County Sheriff’s Office Criminal Investigation Division to determine how the narcotics were brought in to the Detention Center.

Monday numbers: A closer look at COVID exhaustion and how it’s affecting our response to the pandemic

By

 NC POLICY WATCH

The latest poll results from the the Axios/Ipsos Coronavirus Index show that Americans are exhausted with COVID-19 and its variants, with a majority saying they don’t believe they will ever be rid of the virus in their lifetimes.

The results, released last week, are the latest indication that while the current BA-5 variant continues to spike infection levels and spur new waves of hospitalizations, fewer Americans are wearing masks, are familiar with the latest treatments or are inclined to get a booster shot if they became available.

Last week, Gov. Roy Cooper announced he would lift the state of emergency related to the pandemic in North Carolina.

This week Dr. David Wohl, professor in the Division of Infectious Diseases at the UNC School of Medicine, told Policy Watch there is an obvious divide between the statistics and medical realities of the pandemic and public perception and sentiment.

“What we’ve seen over the last several months, if not longer, is a disconnect between what may make sense from a public health perspective and what the perspective is of the public,” Wohl said. “Regardless of the way the curves look, whether we’re talking about peaks or valleys, in general, the public has said, ‘We’re going to move on. We’re going to take it on the chin if we’re seeing more cases. We’ll take it on the chin if we see more hospitalizations, maybe even more deaths.’”

Listen to Rob Schofield’s entire conversation with Wohl here.

 

Today, a by-the-numbers look at COVID exhaustion nearly three years into pandemic that has killed more than a million people in America alone.

78 – the percentage of poll respondents who somewhat or strongly agreed with the statement “we will never fully be rid of the coronavirus in my lifetime”

46 – the percentage who said they have had or suspect they have had COVID-19 since the onset of the pandemic.

71 – percentage who said they believe they have had it once

25 – percentage who said they believe they have had it twice

3 – percentage who said they believe they’ve had it three times

61 – percentage who said their most recent COVID infection came after they were fully vaccinated

33 – percentage who said they personally know someone who has been reinfected in the last few weeks

36 –  percentage who said they sometimes or always wear a mask when they are outside their own homes — that is the lowest percentage the polling has found since the onset of the pandemic

36 – percentage who said they never wear a mask outside their homes — a number that is up 14 percent since this time last year

36 – percentage who said they feel as though those around them have moved on from the pandemic but they haven’t

26 – percentage who said they were familiar with the antiviral pill treatment Paxlovid

27 – percentage who said their greatest concern was potentially passing the virus to someone with a higher risk of serious illness

17 – percentage who said their greatest concern was developing long COVID (the next highest concern)

85 – percentage of those fully vaccinated who said they would be very likely get a fourth shot if it were available

74 – percentage who said they would be likely to get another booster if it was recommended annually

76 – percentage if the booster was one that protected against new variants

54 – percentage who said other Americans are behaving in ways that are making the country’s recovery from the pandemic worse

Breaking News: Shooting Incident Did Not Occur At Hospital

July 8,2022

Rutherfordton- A shooting was incorrectly identified as occurring at the parking lot of Rutherford Regional tonight by Rutherfordton Police Departments. Rutherford Regional and Rutherford Police have released statements concerning this.

The shooting it appears occurred off site of the hospital and the victims were dropped off there by car.

“Rutherford Regional is safe and sound. An earlier statement released by the Rutherfordton Police Department incorrectly referenced a shooting incident at our hospital. There has been no incident or threat to safety at our campus, however, we are treating victims of a shooting incident that occurred outside Rutherfordton city limits.

We appreciate the concern of our community and the support of our law enforcement officers, and apologize for any concern the miscommunication may have caused. We want to assure the public that our patients and staff are safe and secure here at Rutherford Regional, as we continue to work diligently to provide the highest quality of care.” per Rutherford Regional Facebook page

Rutherfordton Police updated their post that incorrectly identifed the hospital parking lot as the area where the shooting occurred.

UPDATE: This incident has been determined to have occurred outside the city limits of Rutherfordton, and the individuals involved dropped off in the hospital parking lot. ** The Rutherfordton Police Department responded to the Rutherford Regional Hospital regarding a possible shooting in the parking lot. Our officers along with the assistance of the Rutherford County Sheriff’s Department, and Spindale Police Department quickly located two individuals that sustained gun shot wounds. Upon speaking with the individuals, the incident is believed to have occurred outside the city limits of Rutherfordton. At this time, we don’t believe their is any threat to the public. Please use caution around the hospital, for officers will be in the area processing evidence, and making sure the hospital is secure. Thank You! Clint Ingle Chief of Police

We appreciate the police department and Rutherford Regional for making this clear and as always keep all officers and health care workers in our thoughts and prayers.

Why small NC mountain city is taking on nation’s largest hospital system

Brevard officials hope other Western NC local governments will join lawsuit alleging monopolistic practices by HCA. None have, but none say they have ruled it out.
CAROLINA PUBLIC PRESS
Emergency room entrance of Transylvania Regional Hospital in Brevard, seen here on June 9, 2022. Frank Taylor / Carolina Public Press

A small mountain city is challenging the nation’s largest hospital system in court.

Brevard officials say that, after years of community complaints and declining medical care, they saw no other option.

“Somebody’s got to be first,” said Mack McKeller, Brevard city attorney.

On June 3, attorneys from Greensboro and Washington, D.C., filed a lawsuit on behalf of the city of Brevard alleging a scheme by HCA Healthcare to monopolize medical services in seven Western North Carolina counties — a scheme that the lawsuit claims has led to inflated prices, lower quality of care and loss of services.

HCA bought roughly a third of the hospitals in Western North Carolina, including Transylvania Regional Hospital in Brevard, from nonprofit Mission Health System in 2019.

“HCA purchased Mission’s assets, in significant part, because Mission had monopoly power in the (general acute care) market in the Asheville Region — monopoly power that HCA knew it could exploit to maintain and enhance Mission’s monopoly power in the relevant markets,” the lawsuit states.

Relevant markets include Madison, Mitchell, Buncombe, Transylvania, McDowell, Macon and Yancey counties, where HCA owns between 70% and 90% of the counties’ acute care providers.

City struggles with alleged monopoly

Since HCA’s purchase of Transylvania Regional Hospital, Brevard Mayor Maureen Copelof said the hospital and connected HCA health care providers have both declined and become more expensive.

“The largest fear of our community is that our hospital will become just an emergency room and most services will only be available at Mission Hospital in Asheville,” Copelof said. Mission Hospital is roughly an hour’s drive from Brevard’s city center.

Since 2019, HCA has closed outpatient rehabilitation, primary care and chemotherapy service clinics in Candler, Asheville, Brevard, Franklin, Marion and Spruce Pine, according to the lawsuit.

Additionally, 79 physicians “had left or planned to leave the system since HCA’s takeover” as of March 2021, and several nurses described their units as “inhumanely understaffed.”

“Other doctors describe new employment contracts with HCA in which the compensation equations remove quality-of-care metrics and focus almost entirely on the number of patients seen and amount billed,” the lawsuit states.

“A significant number of patients have lost their preferred family doctors either due to doctors leaving the system or from HCA’s clinic restructurings and closures.”

Copelof’s concerns with HCA’s alleged monopolization is not only rooted in the fear that the hospital system is decreasing services and quality of care but also that it’s wasting taxpayer money.

As a city that operates under a self-funded insurance plan for its employees — or one that partners with a health care provider and foots the bill for the employee medical costs — Brevard officials say they are also concerned that the lack of options has led the city to pay more than it should have for employee medical care. This, consequently, meant more expensive health insurance rates for city employees.

“These higher costs impact the city in what we pay, and it also impacts the individual through their copay requirements,” Copelof said.

“No one is happy paying more than they should for health care. When extra tax dollars must be spent on paying for the city’s health care plan, then those tax dollars are not available for other pressing community needs. This impacts our entire community.”

Because HCA holds claim to the majority of hospital services in Western North Carolina, McKeller said, the system is able to inflate prices because insurance companies, without any other provider options, know they “are going to have to deal with (HCA).”

In some cases, he said, the region’s residents are paying as much as 75%-100% more for a procedure than its average cost in North Carolina — percentages also cited in the lawsuit.

“By tying their services and regions together, defendants coercively rob health plans of the ability to choose which service and providers are in or out of network,” the complaint states.

“At the heart of the scheme is this immutable fact: Because of Mission’s monopoly power, health plans require in-network access to HCA’s (acute care) services in the Asheville Region in order to offer any minimally viable health plan in the relevant geographic markets.”

Brevard is not the first issue to file a lawsuit against HCA, which grossed more than $50 billion in 2020, according to the June 3 complaint. Another case filed in Buncombe County last summer by a group of individuals alleged the same monopolistic practices. But Brevard is the first local government in Western North Carolina to take this step.

Even so, HCA spokesperson Nancy Lindell said Brevard’s lawsuit was “beyond disappointing” specifically because the hospital system’s CEO Sam Hazen met with Copelof and other community members just a month before the complaint was filed.

The meeting before the lawsuit

In May 2021, Hazen traveled to Transylvania County to meet with Copelof and a handful of other individuals concerned with HCA’s practices in Transylvania County. Among those was Mark Weinstein, president and CEO of nonprofit Brevard Music Center.

“It was amazing that this guy, the head of this multibillion-dollar operation, would come and visit with us and talk to us,” Weinstein said.

“It was encouraging.”

Weinstein served on Transylvania Regional Hospital’s board of directors until he and fellow board member Parker Platt, owner of a Brevard architecture firm, resigned in September 2021.

Weinstein and Platt stepped down after realizing that board members had “no real ability to have any kind of positive impact” while HCA was in charge, the pair wrote in an opinion piece for the Transylvania Times.

Weinstein said he was excited when HCA bought the local hospital — expecting growth and exceptional health care to follow the sale. Since then, however, he said he’s been disappointed and discouraged.

That article in the local newspaper stated, “In almost all instances, from the essentials of staff and community relations to marketing to the mass exodus of our physicians, our inability to provide direction or influence decisions have been apparent.”

Weinstein and Platt sat in on the May meeting with Hazen to express their concerns that the hospital was being operated from the top down rather than with input from community members.

During that meeting, Weinstein said the idea to create a “community council,” a group intended to link citizen concerns directly to hospital officials, was established. The 10-person council, which includes three physicians, has met only once so far.

Regardless of how the lawsuit unfolds — if Brevard does win and a jury requires HCA to pay the city’s legal fees and “recover threefold the damages determined to have been sustained by (Brevard) as a result of Defendants’ misconduct” — the community council will still gather to discuss issues with hospital officials, Weinstein said.

Aside from the establishment of the council, the meeting appears to have been less productive than HCA assumed.

“We hoped that meeting would be the beginning of a thoughtful and ongoing dialogue about health care in the city of Brevard and the broader Transylvania County region,” HCA’s Lindell said last week.

“In fact, we provided information requested during the meeting and hosted our first Community Council meeting just this week. At no point did Mayor Copelof mention this apparently long-planned lawsuit, which is frustrating and undermines what we thought were sincere efforts to build open, constructive relationships and lines of communication.

“We will now turn our attention and efforts to vigorously defending the lawsuit while continuing to provide excellent health care to the citizens of Western North Carolina.”

Copelof said the lawsuit has been in the works for several months, and while she “appreciates” Hazen meeting with her in May, that conversation surrounded issues specific to Transylvania Regional Hospital that are not “directly addressed in the lawsuit.”

“The lawsuit deals specifically with predatory monopolistic actions by HCA that impact available health care options and raise the cost for self-funded health care plans in the region and specifically the self-funded plan that we offer to city of Brevard employees,” Copelof said.

“Both the community concerns and the larger systemic practices alleged in the lawsuit are, however, related in that they impact the overall availability of quality healthcare for our local community.

“As such, I will continue to work on those issues that can be resolved locally via our community council and the larger issues of monopolistic practices in the region will be addressed via the legal system.”

Other counties react

The lawsuit alleges HCA’s monopoly has impacted seven Western North Carolina counties. The hope, McKeller said, is that those counties will join the lawsuit as plaintiffs.

Whether Madison, Mitchell, Buncombe, Transylvania, McDowell and Macon counties will join remains up in the air.

“I will tell you, since the lawsuit was filed, I have received a lot of phone calls,” McKeller said.

Carolina Public Press reached out to each of the counties and the city of Asheville and asked whether they planned to join the lawsuit. Representatives of Macon, McDowell and Transylvania counties as well as Asheville declined to comment, citing attorney-client confidentiality, or said no official decisions have been made.

Buncombe County, however, reacted to the lawsuit in a roundabout way during its June 7 County Commission meeting when commissioners approved a letter of support for a new, alternatively owned hospital — citing the need for more acute care beds and residents becoming “increasingly vocal of their desire for improved access and patient choice,” a county press release stated.

“There’s at least two nonprofit hospitals who have submitted proposals or expressed their intent to submit proposals (for a new hospital),” Buncombe County Commission Chair Brownie Newman said, specifying that the two interested entities were AdventHealth and Novant Health.

“The letter that’s been drafted does not endorse any one organization over the other but does endorse that we would like to see additional alternatives for families who need health care in our areas as well as endorsing the idea that it would be desirable to have a nonprofit hospital serving the region.”

Commissioners unanimously approved the letter. No further plans about establishing a new hospital were discussed.

Jail Deaths and Jail Conditions

On January 12, 2022, Andrew Hodge was found dead in his cell in the Rutherford County Detention Center from an alleged drug overdose.

Shortly thereafter, Sheriff Chris Francis suddenly pulled his bid for re-election. Since this incident, the Rutherford County Sheriff’s Office and the District Attorney’s Office have refused to provide Hodge’s family with any information to date as to what happened, leaving the family with nothing but questions.

Newly obtained information, however, tells a disturbing tale of willful and pervasive negligence, ignored warnings, and a nearly ten (10) year period in which the Sheriff, jail administrators, the County Manager, and the County Commissioners have disregarded countless orders from the Department of Health and
Human Services (“DHHS”) instructing them to immediately remedy critical safety failures and policy violations that were directly attributable to a number of deaths in the Rutherford County Jail.

(N.B. Neither the Commissioners nor the County Manager have direct oversight of the Sheriff or jail, but they do control the funding.)

Because many of these orders were issued in response to egregious safety concerns discovered after deaths occurring in the jail, the decision to ignore these directives led to the predictable result of a series of preventable deaths and overdoses, including, most recently, the passing of Andrew Hodge.

YEARS OF NEGLIGENCE, OVERDOSES, AND DEATHS FORECAST THE DEATH OF ANDREW HODGE

On January 11, 2022, five (5) inmates in the Rutherford County Jail overdosed, with at least four (4) of those being transported to Rutherford County Hospital for treatment.

In response, the Criminal Apprehension Team, Narcotics Unit, i.e., the “Black Team,” were called to search the jail for narcotics, which included the use of drug sniffing dogs. Nevertheless, Hodge was found dead in his cell at 4:53 a.m. on January 12, 2022 from an apparent drug overdose.

Based on a newly obtained report from DHHS (Dept. of Health and Human Services), as well as statements from several previous jail employees who have asked not to be named, Hodge’s death was precipitated by years of severe administrative failures, including the failure to comply with mandatory safety laws, as well as an acute
failure to competently respond to the five (5) overdoses that immediately preceded Hodge’s death.

In an April 6, 2022 report, DHHS concluded that “supervision rounds are not being conducted” in accordance with applicable rules.

Absent any other circumstances, DHHS explained that a “jail shall have an officer make supervision rounds and observe each inmate at least two times within a 60 minute time period on an irregular basis with not more than 40 minutes between rounds.”

In addition to this baseline rule, Hodge had been placed on a heightened supervisory tier, which required a “twice per hour direct observation watch.”

Despite Hodge’s special observation status, “there was only one documented supervision round conducted” on January 11, 2022, and “only one documented supervision round conducted during the 12:00 a.m. hour” on January 12, 2022.

In other words, despite the occurrence of five (5) separate overdoses in the late hours of January 11, 2022, jail staff only checked on Hodge – who was in a heightened supervision category – one single time at 12:00 a.m. on January 12, 2022, nearly five (5) hours before he was found lifeless in his cell.

In speaking with several former jail employees about the incident, each employee stated that inmate supervisory obligations are openly ignored by jail employees and have been for years. In addition to these historical failures, those employees each opined that, after five (5) overdoses on the evening of January 11, 2022, the Sheriff and jail administrators should have immediately called in officers from road patrol and from other departments to assist with monitoring responsibilities at the jail given the acute risk of additional overdoses or deaths. That was not done.

HISTORY OF NEGLECT FORECASTED (AND FORECASTS) FUTURE DEATHS

As reflected from the following examples, the failures contributing to Hodge’s death were known to Sheriff Francis, deputies, jail administrators, the County Manager, and the County Commissioners for years, seem entirely preventable, and almost certainly led to (or failed to prevent) many other deaths and near-death overdoses.

In fact, the severe nature of the unabated safety concerns, along with the resulting deaths and overdoses in the jail, have become so pronounced that the exceedingly high death rate is being discussed far beyond the Rutherford County Line.

As but one example, during a recent NAACP debate between Sheriff candidates, moderator Jerry Wease emphasized this problem by describing a recent
incident where a Rutherford County woman was visiting Myrtle Beach and, after identifying Rutherford County as her home, was asked by a local “isn’t that the place where y’all kill people when they are in the jail with drugs?”

The basis for this question is illustrated by the following examples:

1. In April 2012, Jeffrey Neil Watkins was found dead in his cell. As part of the investigation that followed, DHHS cited routine failures to supervise inmates and also found that the intercom system that would have allowed Watkins to seek help was broken.

In criticizing the jail for failing to fix the intercom after being instructed to do so after prior inspections, DHHS noted that it had “instructed your facility to utilize direct supervision some time ago or repair the two-way communication system . . . . The facility has failed to do either.”

https://www.google.com/amp/s/amp.newsobserver.com/news/local/crime/article164837212.html

Moreover, DHHS concluded that jail administrators failed to take preventative actions when realizing Watkins was standing naked in his cell, he had not eaten from three separate food trays, and his mattress was soaked with urine. DHHS instructed the Sheriff, jail administrators, Sheriff, County Manager, and County Commissioners to immediately address these issues. They did not.

2. In 2014, William Anthony Miller was found dead after hanging himself in his cell. Miller was considered suicidal and, per DHHS rules, should have been monitored four (4) times per hour. However, DHHS found that Miller had not been checked on for, at least an hour, prior to being found. Critically, DHHS, once again, discovered that the broken intercoms identified as an issue in Watkins’ death was still not repaired.

The Sheriff’s Office settled this matter for $9,000 with Miller’s family.

***

While it is difficult to locate all records for inmate deaths in the Rutherford County Jail, the next known death occurred on January 25, 2020 when Jackie Israel Sanders died shortly after being transported to the jail.

In February 19, 2021, Robert Lattimore was found dead in his cell. While the Sheriff’s Office and jail administrators informed DHHS that Lattimore was found in “distress” and transferred to the hospital where he died approximately thirty (30) minutes later, several former jail employees have disputed that claim. Instead, those employees adamantly stated that Lattimore was dead when found in his cell.

In the investigatory report, DHHS found that only one supervisory round had been conducted on February 18, 2021, and only one supervisory round was made on February 19, 2021, which was the supervisory round where Lattimore was found dead.

In response to DHHS’ findings and demands that the continuing rule and safety violations be immediately corrected, the Sheriff’s Office and jail administrators responded that, “[d]ue to working shorthanded in the jail supervision rounds may have been missed. Administration have given the Sgt’s and Cpl’s access to Guard One plus in order to keep up with rounds being missed and documentation will accompany the officers and the officers will be held accountable if the supervision rounds are not met per regulations.”

In a subsequent report dated May 10, 2021, DHHS noted a total failure by jail staff to comply with supervisory rounds for the period audited in the report. As with other previous inspection reports, DHHS emphasized that “supervision rounds should be reviewed on a regular basis by the administration and any non-compliance with the Rules should be addressed immediately.”

Despite assurances from the Sheriff, jail administrators, the County Manager, and the County Commission, it appears no officers were “held accountable,” and the complete neglect of these issues continued.

As became apparent with the death of Andrew Hodge on January 12, 2022, the Sheriff’s Office, jail administrators, the County Manager, and the County Commissioners, once again, failed to correct  or ensure corrections of these
issues that DHHS has demanded be addressed for nearly a decade. As a result, the negligence of our local officials – particularly when five (5) other overdoses had just occurred hours before – paved the way for this tragedy.

As with all previous safety and rule violations, deaths, and overdoses, it appears
no officials or officers were “held accountable,” and, with history as a guide, it is doubtful that any officials or officers ever will be.

MOVING FORWARD
In addition to the issues identified above, multiple DHHS reports have identified a laundry list of other serious violations. As but one example, DHHS repeatedly notified the Sheriff, jail administrators, the County Manager, and the County Commission that that the fire sprinkler system in the jail was non-functional and must be immediately repaired. Those instructions were ignored and, based on a recent DHHS report, these officials demonstrated a complete disregard of DHHS’ instructions by stating that
they were “waiting for the inmates to ‘pop’ the other sprinklers before they were replaced.

Many other violations identified by DHHS, e.g., no soap, hot water, or hand drying items during the height of the COVID pandemic, flammable chemicals stored and zip tied to electrical conduits, damage to ceiling tiles that “negat[e] their fire barrier protection” (that, combined with non-functional sprinkling system, and flammable chemicals stored next to electrical conduits, could be catastrophic), ventilation
and sanitary issues, etc. have also been entirely ignored.

The years of neglect, ignored instructions from DHHS, deaths, and overdoses are extraordinarily serious problems.

In fact, according to an August 13, 2017 article by The News & Observer, these (and other issues) in the Rutherford County Jail are of such a severe nature that calls for the Rutherford County Jail to be shut down began.

In the nearly five (5) years since discussions of shutting the jail down began, at least four (4) jail deaths and countless overdoses have occurred.

The Sheriff’s Office and jail administrators have repeatedly acknowledged the failures identified above and made unfulfilled promises to remedy those issues. For the approximately ten (10) year period discussed above, the Sheriff’s Office and jail administrators routinely claimed that understaffing is significant component of these failures.

Yet, despite the rising death toll and troubling incidents of overdoses, no one – not the Sheriff, the jail administrators, the County Manager, the County Commissioners, etc. – have taken any actions to properly staff the jail – even if that means bringing
officers from other departments or requesting assistance from the Governor.

Since Andrew Hodge’s passing, the Sheriff and District Attorney have refused to provide Hodge’s family with any answers as to what happened and why.

From the newly obtained information detailing the severe and longstanding safety concerns, our local officials’ silence raises questions as to whether their intent was to conceal the negligence intertwined with Hodge’s death and, once again, move forward
without remedying the many issues identified by DHHS over the past ten (10) years.

When local officials fail to address issues of this magnitude, it often becomes necessary to seek assistance from outside State officials or agencies, e.g., the Governor, the Attorney General, DHHS, etc., or to request federal oversight, which is often precipitated by filing complaints with the United States Attorney, the FBI, etc.

Based on our local officials’ complete neglect of these issues, it may now be time
to pursue these options.

Year in review: North Carolina and COVID-19

By

NC POLICY WATCH

– in NewsTop Story
Getty Images/Photo: Drazen Zigic

This year started with the promise of new COVID-19 vaccines that could push North Carolina and the country beyond the pandemic. It ends with the rise of a new COVID-19 variant that once again has the state and the world on guard.

COVID-19 cases spiked after last year’s Christmas holiday. Infections caused by the delta variant, which spread more easily than earlier ones, led to another surge this summer that filled hospital beds.

The year is ending with public health warnings about a new, more infectious variant called omicron.

Dr. Mandy Cohen, head of the state Department of Health and Human Services said on Dec. 20 that omicron infections could soon push new COVID-19 cases in North Carolina to 10,000 a day, peaks not seen since the worst days of the last winter and summer surges.

Thomas Denny, chief operating officer at the Duke Human Vaccine Institute, said he was disappointed about where the fight against COVID-19 stands nearly two full years into the pandemic.

“Two years ago, I would have said that we would be beyond it by now,” he said told reporters during a webinar this month. “Unfortunately, we’re not. I’m very disappointed at overall society’s reaction to masking and public health policies. I’m very disappointed at the amount of vaccine hesitancy that’s there. I’m just concerned how we find our way out of this.”

COVID-19 vaccines became widely available 

Dr. Mandy Cohen, head of the state Department of Health and Human Services

North Carolina’s first COVID-19 case was identified in March 2020. The first COVID-19 vaccines were distributed in the state a little more than a year ago, on Dec. 14, 2020. Health care providers at high risk of exposure and staff in long-term care facilities were first in line for shots. They were followed by nursing home residents, people over 65, staff at congregate living settings, and people at high risk of severe illness.

In the early months, demand outstripped supply. People scrambled for vaccine appointments, some traveling far from their home counties for shots.

Eligibility expanded and vaccine supplies increased in late winter. Vaccinations in the state peaked the week of April 4, when 703,438 doses were administered, according to DHHS. Interest dropped from there and hit a low in early July.

North Carolina lagged slightly behind national averages in the percentages of vaccinated residents as of mid-December, according to CDC and DHHS data.

Governor Roy Cooper and one of NC’s vaccine lottery winners.

People 5 years old and older can be vaccinated for COVID-19. To help stop the more contagious omicron variant, public health officials are encouraging booster shots for people 16 and older.

Last summer, the state began using money to encourage more people to get shots. It distributed cash cards to people who were vaccinated at certain locations and gave some cards to drivers who offered people lifts to vaccination events.

Gov. Roy Cooper in June announced a vaccine lottery in which four vaccinated adults would win $1 million each, and four vaccinated people ages 12 to 17 would win $125,000 to put toward their post-secondary education. However, a study of state vaccine lotteries found they did not lead to increased vaccination ratesColorado Newsline reported.

COVID-19 and health equity 

Healthier Together, a partnership between DHHS and the NC Counts Coalition, distributed $1 million in two $500,000 chunks to nonprofits for vaccine education and vaccination events in historically marginalized communities, Policy Watch reported.

State officials have prioritized equitable distribution of vaccines. After months where Latino vaccination rates lagged rates for other demographic groups, the vaccination rate for Latino residents who have received at least one dose now exceeds the rate for non-Latino residents, DHHS reports.

Monoclonal antibodies, laboratory-made proteins that mimic those the human body produces, were found to be effective as a COVID-19 treatment for people in danger of severe illness if patients received the treatment within 10 days of showing symptoms. Though state officials began promoting the treatment earlier this year, it was not available in all counties, and information about the therapy was spotty, Policy Watch reported.

Kody Kinsley

In late September, the state’s chief medical officer for the Medicaid program told a group of Latina doctors and health advocates that early data showed a wide disparity between Latino patients’ and non-Latino patients access to the therapy.

Cohen pointed to vaccination progress in the Latino community in a news conference on Dec. 14. But with monoclonal antibodies, “We have a lot of work to do,” she said.

Cohen, the NC DHHS secretary and the face of the public health response to the pandemic, announced in late November she was leaving that job. North Carolina will begin 2022 with one of Cohen’s deputies, Kody Kinsley, running the department.

DHHS launched an Office of Health Equity and named Victor Armstrong as its first chief health equity officer. Armstrong said in a Policy Watch interview that advancing health equity in COVID-19 vaccinations and therapies, and using those strategies to tackle health disparities beyond COVID are department priorities.  

Health precautions and politics 

Clashes over health precautions between Cooper, a Democrat, and Republicans who control the legislature carried over from 2020 to 2021. In the first year of the pandemic and before vaccines were available, the legislature passed bills that would reopen bars, bowling alleys, amusement parks and other businesses. Cooper vetoed them.

The legislature passed bills last year and this year to limit Cooper’s powers in statewide emergencies. He vetoed those, too. However, a provision of the state budget, which Cooper signed, requires governors declaring long-term states of emergency to obtain agreements from a majority of the Council of State beginning in 2023.  The Council of State is a group of statewide elected officials.

The persistence of myths 

Rep. Mark Brody

Some Republican legislators continue to question the value of COVID-19 vaccines. Rep. Mark Brody, a Monroe Republican, said at a Joint Legislative Committee on Governmental Operations meeting this month that he had not taken the vaccine and questioned whether it can alter DNA, Policy Watch reported.

The claim that vaccines can alter DNA has been repeatedly debunked by The Associated Press, Reuters, and hospitals nationwide.

With COVID-19 cases climbing again at year end, Denny said during the webinar that he hopes 2022 marks a permanent pivot to pre-COVID-19 pandemic living.

“What we have to realize this virus is going to become endemic,” he said. “We have to learn how we’re going to deal with it and how we’re going to prevent severe disease. About the only tool we have right now to prevent severe disease is the vaccines that we now have.

“Hopefully we will get another generation of vaccines, whether it be ‘22 or ‘23 that will prevent transmission of the virus or not require us to not have so frequent of a boosting. Until then, I think we’re going to have to remain on guard and utilize good sensible public health prevention technique to help get us through the transition.”

ABOUT THE AUTHOR

Lynn Bonner, Investigative Reporter, joined Policy Watch in October 2020 after 26 years as a reporter at The News & Observer. She covered the state legislature and politics for 20 years, and wrote extensively about mental health, state Medicaid policies and spending, and public education. Before coming to North Carolina, she wrote for newspapers in New England.

Flu brings fear of ‘twindemic’ in NC

Health officials urge vaccination against influenza and COVID-19 to avoid respiratory illnesses.
A 3D computer-generated rendering of a whole influenza (flu) virus. CDC.

As the omicron variant of the COVID-19 virus makes its way across the nation and delta variant cases surge once again, North Carolina health officials see the possibility of another viral threat: influenza.

Last year, many health officials warned of the possibility of a “twindemic,” in which high amounts of both flu and COVID-19 cases occur at the same time. Instead, the flu rate stayed low, a blessing many health experts attribute to greater precautions being taken during the pandemic than in a normal flu season.

This season, experts predict flu cases will increase as local governments relax restrictions and more people forgo masks and social distancing.

Flu deaths are tracked, but individual cases are not. The COVID-19 dashboard allowing the public to track COVID cases is unique to the pandemic.

The state does offer weekly snapshots of flu-like and COVID-19 activity across the state in the “Respiratory disease surveillance summary,” published by the N.C. Department of Health and Human Services on Thursdays during the reporting season from October through May. Providers across North Carolina submit samples to the state.

As of Dec. 9, both the DHHS summary and data from the national Centers for Disease Control and Prevention showed a low but rising number of flu cases in North Carolina.

Emergency department visits for “COVID-like illness” increased in most parts of the state. Only one region showed lower amounts of visits as of Dec. 4 than it had the week before. All other areas of the state showed more or the same number of visits.

The CDC classified North Carolina’s influenza-like illness activity and that of Tennessee and Virginia as “low.” South Carolina and Georgia were listed as “moderate.”

As of Thursday, there had been no flu-associated deaths reported this season in North Carolina. The flu reporting season began Oct. 3 and will conclude on May 21.

Possible protection

As cases of flu rise and temperatures drop, DHHS is encouraging residents to “layer up.”

Just as residents can wear layers of clothing in the winter to protect themselves from chilly temperatures, DHHS recommends stacking different types of defenses against respiratory illnesses.

“It is possible to be co-infected with flu and COVID, and if you have both at same time, you are at an increased risk of severity of illness, because they are two different viruses, two different infections, and both at same time is an increased risk of disease severity,” said Dr. Elizabeth Cuervo Tilson, state health director and chief medical officer for DHHS.

Many flu symptoms overlap with COVID-19 symptoms.

According to the DHHS website, flu symptoms can include “fever or feeling feverish/chills, cough, shortness of breath or difficulty breathing, fatigue, sore throat, runny or stuffy nose, muscle pain or body aches, headache, (and/or) vomiting and diarrhea, but this is more likely to occur with children.”

Some people may notice different symptoms that might indicate a COVID-19 infection.

“Flu viruses can cause mild to severe illness, including common signs and symptoms listed above,” DHHS states on its website. “COVID-19 seems to cause more serious illnesses in some people. Other signs and symptoms of COVID-19, different from flu, may include change in or loss of taste or smell.”

Testing can help reduce uncertainty.

The flu shot doesn’t always prevent infection, but even if an infection occurs, the shot can reduce the degree of the symptoms, Tilson said. Along with the COVID-19 vaccine, it represents a good first layer of protection.

The CDC recommends that members of the public receive a flu vaccine as quickly as they are able to, practice proper hygiene and basic preventive steps, including staying home when ill, communicating with health care providers when symptomatic and following their provider’s instructions regarding antiviral medications in the event of a flu infection.

Anyone presenting symptoms of the flu or COVID-19 can receive testing for a diagnosis and should seek treatment quickly, according to Tilson.

Masks are another layer, Tilson said. Social distancing when possible offers another protective tool.

Last year’s low levels of flu illustrated how well those layers work, according to Tilson.

“We had almost no flu spread because hand-washing, masks and limiting crowds were effective in preventing the spread of respiratory viruses, COVID and flu,” Tilson said.

According to the CDC, between 12,000 and 52,000 deaths were caused by flu each year nationally between 2010 and 2020. The 52,000 high point came in the 2017-18 season, but then dropped to 28,000 the following year.

As more people leave their masks at home or skip vaccines, cases will likely rise this year compared to last year, according to Tilson.

“What we’ve been stressing is no one prevention strategy is 100,% and that’s why it’s important to layer strategies,” Tilson said.

“Vaccines are really important, but not 100%. Masks are not 100%. Social distancing is not 100%. So, the best thing people can do is layer those protection strategies to protect themselves and their loved ones.”

Tracy Jones, the epidemiology nursing supervisor at the Robeson County Health Department, encourages everyone who is eligible to get their flu and COVID-19 vaccines.

“Don’t let your guard down,” Jones said.

“Don’t become complacent. I’m tired of wearing masks also, but I’m also tired of reading death reports and seeing all these case reports coming in and reporting clusters and outbreaks to the state. People just need to realize that the longer we go with this low vaccination rate, the longer this (corona)virus has to mutate.”

Four hundred and forty-four deaths occurred from COVID-19 in Robeson. A “couple of those” were residents with co-infections of COVID-19 and flu and occurred during last flu season, according to Jones.

Jones estimated the Health Department has administered at least as many vaccines this year as it has in previous years.

“For older people, we do offer the high-dose flu vaccine here,” Jones said. “We actually ran out and had to order more. It was one of the first times I can remember that happening that we had to order more high-dose flu vaccines.”

The tricky part is getting younger residents to get their flu shot.

“We have folks who come here every year to get flu shots, and the majority is the older population,” Jones said.

“They will continue to get flu shots. They have been for years. We’ve never had a large number of young folks come here to get their flu shots, so that hasn’t changed.”

The Health Department also offers the shots to pregnant women during maternity clinics.

Jones wants people to understand that while most people recover, the flu can be serious.

“I always promote the flu vaccine,” Jones said. Even before COVID started, she always told people how many people die every year from flu. “It’s not an old disease. It’s still present. It still kills people.”

In Guilford County, the Health Department tries to enter into a dialogue with residents.

Kenya Smith Godette, communications manager for the Guilford County Division of Public Health, said the county has partnered with local media outlets to ensure residents have access to information.

Every two weeks, Dr. Iulia Vann, the division’s health director, speaks with FOX8 to address viewers’ questions and concerns. Recently, Vann answered community questions about the efficacy of the flu vaccine, how long protection from the shot lasts and other viewer questions on the program.

The clips are often posted to the Guilford County Division of Public Health’s Facebook page along with other information.

“People were really curious about children getting immunized against flu and about nasal sprays, so we did some on what’s effective for that age group,” Smith Godette, communications manager for the Guilford County DPH, said. “People are wondering if pregnant people could get it, so we addressed that, too.”

Smith Godette said the county also hopes residents will consider taking COVID-19 tests before attending holiday gatherings to reduce the spread of respiratory illnesses.

COVID-19 vaccines and flu shots can safely be administered during the same visit, whether the COVID-19 shot is a first dose, second dose or booster.

According to Tilson, surveys indicate that more residents are expressing confidence in the COVID-19 vaccine. She attributed it to the good experiences many have had with it as well as the ever-increasing amount of data related to it.

“That’s been really nice, seeing the increasing vaccine confidence and the understanding that the benefits greatly outweigh the risks,” Tilson said.

Many pharmacies offer both the flu and COVID-19 shot. To help find a location, try the vaccine finder at Vaccines.gov or call 800-232-0233.

Feds put ‘special focus’ on 10 NC nursing homes with sketchy performance records

Feds put ‘special focus’ on 10 NC nursing homes with sketchy performance records

By Thomas Goldsmith

In September 2020, federal regulators determined that residents of the Lillington nursing home Universal Health Care were in “immediate jeopardy,” the most serious warning status issued by the federal Centers for Medicare and Medicaid Services, regulators announced recently.

That designation became part of the reason that Universal Health Care, along with nine other North Carolina nursing homes, appears on the CMS list of the state’s worst-performing skilled nursing facilities. 

In one incident, cited on May 31, 2020, a resident of Universal Health Care who had tested positive for COVID-19 went for nearly 11 hours without being checked by a nurse, despite breathing problems that had previously put him in the hospital. After that delay, it was too late; the resident was dead, according to a terse report from inspectors.

“Emergency Medical Service’s record dated 5/31/2020 revealed they arrived at the facility at 6:42pm on 5/31/2020 to find resident #1 cold, absent of pulse, absent of spontaneous respirations, with pupils fixed and dilated at 4mm,” the report stated.

In their report, inspectors found that the Lillington nursing home had failed to:

  • Put specific staff to work only at its unit for people with COVID-19; 
  • Supply the needed personal protective equipment, or PPE, for people who worked in the unit and a quarantine unit for people exposed to the disease; and 
  • Make sure that staff put on PPE before working with residents and that they took it off before leaving their rooms.

The finding of “immediate jeopardy” describes the situation in which a facility clearly hasn’t done its job, according to CMS. This designation means that the facility has “placed the health and safety of recipients in its care at risk for serious injury, serious harm, serious impairment or death.” 

It’s the kind of incident that can give a nursing home the unwelcome distinction of appearing on a list for a category CMS refers to as “special focus candidates.” The only appearance that’s more negative is to be on the special focus list itself.

The Citadel of Salisbury is the only North Carolina nursing home to appear in special focus status in the most recent CMS list. The status means the Citadel at Salisbury is under the gun, or in the words of CMS’s rating site Nursing Home Compare: “The facility is subject to more frequent inspections, penalties of escalating size, and the possibility of losing Medicare and Medicaid funding.” 

If some of the incidents took place in September a year ago, why would a nursing home appear 

on the candidates list now? That’s part of the point, according to CMS:

“Such facilities with a ‘yo-yo’ or ‘in and out’ compliance history rarely address underlying systemic problems that give rise to repeated cycles of serious deficiencies, which pose risks to residents’ health and safety.”

Along with listing the low-performing facilities, the feds take notice when a nursing home performs better and is removed from the candidate list, as they did with Accordius Health at Clemmons. 

Additional North Carolina homes named as candidates for special focus are:

Accordius Health at Concord, Concord; Carolina Rehab Center of Cumberland, Fayetteville; Peak Resources — Shelby, Shelby; Pelican Health, Thomasville; Person Memorial Hospital, Roxboro; Pruitthealth-Rockingham, Rockingham: The Ivy at Gastonia, Gastonia; Universal Health Care and Rehab, Concord; Westwood Health and Rehabilitation, Archdale.

This article first appeared on North Carolina Health News and is republished here under a Creative Commons license.

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