Inside the COVID-19 outbreak at the Carriage House nursing home in Bay City, Michigan

A disaster is unfolding at nursing homes across the United States. The elderly are once again contracting COVID-19 in huge numbers and health care facilities everywhere are dangerously unprepared. Workers at the Carriage House, a nursing home in Bay City, Michigan, reached out to the World Socialist Web Site in an effort to expose these conditions and save lives. To submit your own exposure, contact healthcare@wsws.org now.

COVID-19 has spiraled out of control at the Carriage House nursing home in Bay City, Michigan. At least three residents have died from the disease in the last three weeks and workers report as of this writing 33 of the 61 remaining residents are COVID positive and have been moved into two “COVID wings” at the facility. If the trajectory of weekly new cases continues, every Carriage House resident will have COVID by Christmas.

This nursing home is theoretically under quarantine. All residents are confined to their rooms, whether or not they have COVID. Staff are tested twice a week. No visitors are being admitted—the closest they can come is the parking lot, where they can wave to their loved ones through the window.

But according to Carriage House workers, these basic measures are fatally undermined by the following circumstances: All workers enter the building through a single front entrance. A single main hall connects all of the facility’s different wings. Two of these wings house the 28 remaining COVID-negative residents, and two other wings together house the 33 COVID-positive residents. A single kitchen serves the entire facility and certified nursing assistants (CNAs) assigned to both COVID-positive and COVID-negative wings move through the main hall throughout the day, creating many opportunities for the disease to spread.

Disturbingly, Carriage House workers also report that CNAs were told by a head nurse that they could continue to come to work in the COVID wings even after receiving a positive test result themselves. The latest figures from the state of Michigan show 26 COVID cases among Carriage House workers, and according to workers at least one CNA who tested positive continued to work on December 5, 6 and 7, before deciding to quarantine.

Charlene, a Carriage House worker whose name has been changed to protect her from victimization, gave some examples of what goes on. “When a dietary aide brings meals to the COVID wing,” she said, “they don’t use any real dishes. It’s all disposable—Styrofoam and plastic—so they don’t have to take anything back to the kitchen. The CNA working in the COVID wing meets them at the double doors connecting the wing to the main hall. Then they open the doors, take the food off the kitchen cart, put it on their own cart and take it to the residents down the hall. That’s the official procedure.”

“But,” she continued, “CNAs from both the COVID and non-COVID wings are going down to the kitchen all day, to make lunch and dinner orders, or to get a snack or something that a resident asked for, or to use the only microwave. Each wing has a kitchenette and they used to have microwaves, but the new owners got rid of them. The only coffee machine is also in the dining room, next to the kitchen.”

Each wing at the Carriage House holds between 10 and 20 residents and during any given shift one nurse and two CNAs are assigned to care for them. The CNAs go into all the residents’ rooms in a given wing.

“CNAs are the people who work most closely with the residents,” Charlene explained. “They help them with what are known as their ‘activities of daily life.” Depending on the resident, that means they may have to help them get up in the morning, get dressed, take their medicine, bathe and brush their teeth, or help them go to the bathroom. Some people here have Alzheimer’s or dementia, and some people have physical disabilities. Most are between 60 and 80 years old, but some are over 100. A lot of people can’t do almost anything for themselves and the CNAs even have to feed them.”

These essential health care workers are criminally exploited. In Michigan, the average wage of a CNA is less than $15 per hour. Some staff at the Carriage House are paid less than $10 an hour. And unlike some other facilities, COVID-positive workers here do not receive any pay if they stay home to quarantine. This economic blackmail forces sick workers to choose between going hungry or endangering everyone in their community by reporting to work.

These practices have not only led to the outbreak at the Carriage House itself. They also contribute to spreading COVID-19 to other facilities. Several workers at the Carriage House work part-time at two or more nursing homes in the area, some of which are suffering even larger outbreaks right now. “CNAs change positions frequently,” Charlene said. “They move around facilities a lot. Some work at two at once. Some do home care in addition to Carriage House.”

Bay County alone has five other “skilled nursing facilities”—the category of nursing home where residents need the most care—and there are major outbreaks taking place at all of them.

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According to the state’s latest figures, 4,373 of Michigan’s 10,900 total COVID deaths have been residents in nursing homes and other long-term care facilities. At least 225 nursing home residents died from COVID in Michigan in the last week alone. Nationwide, over 110,000 have died, accounting for 39 percent of all US COVID deaths.

The Carriage House was recently sold and has been under new management since November 1. It is now run by Preferred Care, which manages three other nursing homes across Michigan, including ALLEGRA Nursing and Rehab in Jackson, where at least 25 residents have COVID and six have died from it.

Charlene said that while the Carriage House was pretty miserable before, things have gotten worse under the new management.

“We used to have flip-phones in every area, with the numbers stored in them for all the areas, so we could contact one another remotely from one department to another. But the new owners got rid of them and replaced them with nothing. So now we’re all calling each other on our cell phones, which we’re technically not allowed to have in the building. But you don’t always have the number for a person in the area you need.”

She also explained what life is like for residents during the pandemic:

“Before the pandemic, we used to have ‘activities,’ where people would come in and play music and sing, or they had a pastor come in for church service. But that’s all cancelled now. They can’t even get everyone together to play bingo, so we started doing a version of bingo where everyone stays in their room. We used to have ‘the library,’ which was a big room with lots of books and nice furniture. Now it’s being turned into office space or something.

“Each room at the Carriage House holds one or two residents. One if they had enough money, two if they didn’t. All the rooms are in pairs, with one bathroom between two rooms. So, there’s four residents per bathroom, potentially. Each person has a bed and a dresser and a TV and a closet. In each room, outside the bathroom, there’s a sink and mirror. Everyone has a big bedside table that goes up over the bed. Some have recliner chairs. A clock. That’s about it. Every room has a window. Some people bring in their own pictures and other stuff.

“There are not enough CNAs. There’s never been enough CNAs. That’s just how every nursing home is run. It’s how companies are run. They keep as few people on the payroll as possible, and pay them as little as possible. Everyone working on the floor is doing everything they can. But we need more resources and better leadership.”