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Resident locked out of assisted-living home for two weeks due to stringent COVID-19 policies

Burton Keen was locked out of his assisted living facility for two weeks due to COVID-19 protocols. Thankfully, his daughter Nancy Potter and son-in-law were able to take Keen in and house him. He's now made the decision not to go back to his community. (Colin Mulvany / The Spokesman-Review)

Nancy Potter knew that Riverview Retirement Community had installed a stringent visitor policy to keep COVID-19 out.

Her father, Burt Keen, has lived there for six years, and had his own apartment in the assisted living part of the community. On March 14, she had wanted to pick him up for dinner but was told that if he left he would need to stay away for two weeks, so she did not pick him up.

But on March 19, Potter got a call from staff at Riverview. Keen had been to the emergency room three times that month already for his bloody noses, which he had gotten cauterized multiple times before. The medical staff at Riverview could not get his nose to stop bleeding, and they wanted to send Keen to the emergency room. Either they could call him an ambulance, or Potter could drive him.

Potter, a professor at the WSU College of Medicine, was working from home already and was able to drive her father. As they were rushing out, she thought to specifically ask staff members if they could come back, remembering the new policy.

“One person said he will have to be in isolation in his room, and another said he might have to go to the Care Center,” Potter said.

No one said he would not be allowed to return at all, so she rushed her father to the emergency room at Holy Family Hospital, where they got his nose to stop bleeding. Both Potter and Keen were screened for COVID-19 symptoms at the hospital, she said, including getting their temperatures checked.

Keen had no symptoms of the respiratory virus, and he was in and out in about two hours. Potter began to drive him back to Riverview when she got a call from staff there saying Keen could not return. Potter turned the car around in desperation, thinking maybe if the doctor could call the CEO directly they would let Keen back in.

Keen had no symptoms of COVID-19, and he’d had his nose cauterized. Potter returned to Riverview, where her father was effectively locked out. He had no clothes or medicine with him, but he was not allowed to go back inside. She talked to both the CEO and a nurse at Riverview on the phone outside the facility and was told that he could come back in 14 days due to COVID-19 precautions.

She got back in the car with tears in her eyes and drove her father back to her own home, where he would stay for the next two weeks.

Keen is 97 years old and a World War II veteran. He uses a lift chair to keep his feet above his heart, due to his past heart failure, for a part of the day, but Potter and her husband had to call Riverview later to get clothes, medicine and eventually, Keen’s lift chair.

Keen was confused as to why they would not let him back into his own apartment and has decided not to return to Riverview.

“I would like to go somewhere where I can go to the doctor and know I have a home when I come back,” Keen told Potter later when they were discussing his options.

KXLY first reported on Keen being locked out, and last week, Charles Tirrell, CEO of Riverview, published an email he wrote to that reporter online. The email references the facility’s guidance to residents due to COVID-19.

“On March 14th, all Residents and families were informed in writing of the new containment measures that were enacted for their safety. Our on-site clinicians are able to provide necessary care to residents,” Tirrell’s published email says. “Residents were given the option to leave if they choose. However, before we would allow them to return, they would be required to remain offsite in quarantine for 14 days or present a negative Covid-19 test result. All but one have chosen to abide by these safety measures.”

Testing for COVID-19 is limited in Spokane County, and even if a person has symptoms and is tested, results can take up to a week to come back depending on which lab runs the test.

“When compared to our situation in pre-covid19 times, this action may seem harsh, but today, we and the world are in a very different place,” the published email continues. “Sadly, the reality that has been seen in Kirkland and now at several other facilities in Washington State dramatically prove that any unnecessary breech of containment measures could have very deadly consequences for the remaining 130 residents in that building. We will continue to enforce these life-preserving precautionary measures for our residents.”

Tirrell did not respond to requests for comment in emails or messages left with Riverview staff for him for this story.

On April 2, Keen hit his two-week mark, and he technically could have been admitted back to the facility. He decided against it, however. Potter said she has called 10 facilities that could accommodate her father, all of which are accepting new residents.

The Centers for Disease Control and Prevention and the Centers for Medicaid and Medicare Services both have guidance for long-term care facilities and retirement facilities nationwide to prevent the spread of COVID-19. Both federal agencies recommend strict no-visitor policies, except in rare end-of-life situations. Group gatherings should be prohibited, and residents should stay as quarantined as possible under the CDC and CMS guidelines. Both the CDC and CMS recommend screening all visitors, staff members and residents for COVID-19 symptoms. While screening, quarantining and monitoring symptoms are all listed as good practices for residents and staff members coming into the facility, federal guidelines do not suggest that residents cannot leave for medical procedures. This weekend, the CDC updated recommendations that people going into public spaces as well as staff members at long-term care facilities should wear masks, however.

Facilities in other parts of the state have asked residents to self-quarantine in their rooms for two weeks if they leave, and Keen, who lived in his own apartment in the assisted living portion of Riverview, was in isolation prior to needing emergency health care.

Administrators’ fears of COVID-19 spreading in facilities are well-founded, as has been seen in several facilities statewide. Two hours southwest of Spokane, in the Tri-Cities, 104 residents and employees in six long-term care facilities and retirement communities have COVID-19. Administrators there have had to contact private lab companies to access testing for residents, and even still, they do not have enough resources to test all residents. Health officials are still only recommending that symptomatic people be tested for the virus, making it difficult for administrators to tell how widespread the virus is in their facilities.

Last week Washington State Health Officer Kathy Lofy said that her department had identified 108 long-term care facilities with cases statewide. So far, in Spokane County, three retirement or long-term care facilities have had staff or residents test positive for the virus, but so far, no community-wide outbreaks in those facilities have been detected. Lofy told reporters last week that outbreaks in long-term care settings can have high “attack rates,” when nearly half of a facility can get infected.

“This situation is very concerning to us because we know that people who are older are at much higher risk for complications from COVID-19 and deaths,” she said.

Potter, who is Keen’s legal caregiver, understands why policies need to be in place to protect elderly people from COVID-19, but she is also frustrated that she was called to get her father to emergency medical care, told he might need to isolate or go to the Care Center but then was locked out altogether. She was also disappointed to lose such a previously great place for her father to live, and she said the staff had taken great care of her dad.

“I thought we had a place for life,” she said.

Potter has filed a complaint with the Department of Social and Health Services on her father’s behalf. She points to how fortunate it is that both she and her husband are working from home so they can help Keen when he needs it. She knows this is not the case for all people, however.

“I am not stuck, but what if it was somebody considered an essential employee at minimum wage, and you’re working at a grocery store?” she said, asking who then would be able to care for someone like her father.

Arielle Dreher's reporting for The Spokesman-Review is primarily funded by the Smith-Barbieri Progressive Fund, with additional support from Report for America and members of the Spokane community. These stories can be republished by other organizations for free under a Creative Commons license. For more information on this, please contact our newspaper’s managing editor.