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Inside and outside of a N.H. nursing home during a COVID-19 outbreak

A photograph of Charles Vinson (Vinny) and his daughter, Isabel Vinson inside Alpine Healthcare Center in Keene. Charles uses a wheelchair, his daughter stands behind him and wraps her arm around him.
Alli Fam
New Hampshire Public Radio
Charles Vinson (Vinny) and his daughter, Isabel Vinson inside Alpine Healthcare Center in Keene.

Charles Vinson, landed at the Alpine Healthcare Center in Keene after he was hospitalized with COVID in Vermont last spring.

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In late August, the nursing home had a COVID outbreak lasting until mid-October. During the outbreak, Vinny (as everyone calls him) broke his hip. The fall meant he went to the hospital.

Vinny’s daughter, Isabel Vinson, said Alpine never told her about her dad’s hip injury or his positive COVID case.

“I have really high anxiety, so it was traumatizing, slightly,” she said.

Alpine's COVID outbreak was big. Twenty-three out of around 110 staff members caught the virus and 62 out of 75 residents also got it. Six residents died.

And the outbreak at Alpine isn’t an isolated incident. Vaccination efforts have helped curb the severity of cases and the death rate of COVID outbreaks across the state.

But in some New Hampshire long-term care facilities, dozens of residents are catching the virus as COVID-19 outbreaks continue to increase with cases surging to record levels across the state.

This week, there are 19 active outbreaks in long term care facilities, up from two in early August. The COVID-19 pandemic continues to disrupt life for residents and staff on the inside. Some families on the outside are left uninformed and distant from their loved ones' conditions.

Aside from being stuck in his room for a week or so, Vinny, 69, said he doesn’t remember much about the COVID outbreak. He said he’d been through worse.

“I had heroin withdrawals. They were way worse than COVID, way worse,” he said.

During that time, Isabel said she tried to call her dad’s cell phone and couldn't reach him. She said she didn't find out about his broken hip or the new case of COVID until the hospital called the next day, despite being listed as his emergency contact. And it is possible that until Vinny got to the hospital, he’d been testing negative for the virus.

Ti-Tye DeNault of Alabama has an aunt who lives in Alpine. Just like Isabel Vinson, DeNault couldn’t get in touch with her family member.

DeNault said she called the facility multiple times a day after learning about the outbreak to ask about her aunt’s condition. The two talk regularly, so she was concerned when her aunt didn’t answer.

“I couldn't get in touch with her,” DeNault said. “I kept calling back, calling back, calling back.”

She recalled reaching staff on the fourth or fifth day. They told her that her calls had been going unanswered because her aunt had been moved to the COVID positive unit.

Peak Healthcare is the registered owner of Alpine Healthcare Center. Peak’s CEO, Avi Goldstein, said family members were informed if their loved one tested positive within 24 hours, except in cases where the resident wanted the information kept private.

But DeNault said it's unlikely her aunt wanted her diagnosis to be kept private because when DeNault finally reached the facility, she was informed of her aunt's positive case.

But the difficulty in communicating frequently with her aunt has continued. DeNault said her aunt has told her the phone is sometimes too far away from her to reach.

The high rates of positive cases during the Alpine outbreak raise questions about how the facility handled the outbreak and their COVID vaccination rates, according to Charlene Harrington, a professor at the University of California San Francisco who studies long-term care.

Federal data show that at the time of the outbreak, around 10 percent of Alpine residents were unvaccinated and so were 30 percent of the staff. Unvaccinated visitors can also visit Alpine, which is true for all nursing homes.

“It only takes one person to infect the whole building,” Harrington said.

When NHPR reached out to Alpine for comment on these concerns, the owner of Alpine Healthcare Center is unclear, even though Peak Healthcare is listed.

The facility was sold and changed hands last year. Peak Healthcare at Keene LLC (the organization’s full name) registered with the state with an address in Brooklyn, New York. That address is connected to another company called Recover Care.

But CEO Avi Goldstein said Peak is the consulting firm that manages Alpine. He did not respond to email requests to comment further on ownership.

DeNault said since the facility changed ownership, she feels more left out of her aunt's care, despite having durable power of attorney for her aunt. That designation gives her the authority to make medical decisions. Under the old ownership, DeNault said details as small as what cold medicine her aunt should get were communicated to her.

And that lack of transparency makes it difficult to know who exactly to hold accountable for safety concerns.

But Goldstein said the facility follows federal regulations, which include regular testing of unvaccinated staff members.

State inspectors who visited the facility in the early days of the outbreak agreed the facility was in compliance with infection protocols.

The investigators did cite a few deficiencies, including a staff member not being properly trained for stabilizing an injured resident after a fall, dishwasher temperature too low to ensure sanitary washing and an open container with sharp objects, like syringes.

Alpine outside
Alli Fam
Ownership of Alpine Healthcare Center in Keene is murky. Peak Healthcare CEO Avi Goldstein says Peak is the consulting firm that manages Alpine. He did not respond to email requests to comment further on ownership. That lack of transparency makes it difficult to know who to hold accountable for safety concerns.

The outbreak also came before booster shots were available for people in nursing homes.

And the large outbreak might have spread quickly because Alpine residents live in close quarters. Vinny lives with three other men in a cramped room with just enough space for their beds, nightstands and dressers.

Vinny said he's gotten at least one vaccination shot, but he said he doesn’t know what brand or if he's gotten any more. Isabel Vinson said she’s unable to find the documentation in his medical records. Ti-Tye DeNault said she’s been told her aunt has been fully vaccinated.

Vinny wants to leave the facility and be back in Vermont, and Isabel has been trying to get him out for months.

Vinny lives with three other men in a cramped room with just enough space for their beds, dressers and nightstands.
Alli Fam
Vinny lives with three other men in a cramped room with just enough space for their beds, dressers and nightstands.

Alpine’s Executive Director, Melissa Castor, told Isabel over email that Alpine has reached out to other facilities to transfer Vinny but hasn’t heard back. Isabel was frustrated after Castor suggested Isabel call the facilities herself.

To make a transfer happen, Isabel will need to be persistent. Even hospitals are struggling to discharge patients who are ready to leave because long-term care facilities are so full.

Isabel said the first facility she tried to move her father to couldn’t find Alpine’s referral, but added Vinny to the waitlist.

In the meantime, Isabel Vinson has been getting more involved in her dad’s care. She’s now trying to become her Dad's medical power of attorney, although the paperwork has dragged out. She visits from Brattleboro when she can.

“I'm going to try to bring you banana nut muffins tomorrow,” she said, as she hugged her dad goodbye.

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