The minute Peter Rosasco walked into Green Mountain Treatment Center in Effingham, he knew there would be problems.
“It was just a ticking time bomb, that place,” Rosasco said.
It was mid-November, and his mother, Susan Axelrod, was bringing Rosasco to residential treatment as part of a plea deal he reached over recent drug charges.
But when they arrived at Green Mountain, one of New Hampshire’s largest residential substance use disorder treatment facilities, both Rosasco and his mom said they noticed that the staff member doing patient intake was not wearing a mask.
“If I had not been so, sort of, just shell shocked from the day, I think I would have said, 'Hey, can you go put a mask on?' " Axelrod said. "Because I thought about it later, I was like, ‘That was not good.’ ”
It felt odd, they said, especially given that Rosasco had just come from another treatment center in Maine where he was forced to quarantine upon arrival, was tested for COVID-19, and, he said, they were incredibly strict about mask usage.
But at Green Mountain, Rosasco said, he was never tested. And while there may have been a mask policy, for the two weeks he was there, he said, some people wore masks, some didn’t.
Interviews with clients, their relatives, current and former staff, and internal communications suggest Green Mountain Treatment Center failed to take basic steps to protect residents from a COVID-19 outbreak that has so far, according to state numbers, infected nearly 50 people. Complaints include a lack of social distancing in company-managed transportation and the dining area; the absence of a plan to protect clients in the event of an outbreak; and a lack of enforcement of mask-wearing among both clients and staff.
Now, the company that runs Green Mountain is launching a new treatment unit there, specifically for people who have tested positive for COVID-19. This comes more than two weeks into an outbreak at Green Mountain that several clients and staff say caught the company off guard.
“They had 10 months to come up with a solution for if something like this happened, and they were not ready for it at all,” said Robert Hunt, another client of Green Mountain who was in treatment before and during the outbreak.
“I didn’t get the sense that anybody was going to say anything.”
Green Mountain Treatment Center is managed by Granite Recovery Centers, one of the biggest providers of substance use disorder treatment in New Hampshire. It’s a residential facility on a remote, 72-acre property in Effingham that provides detox and treatment to clients from all over the country, some by court order.
When news first broke of an outbreak at Green Mountain earlier this month, Granite Recovery Centers CEO Eric Spofford said in a statement that the company has been following CDC and state health guidelines since the beginning of the pandemic.
“As always, the health and safety of our clients and workforce is a top priority,” Spofford said in the emailed statement. “Granite Recovery Centers has a COVID-19 protocol in place and we have been following that plan since March.”
But in August, months into the pandemic, Green Mountain’s executive director said in a staff-wide email obtained by NHPR that clients were complaining and threatening to leave, “all related to the lack of COVID protocol.”
Those concerns persisted into the fall. Multiple current and former clients shared stories with NHPR of inconsistent mask-wearing and a lack of social distancing in the weeks before the outbreak began.
One of the biggest concerns was the on-campus dining hall. Rosasco and others shared similar stories about the buffet, where clients would stand close together in line, “with or without masks,” handling the same utensils to serve their food, even though “no one was really sterilizing their hands.”
A client named Dan M., who was also at Green Mountain in mid-November, and has asked NHPR not to publish his full name, said he really enjoyed the community at Green Mountain, and it was nice to share meals with friends. But he said was surprised to see that, this far into the pandemic, staff allowed so many people to sit so close together.
“There were ways to separate us,” Dan M. said. “They could have done two chairs per table or something.”
And then there were concerns about the vans that brought some clients to and from Green Mountain. Not everyone in treatment at the facility sleeps there; some clients stay at Forest Glen Inn, a former inn in North Conway run by Granite Recovery Centers that’s about 35 minutes away.
To get back and forth, sources told NHPR that clients are often crowded into these vans: like “sardines in a can,” said Rosasco, who also said not every passenger would wear a mask.
“I kinda found it contradictory,” Rosaco said in an interview later. “The whole system of recovery and mentality is like, doing for others and s*** like that. And then to, like, not wear a mask just because it bothers you a little bit? I mean, the whole point of wearing them was for other people.”
Granite Recovery said it notified the state health department of a COVID outbreak at Green Mountain on Nov. 28. But many clients said that they didn’t hear about it from staff; they heard about it from each other.
A client named Mike, who also asked us not to publish his full name, became friends with Dan M. during treatment. He found out Dan M. was positive for COVID-19 and said he was upset that staff were not sharing that information with everyone.
According to staff, the client population often includes people with health problems that the CDC considers high risk for severe illness from COVID-19, such as heart conditions and diabetes. Mike decided someone needed to share the news: So he stood up in front of a group of clients and told them what he knew.
“I said, ‘Everybody in this room is exposed.’ And that was a hard pill to swallow for a lot of people, because they just didn't know,” Mike said. “And I mean, in a way, if we hadn't stood up and started talking about this, I didn’t get the sense that anybody was going to say anything.”
When Peter Rosasco got word of the outbreak, he said he tried to just stay in his room in the former inn run by the treatment center. Rosasco said he’d only leave his room to smoke, and later Saturday night, he said, he noticed vans coming from Green Mountain.
“I was just outside smoking a cigarette and I was like, what the heck are these people doing? Don't tell me that they're the COVID-positive people, which they were,” he said.
Multiple people reported that once staff became aware of the outbreak, they moved clients who were positive for COVID-19, or likely exposed to the virus, from the treatment center to the inn. Yet there were many clients living in the inn, like Rosasco, who didn’t know if they had contracted the virus or not.
Robert Hunt said he was one of those clients moved from the main campus. He had tested negative for COVID-19 after potentially being exposed by his former roommate.
Hunt said he was not quarantined or isolated after his negative test, even though public health guidelines recommend quarantine for people who have been exposed, because negative tests can be wrong. More concerning, he said, is that he was then moved into a shared room with a person who tested positive the same day, a story NHPR has confirmed.
“It's just frustrating; everybody comes here to try and get better, and the way that they're handling this just isn't right,” Hunt said.
Multiple sources described lax quarantine procedures, including the use of a plastic sheet over a doorway to separate COVID-postive clients from others in the same residential building.
COVID is “risky but addiction is riskier”
NHPR has tried to ask CEO Eric Spofford about these complaints, but he has declined to respond. He announced last Thursday, during the outbreak, that Green Mountain was launching a new treatment program, specifically for people with COVID. He said it involves an isolated unit for people with COVID that follows CDC guidelines.
NHPR was invited to interview Spofford about the new initiative, where he said people dealing with addiction and COVID can’t wait for their quarantine to end to get help.
“For our clients, the risk, COVID certainly is risky but addiction is riskier,” Spofford said. “Fourteen days is an eternity for somebody that's seeking help for a substance use disorder. And a lot can happen in that, and there's a lot of risk in waiting that time.”
But when Spofford was asked about his staff's ability to safely care for COVID patients, given the complaints NHPR has received, his press spokesman Josh McElveen cut the interview short. McElveen said he wouldn’t let Spofford respond to allegations that he hasn’t seen before.
In response to an email with a detailed list of staff and client complaints, McElveen said that they wouldn’t “start chasing our tails by lending credibility [to] anonymous claims nor will we litigate those claims through the press.” McElveen said Granite Recovery Centers is committed to providing treatment to anyone who seeks help in the safest environment possible.
Peter Rosasco decided that Green Mountain wasn’t safe, so he and other clients checked themselves out of treatment after the outbreak. Three now discharged clients who reached out to NHPR said Green Mountain staff have called them since they got home, but they did not mention COVID-19; the calls were to ask if the clients want to sign up for treatment via telehealth. One client allowed NHPR to listen to voicemails that verified this.
Many of those who've left Green Mountain since the COVID-19 outbreak say the experience has thrown their lives into disarray. Many clients who returned home said their families are now separated to keep partners, children and older or sick relatives from getting COVID-19. One partner of a client is already showing symptoms. Several said they are worried, frustrated, and angry.
“I feel bad for the people that were there for 60-plus days, forced to go home and risk their recovery,” Dan M said.
Rosasco ended up testing positive for COVID when he got back to Maine and has now developed symptoms. His mom Susan Axelrod is worried about how all this could hurt her son’s recovery.
“I worry that without his community, it'll be a step back for him. I’m comforted by the fact that he’s very committed to his recovery at this point,” she said. “But yeah, it’s definitely something that keeps me awake at night.”
As for Granite Recovery Center’s plan to take on more clients with COVID, Axelrod said it was an "admirable effort." But she said she’d have to know what the health department thinks before she sends another family member there. (A spokesman for the New Hampshire Department of Health and Human Services did not respond to questions from NHPR by deadline.)
After everything she’s heard from her son, she said, she “wouldn’t take Eric Spofford’s word for it.”