Family of nursing home resident who died: ‘She had 3 really good years there and 1 really bad week’

Karen Johnson, 77, spent about three years in the Highland Springs Care Center in Beaumont.

“She was at an unlocked memory care facility in Hemet, but she got to the point with her Alzheimer’s and dementia … where she needed to be in a locked facility,” said her daughter, Dena Garcia.

Eye of the Storm

Southern California Nursing Homes during the Coronavirus Pandemic

Latest installments in a continuing series

• Part One:  What do Southern California nursing homes hard hit by COVID-related deaths have in common? We spoke with experts, nursing home administrators and advocates to find out.
• Part Two: A tale of two Pasadena nursing homes. One, Gem Transitional Care Center, hard hit by COVID deaths and another, Camellia Gardens, about four miles away, that wasn’t.
• Today, Part Three: Highland Springs Care Center in Beaumont has one of the highest percentage of COVID-19 deaths per average daily number of residents of any skilled nursing home in Orange, Riverside or San Bernardino counties.

The series was produced by correspondent Brenda Gazzar and SCNG staff writer Beau Yarbrough, participating in the USC Annenberg Center for Health Journalism’s California Fellowship.

Garcia, who lives in Moreno Valley, would visit her mother regularly.

“I had a really good relationship with people who worked there. I knew them, they knew me, I could show up at any time,” she said.

And her mother seemed to like Highland Springs:

“She was a very outdoorsy person, so I think she liked getting outdoors and still feel like she was getting outside,” Garcia said, although she noted that Johnson still wasn’t allowed to leave the grounds.

In March, as the coronavirus pandemic swept into Riverside County, Highland Springs stopped all visitation. Management told residents’ families they had a rigorous routine for keeping staff, residents and the facility clean and virus-free. All employees were screened for temperatures when they arrived each day, for example. According to her family, Johnson even appears in a March 23 video about hand washing on the Highland Springs Facebook page.

“She had three really good years there and one really bad week,” said Johnson’s grandson, Kyle Garcia, who lives near Fort Worth.

On April 11, Dena Garcia was told that her mother was running a fever. Three days later, Johnson was sent to the emergency room at Banning’s San Gorgonio Memorial Hospital, where she was nonresponsive. Previously, she was capable of holding conversations and, her dementia and Alzheimer’s aside, was in generally good shape, according to her family.

Highland Springs spokeswoman Liz Tyler blames asymptomatic spread for the virus getting into Highland Springs.

“It’s not like the memory care facility created this virus or served it with breakfast,” she said. “It came in from the outside.”

Despite housing those most vulnerable to COVID-19, nursing homes don’t have the same tools as hospitals do to fight it, she said.

“Nursing homes, they don’t have negative space rooms like you have in hospitals. They have shared ventilation,” Tyler said. “It is an extraordinary effort to contain it.”

Highland Springs stopped admitting new residents on April 13, after the facility was first informed a resident had tested positive for COVID-19.

On April 17, Highland Springs was told Johnson had tested positive for COVID-19. Staff ended up testing all of their patients that same day, Tyler said. Sixty-one out of 86 residents tested positive, most of whom were asymptomatic.

“Their suspicion is it came with an asymptomatic staff member and it may have been a staff member who had a job in more than one facility,” Tyler said.

The facility gave employees an ultimatum, requiring them to only work at one facility, and residents who had tested positive were put in isolation.

Johnson died April 19 — the only person to die of COVID-19 in Riverside County that day, according to county health officials. She was the 75th person to die in the county of the disease.

A nurse at the hospital held up the phone so Dena Garcia could say goodbye to her mother.

“I just told her that I loved her and that we didn’t want her to suffer,” she said. “If it’s your time, it’s your time and you can go. Even without the coronavirus, Alzheimer’s is just a terrible, terrible disease.”

It has been a tough year for Dena Garcia: The last time she saw her mother alive was the day before Garcia’s father was buried. Two of Johnson’s six other siblings also have been diagnosed with COVID-19.

As of Sept. 11, 20 Highland Springs residents have died of COVID-19, roughly 24% of their 84 average daily residents, according to an analysis of data from Medicare’s Nursing Home Compare database and the California Department of Public Health’s Skilled Nursing Homes COVID-19 database.

According to Tyler, Highland Springs hasn’t had any new residents test positive for COVID-19 since the beginning of June.

“They got hit with an invisible bomb, they jumped on it, they did the isolation necessary,” she said. “Even with their dementia population, they kept it from spreading.”

The Garcias feel Highland Springs wasn’t as forthcoming as it should have been about the spread of the coronavirus in the facility, something Tyler denies. But the family is sympathetic to the challenge that Highland Springs faces trying to keep dementia and Alzheimer’s patients from contracting COVID-19.

“You can’t teach them to not eat off each others’ plates. You can’t teach them to keep their hands to themselves. You can’t teach them to not pick up a half-smoked cigarette and smoke it for themselves,” Dena Garcia said. “It’s just going to happen.”

According to Tyler, the big challenge isn’t keeping the virus controlled inside nursing homes; it’s keeping it from coming in from the world outside, where, six months on, the public still can’t agree on how to prevent the virus’ spread.

“This bug is easy to kill. You just have to know it’s there. Once you know it’s there, you separate, do all the cleaning and all the things like that and you get rid of it, like this facility did,” Tyler said. “But any facility in this country, no matter how good their protocols are, they’re just one day from an asymptomatic person coming in.”

This article was produced as a project for the USC Center for Health Journalism’s California Fellowship.