Adenovirus kills 7th child at New Jersey long-term care facility

On Tuesday, the New Jersey Department of Health announced that six patients at the Wanaque Center for Nursing and Rehabilitation in Haskell had died and 12 others were sick with adenovirus, a common virus that usually causes mild respiratory illness in otherwise healthy people. The seventh death happened Tuesday night.

At a news conference at the nursing home Wednesday evening, New Jersey Gov. Phil Murphy said many questions remain unanswered on how the outbreak occurred and how the facility communicated that to health officials, parents of patients and staff.

The 227-bed facility, about 25 miles northwest of New York City, has been cited for several deficiencies in recent years that could lead to the spread of infection, according to New Jersey state inspection reports.

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“Facility staff have diligently implemented all available infection control and prevention measures” to protect residents’ health and safety, Rowena Bautista, the center’s administrator, said Tuesday.

Two unions that represent nurses and other health-care workers at the privately owned, for-profit center criticized management and ownership for poor working conditions.

“Since new for-profit ownership took over at Wanaque Center in 2014, workers have expressed serious concerns over worsening staffing levels, lack of adequate supplies, and severe cutbacks to job standards,” said Ron McCalla, a vice president of the Service Employees International Union Local 1199 that represents 136 workers at the facility. 

Staff at the care center referred questions to Braithwaite Communications, a Philadelphia-based marketing agency whose services include crisis communication. The company did not respond to calls or emails.

“When you have so many deaths in such a short time, there was potentially a breakdown in infection-control protocols,” said state Sen. Joseph Vitale, a Democrat from Woodbridge who heads the Senate Health Committee.

The long-term care center that also serves severely debilitated patients of other ages failed at times to properly supervise those in its care and handle medical equipment in a sanitary manner, according to four annual reports from 2015 to 2018. 

“This deadly viral outbreak was clearly a preventable tragedy, and state officials must take immediate action to deliver justice to the families who are being forced to reckon with every parent’s worst nightmare — the loss of a child,” said a statement from state Sen. Gerry Cardinale, Assemblywoman Holly Schepisi and Assemblyman Robert Auth, Republicans who represent the area where the facility is located.

The Wanaque Center for Nursing And Rehabilitation is shown Oct. 21, 2018, and is located in Haskell, New Jersey (Photo: Kevin R. Wexler, The (Bergen County, N.J.) Record)

The state health inspection reports detail instances of nurses not alerted when severely debilitated patients were in need: One patient broke a leg in a shower fall; another struggled to clear his or her lungs.

Management of the Wanaque Center did not immediately respond to a request for comment on the inspection reports.

Until the outbreak ends, the long-term care center has been barred from admitting new patients, state officials said.

Between Jan. 1, 2015, and Oct. 1, 2018, it was inspected three times as a result of complaints, according to the state Health Department’s website. But no deficiencies were observed as a result of those complaints.

Reports from August 2018 and May 2017, the two most recent, cited these individual problems at the time of inspectors’ visits: 

• A strong odor of mold in a patient sleeping area. The facility “failed to provide a clean and homelike physical environment for their residents,” inspectors said.

• Urine dripping into a urinal. A urinary drainage bag with a hole in it was not replaced, which could lead to an infection in the patient.

• Improper handling of a pill. After a nurse picked medication off the floor, she did not wash her hands before preparing to administer more medicine. 

• Syringes improperly cleaned. Nurses were observed not properly cleaning, drying and storing syringes used to give oral medicine.

• Trays improperly sanitized. A nurse did not disinfect medication trays between sessions with patients.

• A utensil left in canister. A scoop was left in amino acid powder, potentially exposing the bulk receptacle to bacteria.

• Tubing exposed to germs. Tubing from an oxygen tank that enters a patient’s nose was left out while the patient was away receiving dialysis. It should have been placed in a plastic bag.

• Containers not cleansed. A nurse did not properly clean the outside of bottles of germicide and hand sanitizer after taking out a patient’s trash. The nurse was going to put them on a treatment cart before the inspector inquired.

In both years, several staff members did not correctly address the needs of patients, many of whom are so badly debilitated they cannot communicate, according to the reports.

Health Department investigators returned to the facility Tuesday after a visit Sunday, during which they found “minor handwashing deficiencies.”

“We were last here before this past weekend in August, and there were a number of, again, low-level, self-limited deficiencies that they had to correct,” said New Jersey’s health commissioner, Dr. Shereef Elnahal, at a news conference Wednesday. “And they submitted a clear plan of correction, we accepted that plan, and when we came back here over the weekend, we checked each and every one of those and they had been resolved.”

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The state will issue a final report on its most recent inspection, conducted Oct. 1, “soon enough,” Elnahal said.

The state was notified of respiratory illnesses at the center Oct. 9. Most of the affected patients were younger than 18, state Health Department officials said.