iTeam Investigation: The outbreak at Eldercare and the state's response

CHARLESTON, W.Va. (WCHS/WVAH) — The resignation of West Virginia State Health Officer Cathy Slemp came as the result of the governor saying he has lost confidence in her.

For weeks, Eyewitness News has been examining the circumstances surrounding the deadly coronavirus outbreak at Jackson County's Eldercare nursing home.

Our iTeam investigation revealed everyone at Eldercare could have been tested a week and a half before they eventually were, because Slemp and state Department of Health and Human Resources Secretary Bill Crouch followed Centers for Disease Control protocols instead of Gov. Jim Justice's orders.

Eldercare Health and Rehabilitation was where the COVID-19 virus hit the hardest among West Virginia nursing homes. According to the state DHHR, 103 people -- 71 residents and 32 staff members -- tested positive. Fifteen residents died.

The number of infections and deaths are both at the top of the list for the state's nursing homes.

Between April 6 -- when Jackson County's Health Department said that Eldercare first reported its initial positive test -- and April 16, when Eldercare tested all residents and staff members, there was a flood of emails and telephone calls to the governor's office from people expressing concern about loved ones at Eldercare and complaining about the lack of information being released by the nursing home.

In its statement, the county health department said it "...made an inquiry with the West Virginia Bureau for Health regarding the need to begin testing all patients in the facility."

The state did not order facility-wide testing.

Did the state handle the Eldercare situation the best it could have?

"I think we all learn from these situations," Slemp said. "I think this is a situation in which we're learning nationally about, about, I think we saw this in the outbreak in Washington state. I think we see this here. Each one, this was one of our big early ones, and I think each one of these we learn more with and we get better with. Do I think we've done them all absolutely correctly? No. I think we've learned a lot from each of them, this one included."

Additionally, the county said, "On several occasions the state health officer reached out for updates on the status of Eldercare. There were multiple discussions about patient status, staffing, personal protective equipment, etc."

But apparently, none of that information was getting to the governor.

"I did not personally speak to the governor," Slemp said. "But he's been very attuned to this issue and very supportive of all of these investigations and all of these situations, no doubt."

Eyewitness News has learned that Justice was not aware of the seriousness of the Eldercare situation until we contacted his staff on the morning of April 16.

By that afternoon during his COVID-19 briefing, the governor ordered the National Guard to Jackson County to test every person at Eldercare.

However, the county health department says the company which owns Eldercare had already made that decision and that testing was underway when guardsmen arrived.

In three previous nursing home outbreaks in Monongalia, Kanawha and Wayne counties, as soon as the governor was made aware of the situation, he immediately ordered comprehensive testing of patients and staff members at those nursing homes.

"That's one of the key things that the governor has pressed us on is surge capability with DHHR and our local health partners in these long-term care facilities," General James Hoyer with the West Virginia National Guard said during the April 10 COVID-19 briefing.

Given the response to the nursing home outbreaks in Monongalia, Kanawha and Wayne, we wanted to know why there was a 10-day delay in testing at the Jackson County facility.

Documents obtained through a Freedom of Information Act request include an April 13 email from Crouch where Jackson County's situation was addressed. Eldercare was among the topics.

Crouch wrote, in part, "All staff are wearing full PPE and facility is taking strong action to assure control measures are in place."

He added, "Facility continues to take strong infection control measures, has adequate PPE, is using the same for all staff, etc."

But neither Crouch nor Slemp, who was also in communication with the facility and Jackson County health officials about the Eldercare outbreak, told the governor what was going on.

On April 15, the day before facility-wide testing started at Eldercare, Justice reiterated his desire to test everyone at nursing home facilities whenever a single positive test was discovered.

"We need to run to the nursing home," Justice said on April 15. "Test everyone there, everyone that's affiliated with that nursing home to where we can isolate and move forward."

Finally, on April 16, after being contacted by Eyewitness News, on the day he ordered the national guard to Jackson County, Justice was visibly upset while talking about the situation during his COVID-19 briefing.

"And I'm gonna tell you, if we have any, any nursing home incident where we have one person that tests positive and we don't run to the fire and test everybody there, we're letting these people down." Justice said during the COVID-19 briefing on April 16.

Slemp said there was room for the state to learn from the Eldercare situation.

"Yeah, I do think we all need to learn from this," Slemp said. "I do think that Eldercare and, all of us our hearts go out to any of the families in any of these facilities because this is a terrible disease that is affecting our elderly. And we have got to all of us work together to do, make sure that we do the best possible prevention of our families and our loved ones."

In the wake of Dr. Slemp's resignation, it remains to be seen if Crouch will continue serving in the Justice administration.

"You know, over and over I said one thing and that is this loud and clear," Justice said. "When we have any issue whatsoever at a nursing home I said test everybody. Run to the fire. Absolutely don't hesitate, run to the fire. Now from the standpoint of if others didn't follow the instructions correctly and there are issues or discrepancies, we have an ongoing investigation going on right now. And when we get to the bottom of that investigation I will address it and I will address it appropriately, forcefully, but absolutely it is only respectful and right to those that are being questioned or being involved in the investigation to find out exactly the truth as best as we possibly can and then deal with it."

Eyewitness News asked Eldercare Health and Rehabilitation Administrator Todd Kimble to talk with us about the COVID-19 outbreak at his facility. An attorney representing the company declined our request, citing the two continuing investigations into the matter.

We will keep you posted on the investigations, their conclusions and if there are any more changes in the Justice administration as a result.