BOISE, Idaho — The Occupational Safety and Health Administration is investigating a group home owned by a Meridian-based health care company after employees who worked at the company's facility in Jerome say they felt pressured to work while presenting with COVID-19 symptoms, or while waiting on the results of COVID-19 tests.
Nor is it an isolated case — the manager of three of the company’s Nampa group homes told the Idaho Press she’s heard from three employees who said they worked while they had symptoms.
The company, CommuniCare Inc., was founded in 1980 and specializes in care for people with intellectual disabilities, according to its website. It operates nine facilities across Idaho and two-day facilities.
At least two employees of the Jerome facility have filed complaints with OSHA, and the company has until Thursday to investigate the conditions.
A resident of a separate Jerome group home managed by the same company has died of COVID-19, according to his obituary in the Times-News. Employees have confirmed some staff members did travel between the two homes.
'I DIDN'T KNOW SHE WAS POSITIVE WHEN SHE WORKED'
In the last week of March, Vivian, who works in the CommuniCare group home in Jerome, and who spoke with the Idaho Press on the condition of anonymity, was feeling sick. She didn’t have a cough, but she lost her sense of smell, had body aches, headaches and a sore throat. It was late March and she wanted to stay home during that time, but the floor manager at the facility told her either she had to personally find someone to cover her shift for her, stay home without pay, or come to work, Vivian said. With more members of an already small staff calling in, everyone was having trouble covering shifts.
So Vivian worked for two days with those symptoms, she said. She was told she could work as long as she didn’t have a fever.
That same week, her managers informed her and her coworkers one of the home’s employees had tested positive for COVID-19.
“I decided April 1 to go to get tested and the doctor told me, ‘OK, you need to be quarantined until you get your results back,’” Vivian said.
She then relayed that information to her manager.
“I told her and she got mad at me,” Vivian said. “She said, ‘I have five staff (members) out and now you?’ She’s like, ‘OK you know what, you have to look for your own coverage and if you don’t find your coverage, you have to come to work.’"
The Idaho Press called the facility and asked to talk with Vivian's manager, but was referred to the company's main office.
Tom Whittemore, the owner of CommuniCare, told the Idaho Press the company was “fully in compliance” with the CDC guidelines for health care workers to return to work if they’ve tested positive or were suspected to have had COVID-19.
Vivian chose to stay home — but she believes the company would have let her work if she wanted to. Her test results came back positive on April 4.
She wasn’t the only one who felt pressured to come into work while waiting for test results. Her coworker Melody, who also spoke on condition of anonymity, was tested April 1, the same day the company had informed the employees one of the staff members tested positive for COVID-19. She'd been showing up to work with symptoms, she said — she had body aches, she couldn't smell or taste; she had a runny nose.
Health care providers told her to quarantine until she got her results back, and gave her a letter to give to her boss after she got the test. According to a photograph of the letter she sent the Idaho Press, she could stop isolating after she had been fever-free for 72 hours, if her other symptoms had improved, and after seven days had passed since the onset of her symptoms.
The day after she got tested, her manager texted her and told her she’d spoken with Bridger Fly, the company’s administrator, about whether Melody could return to work. Her manager wrote to her that, based on guidance from health professionals and the CDC, an employee with no fever or other symptoms can return to work.
CDC guidelines are updated often and, as Brandon Atkins, the program manager for the family and clinic services of Central District Health, pointed out, they are only guidelines. The guidelines for asymptomatic health care professionals returning to work after a potential exposure to the new coronavirus try to plan for a variety of scenarios, and take into account factors such as whether the health care worker was wearing personal protective equipment.
Ultimately, though, companies and agencies will have their own policies to govern such situations, Atkins said, speaking in general terms and not to this situation specifically.
In the final week of March, with employees concerned about coming to work, the virus didn’t appear to have spread to the six residents of the facility. On March 28, Vivian messaged her manager asking what was being done to keep COVID-19 out of the facility, since three staff members were sick.
“All we were told to (do) was to keep cleaning, wear masks, and use gloves,” Vivian’s boss wrote. “None of the individuals (in the facility) have tested positive, which indicated to the nurses that it didn’t begin (at) work, rather that people got it outside of work.”
On April 5 Vivian and her manager were arguing over text message about her manager's decision to let an employee work who later tested positive for COVID-19.
“I can’t foresee the future so I didn’t know she was positive when she worked 6 a.m. — 2 p.m. because she wasn’t told until later that night!!” the manager texted her, according to a screenshot of the conversation Vivian shared with the Idaho Press.
“Yeah but she clearly told you that she was sick, and was clearly presenting symptoms and still was FORCED to work,” Vivian wrote back.
Her boss reminded her no one was “forced” to work — they simply had to find their own coverage.
“Symptoms did not include fever or body aches or cough,” her boss wrote. “I follow what I’m told by Bridger (Fly) and Rhonda (Stewart, the company’s resident nurse). If you want to know more, call them.”
CONCERNS IN NAMPA
Ellen, who managed three CommuniCare group homes in Nampa before the company terminated her on Thursday, and whose name has been changed to protect her identity, said the situation was similar in her area, too. She said three employees told her they worked while they had symptoms — including a cough. They were given the same choice: come to work, find your own coverage, or stay home without pay.
Ellen voiced concerns about the company's policies to Fly, the company’s administrator, part of a weekslong email thread she shared with the Idaho Press. She wrote she was worried for the safety of her staff and residents, and said it didn’t appear the company was following CDC guidelines. In a Thursday email she shared with the Idaho Press, the company's administrator indicated she'd been terminated because she requested leave under the Family and Medical Leave Act, but hadn't worked enough hours in the last year to qualify.
"For this reason we cannot approve this leave and as such will accept your resignation from your position at CommuniCare, Inc. effective immediately so that we may attempt to fill your position with the much needed services to our individuals," the email reads.
The Idaho Press on Friday called CommuniCore's main office and asked for Fly; he did not return the call. In response to an email from the Idaho Press, he said he would respond to emailed questions within a few days.
Those policies didn’t appear to have changed as of Thursday night, when Ellen texted one of her staff members in Nampa and asked what the policy was about going to work sick.
“Well yeah, but like can you come to work not feeling good as long as you don’t have a fever?” Ellen asked, according to a screenshot of the conversation she shared with the Idaho Press.
“Yeah, if not we still have to find coverage,” the employee said. “But fever is the main thing.”
CDC GUIDELINES
Melody and Vivian were told by their managers that the company was following CDC guidelines. The triggering symptom, they were told, was a fever: they should not work if they had a fever.
The CDC has actually recommended two courses of action for health care workers to return to work after they’ve had COVID-19, or believe they have had it. The “test-based strategy” is the preferred method. Under that regimen, the health care worker must test negative for COVID-19 twice over more than 24 hours; they must also be fever-free without the aid of medication, and they must see an improvement in respiratory symptoms as well. Neither Vivian or Melody — nor even Ellen, when she was tested — were tested twice.
As Whittemore, CommuniCare's owner, pointed out, testing isn’t widely available in Jerome, so the company would have used the non-test-based strategy, which more closely resembles the guidance Vivian and Melody received from their managers. That course of action requires the employee to be fever-free for 72 hours without the aid of fever-reducing medication; it requires an improvement in respiratory symptoms, and it also requires at least seven days to have passed since the symptoms first appeared.
“You also understand the people living in the group home are people with intellectual disabilities, unable to care for themselves, which is why they are in our care,” Whittemore said. “We do not have a wide range of employees not coming to work, that we can call to come into work, so each employee’s role is vital.”
Whittemore said employees “must be on the jobs if they are not showing symptoms.”
He said people who think they may have been exposed to the virus, but who aren’t displaying symptoms, are “checked every day when they come to work.”
“So we do encourage people to come to work — obviously the people with disabilities living in the home cannot be left unattended,” Whittemore said.
The employees who have tested positive at the group home where Vivian and Melody work, Whittemore said, “All of them have been encouraged to follow the guidance given to them by their doctors.”
“These group homes … you can’t put the risk of bringing something or introducing something into the environment that could potentially spread throughout the facility,” said Atkins, of Central District Health.
Atkins was not told which company or group home’s employees the Idaho Press had spoken with.
“So if there actually were someone who were pressuring employees to work outside of the guidance that’s currently being provided by the CDC, by our state, by our local jurisdictions, that would be upon that specific facility,” Atkins said. “They are not acting in accordance with what the best recommendations are. … There’s no way you could justify to an employee or a staff member, ‘You’re telling me you’re sick, I need you to come in regardless.’ That’s putting that population inside that facility at risk. And I get it, that sometimes those individuals are pushed up against a wall because they don’t have employees to cover the employee who is going to be out sick, but there’s not a balance to say, ‘It’s OK for you to come into work sick even though I don’t have someone to replace you.’”
Atkins also pointed out people can test positive for COVID-19 and be symptomatic without having a fever.
“There is a large portion of our population that don’t have all the symptoms that are included,” he said. “While fever is indicated as one of the number one symptoms that people do see when they are symptomatic, it doesn’t mean that the person has to have a fever. They may just have a dry cough, they may just have congestion in their chest, they may be feeling unwell.”
COMPLAINTS
Vivian and Melody have both recovered from COVID-19. Staff members in their facility are wearing cloth face masks, Vivian said. The last day she worked was Saturday. She said staff members weren’t wearing gloves, but Melody, who worked on Friday, said they were.
According to a March 31 email from Fly that Ellen shared with the Idaho Press, CommuniCare was working with vendors and health districts to secure personal protective equipment, but the shortage of the gear made it difficult. Ellen had specifically requested the ability to work using an N95 mask.
On Thursday, through an email to Fly, Ellen listed her complaints about the company, saying she had “major concerns over the safety of the residents and staff.”
“It appears to me the ‘CDC Protocol’ that has been put in place isn’t being followed correctly,” she wrote. “I realize that has changed the last few days but this policy was adopted PRIOR to the change. Employees are returning to work prior to having ‘2 negative tests’ which was against CDC recommendations. That is a huge safety concern for me for residents and staff.”
The company terminated her that same day.
Vivian and Melody both filed complaints with OSHA. Jose Carnevali, spokesman for the U.S. Department of Labor, confirmed to the Idaho Press that OSHA is indeed investigating the incident, but wrote in an email that he couldn’t say more.
According to a copy of a letter the department sent the Jerome facility’s manager, which Vivian shared with the Idaho Press, CommuniCare has until Thursday to investigate the unsafe working conditions and respond to OSHA.
Idaho Press Hispanic affairs reporter Rachel Spacek assisted with this story.
If you enjoy reading articles like this one from our partners at the Idaho Press, please consider subscribing to them for newspaper delivery or digital access to help ensure stories like this are told.
More from our partner Idaho Press: Idaho's new ban on gender changes to birth certificates draws legal fire
Facts not fear: More on coronavirus
See our latest updates in our YouTube playlist:
