Families, officials decry Pavilions governance

May 31--TRAVERSE CITY -- Bea Edmond's son is her world.

"I've been his brains, his connection to life, his everything," Edmond said, about Larry, 67, who has Down syndrome and is a resident of Grand Traverse Pavilions.

Bea Edmond is 87 and a widow. Before age and health challenges took hold, Larry had never lived anywhere but at home with his mother.

It was Bea who tied his shoes when he couldn't learn how, Bea who found him a part-time job with Grand Traverse Industries, Bea who took him on shopping excursions to Costco and Bea who made sure he drank enough water and took an afternoon nap.

"It has been a big adjustment for both of us," Bea said. "From the day he moved there, I would be in his room, with him, from morning 'til night. Too long, I think, for some of the workers."

She is complementary of the certified nurse's aides who now provide most of Larry's care, less so about Pavilions' supervisors and upper management.

"Oh, they hear from me," she said. "A mother see's it, if something isn't right."

The smiling son she loves has become more withdrawn, Bea said. When Larry lived at home, he could often use a walker. Now he's in a wheelchair.

At home, Bea didn't just set a glass of water on his bedside tray and walk away; she held the straw to his lips and told him he needed to drink it all.

In March, an executive order signed by Gov. Gretchen Whitmer temporarily banned all outside visitors from nursing homes.

Bea has been able to see Larry once since then. When Pavilions staff rushed her son to Munson's emergency room after he became dehydrated, she said.

"I got to go into the hospital with him, and I've tried to keep a close eye on him since then, but I must tell you, that's been nigh impossible."

A focus on eldercare

The COVID-19 pandemic has put nursing homes like the county-owned Grand Traverse Pavilions under a microscope.

Clinical Director Rose Coleman said the staff works hard to care for residents and respond to family members who wish they could visit.

Grand Traverse Pavilions is one of several in northern Michigan where no positive cases of COVID-19 have been found in residents -- though a staff member did test positive and was immediately quarantined -- yet some officials still say they don't much like what they see at the facility.

Or more to the point, what little they are allowed to see.

"County taxpayers funded that facility with a $40 million millage, paid out over 20 years, and yet the county has no oversight of what they do, or how they spend their money. None," said Grand Traverse County Commissioner Gordie La Pointe.

La Pointe is the county board's liaison to the Pavilions. He attends board meetings and asks questions, but cannot vote.

The 3-member Department of Health and Human Services Board governing the Pavilions could allow La Pointe to attend closed sessions, said Grand Traverse County Deputy Civil Counsel Kit Tholen, but has not.

"I asked once. The answer was no," La Pointe said.

Board member Ralph Soffredine said there was no need for county oversight or county participation in closed sessions where patients' health often is discussed.

"They shouldn't have oversight of the Pavilions, that's the way its set up, that's the law," he said in a telephone interview Friday.

Board Chair John Rizzo said Friday he believed complaints about transparency were coming primarily from one family, though he did not name them.

"I'm relatively new on the board, and since I've been here I'm trying to make our policies more open and available," he said. "I think we are making progress."

Public vs. private information

A Record-Eagle review of DHHS board minutes available on the Pavilions' website show the board went into closed session four times since April 2019.

Once to discuss a labor contract, once to discuss an annual employee review and all four times -- April 2019, July 2019, December 2019 and January 2020 -- to discuss heath incidents with residents.

The discussions "all include Protected Health Information," DHHS board minutes state, which is a permissible reason for a closed session under the Michigan Open Meetings Act.

Whether identifying information could be removed, so incidents with residents could be discussed in public, wasn't something Tholen was willing to offer an opinion on.

Haider Kazim, an attorney with Cummings, McClorey, Davis and Acho, who does not represent the Pavilions but does specialize in municipal law and insurance defense said it isn't that simple.

The Open Meetings Act does not require a public body to separate exempt and non-exempt information, he said in an email.

"Discussions don't occur in a vacuum," Kazim said. "Not knowing the identity of a resident would restrict and hinder the ability of Board members to be fully informed in their decision-making process and to prepare for any consequences that may arise as a result of the incident based upon the unique circumstances of the particular incident."

On New Year's Eve, a patient incident ended in tragedy, state documents show.

A resident who'd been at the Pavilions to recover from surgery was found in her room unresponsive and later died. (See "Pavilions cited in resident death").

A close-kept hierarchy

The DHHS board is chaired by John Rizzo, vice-chair is Cecil McNally and the third member is Ralph Soffredine. Rizzo and McNally are appointed by county commissioners, Soffredine is appointed by the state, in accordance with the provisions of Public Act 280, first passed in 1939.

The facility is owned by Grand Traverse County and with 240 licensed nursing beds and 78 assisted living apartments on 28 acres, it is the largest county-owned nursing home in the state.

Bea Edmond said she finds this hierarchy confusing, and expressed frustration over her inability to get anyone in a leadership position to return her phone calls.

"I can't figure it out," she said in a recent interview. "It's like they think they have their own little fiefdom and don't have to answer to anyone."

Andrea Gerring's 99-year-old mother, Olga Bruce, who has dementia, was a resident at the Pavilions from November 2017 until February 2020, when Gerring moved her to French Manor.

When Gerring began attending DHHS board meetings, she said she was told by Administrative Services Director Darcy Gratton, that if she wanted a copy of the packet of information that accompanied each meeting, she had to file a Freedom of Information Act request.

Gerring later became so riled over the lack of board transparency, she began paying a freelance videographer to tape them and upload the videos to Traverse Area Community Media's website.

On Friday, the board voted unanimously to pay the $50 per month cost, once they are no longer meeting remotely via telephone conference.

"I don't understand it," Gerring said Friday. "What is it that they don't want the public to know?"

Rizzo pointed to legal questions and staff workloads as reasons for the board's initial reluctance to videotape meetings.

In December, Grand Traverse County Commissioner Ron Clous attended the DHHS meeting and requested the board packets be put on the facility's website and made available to the public, the same way the county board's packets are.

Alarming state ratings

Clous, a frequent critic of the county's lack of oversight authority over the Pavilions, once suggested the facility be sold off, for which he received public criticism.

"I got blowback because people are misinformed," Clous said. "The Pavilions is supposed to take care of the indigent, as in, people who don't qualify for Medicaid but have no money to pay. I know of people in that circumstance who have been turned away."

Clous owns Northern Star Assisted Living (previously Traverse Victorian Senior Living) on Munson Avenue, and said he understands the basics of eldercare, insurance and Nursing Home Compare, a Medicare and Medicaid rating system for nursing homes.

The Pavilions' rating isn't great.

The most alarming is a one star rating (out of five) for health inspections and two star overall rating, after staffing (five star), quality measures (4 star) and penalties are taken into consideration.

The incident with the patient found unresponsive and problems with infection control contributed to the below-average rating, documents show.

"They're going to have to improve that rating," Clous said. "What concerns me is, as an elected board member of the county, the county that owns and built the Pavilions with taxpayer money, I have no say over what they do."

Board minutes show the star ratings have been repeatedly discussed, and their accuracy questioned.

Bea and Larry

On Friday, Bea Edmond said she'd had a recent telephone conversation with DHHS board member Soffredine, he told her he understood her worries, and that others with family members in the Pavilions had also reached out to him.

"I'm realizing after speaking with him that I'm not in a unique situation," Bea said. "I have to admire him for bringing me 'round to that. But my only option now may be to take Larry out of there."

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