Nursing home therapist warned supervisors of possible COVID-19 exposure 10 days before deadly outbreak, records show

Staff member resigned after warning supervisors; 10 residents have died, more than 70 residents and staff contracted coronavirus

SAN ANTONIO – A staff occupational therapist at Southeast Nursing and Rehabilitation Center raised concerns to multiple supervisors that a fellow therapist had continued to work there despite possibly being exposed to COVID-19, according to text messages obtained by the KSAT 12 Defenders.

The staff occupational therapist resigned March 20, citing concerns over the nursing facility not requiring her co-worker to self-quarantine and instead having him continue to show up for shifts the entire week, a claim Southeast Nursing and Rehabilitation officials denied on Thursday.

On March 31, a week and a half after she made her outcries, health officials confirmed a localized outbreak had occurred inside the facility.

Ten residents have died and more than 70 residents and staff members have tested positive for the deadly virus, according to the latest figures provided by San Antonio Metropolitan Health officials on Wednesday.

Health officials have not connected to the outbreak at the nursing facility to the therapist’s co-worker but the investigation remains ongoing.

“So after I finish today I won’t be back. I just found out that (Redacted)'s girlfriend is self isolating because of symptoms! I think the worst part is that I feel like since you knew you should have said something and the fact that we’re all out at risk because you guys kept it quiet is just unbelievable! The betrayal I feel is just enormous! Wow! Knowing how things are going and no one reported this!” the woman wrote to both her rehabilitation director and regional director of rehabilitation at Rehab Synergies, a company that contracts with Southeast Nursing to provide therapy services at the facility.

READ MORE: ’We feel helpless’: Family of COVID-19 patient at nursing home concerned about care he’s receiving after fatal outbreak

The rehabilitation director did not respond to the woman, while the regional director, identified as Beth Walters, wrote back apologizing that staff were not informed about the possible exposure.

Walters then shared with the woman CDC guidelines in effect at the time that said health care professionals, even after being exposed to a COVID-19 patient, could continue working if other options to cover staffing had been exhausted.

“Non symptomatic employees need to self monitor and continue to work,” wrote Walters.

“We had community transmission. We were a hot spot,” the occupational therapist told the Defenders this week, pointing out that community-spread cases of the deadly virus had already been identified by Metropolitan Health officials by the time she made her outcries.

She has asked the Defenders not to identify her because she hopes to one day work in the therapy field again.

“The claims made and reported were replete with errors and false statements. Most notably, the person identified as a staff person does not work here. She was an outside therapist and the text exchange occurred between her and her employer," a spokesperson for the nursing home said. "We began aggressive compliance with all local, state and federal guidelines and protocols when they were sent on March 11, 2020. This is a difficult and frightening time, and we believe the professionals here were treated disrespectfully in this story. We are working extremely hard to save lives.”

RELATED: Nursing home with 70+ COVID-19 patients fined $68,000, cited for 28 violations in 2019

See a timeline of events below.

The occupational therapist said she repeatedly tried reaching Southeast Nursing’s administrator via telephone, before asking a co-worker to have the administrator contact her.

On March 21 the administrator, identified as Monica Castañeda, texted the woman.

The woman again raised concerns about the possibly exposed therapist continuing to work inside the building the entire work week.

“I hope I’m wrong and that I’m over reacting like they said but I feel like you are trying so hard to keep our residents safe and if you don’t know about it you should. If you’re already aware, ok,” wrote the therapist.

“Thanks for letting me know!! I appreciate it!” responded Castañeda via text message.

RELATED: Infected staff at nursing home with 75 COVID-19 patients worked at other San Antonio facilities

Four days later Metro Health was notified that a staff member was ill and showing symptoms.

Neither Castañeda or Walters responded to phone calls seeking comment for this story.

Officials from Rehab Synergies and Advanced Healthcare Solutions, the parent company of Southeast Nursing, have not responded to repeated requests for comment from the Defenders this week.

A spokesperson for Texas Health and Human Services confirmed Wednesday the agency is investigating the facility’s infection control practices, whether it properly screened staff and providers of critical services to residents and whether it has been following COVID-19 related guidance from state and federal authorities.

MORE: Facility connected to nursing home with deadly COVID-19 outbreak now under investigation in San Antonio

“I do have a big sense of guilt because I feel like I probably should have pushed the issue harder. I think about what if that were my parents or grandparents?” said the occupational therapist as she cried.

City officials late last week confirmed that staff members at Southeast Nursing had also worked at at least five other long-term care facilities around Bexar and Wilson Counties, exposing residents and staff members who do not live or work at Southeast Nursing to the virus.

San Antonio Mayor Ron Nirenberg on Friday amended the city’s ‘Stay Home Work Safe’ order to prohibit long-term care employees from working at multiple facilities.

The therapist said she was tested for COVID-19 March 30 after contacting the city’s hotline and identifying where she formerly worked.

MAP: These are the health care facilities being monitored for COVID-19 outbreaks in San Antonio

Rehab Synergies accuses therapist of patient abandonment

The occupational therapist was informed late last week that officials with Rehab Synergies filed a complaint with the state, accusing her of patient abandonment.

The Defenders have reviewed a copy of the complaint, which was filed with the Executive Council of Physical Therapy and Occupational Therapy Examiners.

“This patient abandonment created an unnecessary hardship for the Southeast Nursing and Rehab Team as well as for Rehab Synergies, not to mention the patients at risk for decline in function,” the complaint reads.

The complaint also accuses the occupational therapist of failing to follow company policy for notification of resignation, while claiming that the facility was following CDC guidelines in effect at the time of the woman’s resignation.

The therapist has already formally answered the complaint.

An investigator with the Executive Council of PT & OT Examiners told the Defenders this week the investigation was in its preliminary stages but that she could not discuss it because KSAT was not the licensee or the complainant.

WATCH: ‘We should assume the virus is in every corner of this city,’ says San Antonio mayor

COVID-19, the respiratory disease caused by the new virus, stands for coronavirus disease 2019. The disease first appeared in late 2019 in Wuhan, China, but spread around the world in early 2020, causing the World Health Organization to declare a pandemic in March.


About the Authors:

Emmy-award winning reporter Dillon Collier joined KSAT Investigates in September 2016. Dillon's investigative stories air weeknights on the Nightbeat and on the Six O'Clock News. Dillon is a two-time Houston Press Club Journalist of the Year and a Texas Associated Press Broadcasters Reporter of the Year.

Joshua Saunders is an Emmy-nominated photographer/editor who has worked in the San Antonio market for the past 20 years. Joshua works in the Defenders unit, covering crime and corruption throughout the city.