April 15, 2020

Via Email

Commissioner Tommy Calvert, Jr

Bexar County Commissioner, Precinct 4
101 W. Nueva, Suite 1029
San Antonio, TX 78205

Re: Southeast Nursing and Rehabilitation Center

Dear Commissioner Calvert:

I represent Southeast Nursing and Rehabilitation Center (Southeast). On behalf of the

dedicated nurses and caregivers working diligently and tirelessly to assist and treat all of the
residents in the facility, I am writing to request an apology for the appalling letter you sent to city
and state leaders, as well as the news media this morning. The accusations in your letter were
based on fear and not fact. Indeed, the litany of charges you outlined are either blatantly false or
represent a serious misunderstanding of state and federal regulations and guidance regarding
staffing, protocols, and procedures during the COVID-19 pandemic.

In a normal environment, I would invite you to visit Southeast so that you could see for
yourself that the allegations are false. Right now, in an abundance of caution for your safety and
well-being and the health and safety of our residents, it wouldn’t be appropriate for you to come
to Southeast at a time when we can’t allow family members to visit and see their loved ones.

We are, however, continuing to be inspected by the Texas Health and Human Services
Commission (HHSC) and the Centers for Medicare and Medicaid Services (CMS) and their
qualified surveyors. If any of your accusations were correct, I can assure you the agencies’
investigators would have uncovered them and cited the facility. That has not happened.
Southeast has been working with the local health authority and HHSC since mid-March and it
has followed every direction and recommendation they gave the facility.

Let’s talk about temperature first. I am enclosing pictures taken this morning of our
thermostats, all of which have been set for 68 or 69 degrees. The facility has multiple roof top
AC units, which were serviced on April 7, 2020. There are also multiple thermostats in the
facility that are for each unit on the roof. I am unsure which thermostat the picture you circulated
was from, but since we do live in Texas, when thermostats are set too low, a unit can freeze up.
Our multiple roof top units are sufficient to handle the load for the facility and keep our
residents’ environment comfortable. If the individual who took this picture had informed the
facility’s leadership of his or her concerns with the temperature reading allegedly observed at
11:06 p.m. last night, instead of just informing you, the facility could have immediately arranged
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Page 2

for our HVAC service company to come to the facility to evaluate the issue first thing this
morning instead of this afternoon.

Regarding your outrageous and inflammatory statements about our residents not being
fed, all of your allegations are completely false and defamatory. Each and every one of our
residents are being fed and offered meals and snacks throughout the day. That is not only the
law, it is the moral and ethical thing to do. I don’t know who made these statements to you, and I
can’t imagine why anyone would falsely accuse our dedicated staff of such abhorrent behavior,
particularly when they are working tirelessly to take care of our residents.

You also made statements about employees not receiving meals. Again, your statement
was blatantly false. Our dietary department is offering food and snacks to all of our employees
and has done so for many weeks during these difficult times.

Southeast’s staff is providing every resident the care they need under the direction of
their physicians and according to the guidance issued by HHSC, CMS, CDC and our local health
authority. Residents are seen daily by their physician through telehealth or in-person. All
residents are also receiving their medications, treatments, and showers in accordance with their
physician’s orders and care plans. No resident in our facility has a high fever as you allege. The
highest fever in the facility was 99.4 last night. The facility’s medical director was in the facility
earlier today and based upon his observations and assessments, he believes the residents are
doing well.

The facility has all of the staff that is required under state and federal law, including
nurses, nurse aides, respiratory therapists, infection control preventionists, and other support staff
that are caring for our residents. Every nursing facility in the country is having difficulty
retaining staff who are worried about Covid-19, but we are able to provide supplemental staffing
from at least three other facilities. Any staff that tested positive for COVID-19, who have
returned to work, have been cleared by the local health department in accordance with CDC and
CMS guidelines. You might want to review the state and federal guidelines for staffing during
Covid-19.

We have no way of knowing where the mattress pictures originated and if they are in a
patient’s room or in a storage facility or even at this location. State and federal regulations
require nursing facilities to provide clean and comfortable mattresses. As a precautionary
measure, staff is examining all of the mattresses and we have put some on hold, in case any of
them need replacement.

In closing, I do believe you owe Southeast’s nursing staff, physicians and other
healthcare workers an apology regarding the unfounded and inflammatory charges made this
morning in your letter. The letter was an insult to their integrity, professional abilities, and even
their individual morals and honor. We are working as hard as we can to save lives in a difficult
environment, made even more difficult because of your letter sent this morning.
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Page 3

Sincerely,

Nancy A. Shellhorse
Counsel for Southeast Nursing &
Rehabilitation Center

cc: Governor Greg Abbot

Commissioner Phil Wilson
Commissioner John Hellerstedt
Judge Nelson Wolf
Dr. Junda Woo
Dr. Colleen Bridger
Chief Charles Hood
Kyle Coleman
David Smith
Pete Flores
Seth Mitchell
Eric Elpey
Luis Saenz
Jordan Hale
Chelsea Holden
Harold Stone
Gracie Flores
Roland Gutierrez
Katie Farias
Nichole ErFurth