AUSTIN (KXAN) — After a resident from the largest known cluster of nursing home COVID-19 cases in Williamson County died this past week, her family is saying they believe long term care facilities need to have more testing and stricter precautions to prevent the spread of the virus.

Caraday Healthcare, who operates the nursing home — Trinity Care Center — reports as of May 2 that a total of 43 residents and 20 staff members have tested positive for the novel coronavirus over the course of two rounds of COVID-19 tests.

69-year-old Sulema “Sue” DeLeon had lived at Trinity Care Center in Round Rock for around three years, her family said. She had Huntington’s chorea, a degenerative disease, as well as asthma and diabetes. Sue’s family said that her diagnoses did not get in the way of her doing the things she wanted to do.

A photo of Sue DeLeon at a competition where she entered a cross stitch piece she made in 2018. Picture from Mike DeLeon. KXAN blurred out other subjects in the photo.

Cross stitch was her passion, her loved ones said, recalling that even when Trinity Care Center was barring visitors, she would ask family to bring her more thread whenever they could.

“She was a tough bingo player there,” said Mike DeLeon, Sue’s son, who recalled that he couldn’t even give her a phone call when she was playing bingo. “She played on their volleyball team. She was an active person while she was there and was currently quilting a blanket and doing some other cross stitch [work].”

Sue DeLeon passed away in the early hours on April 28 in the hospital due to COVID-19 complications, her family said. Now they are waiting to hear back from Trinity Care about a time when they can come by and pick up her cross stitching, quilting and other possessions out of her room.

Trinity Care Center in Round Rock. KXAN Photo/ Alyssa Goard.

Her family members expressed to KXAN anger and disappointment with Sue’s care, and the communication about it during the last days of her life. They described how Sue went through a rapid decline in condition over the last few days of her life following her COVID-19 test results.

“I think if you have somebody taking care of people that already have some medical issues, it should be a lot more strict as far as who’s working there and testing them,” Mike DeLeon said.

The timeline

As a precaution against COVID-19, Trinity Care had been barring medically unnecessary visitors since March 12, so Sue’s family had not been able to give her a hug since early March. Her family members said they would call her or speak with her on the phone while waving at her through her window.

April 23

Caraday Healthcare, a Texas-based skilled nursing corporation, owns Trinity Care Center and has been providing updates about Trinity Care and its residents. Caraday said that on April 23 that the company had learned ” a Trinity team member who had called off sick to work had ultimately received a positive test result for COVID-19.”

Sue DeLeon’s family said they received a call from a Trinity Care staff member that evening informing them that another staff member had tested positive. Mike DeLeon said the staff member he spoke with on the phone told him residents had not been informed yet, so he called his mom shortly after, urging her to wear a mask and be safe.

Mike said that conversation on that Thursday was the last conversation he recalls having with his mom when she was lucid.

On April 23, Williamson County and Cities Health District updated its control orders, which apply to 65 facilities including assisted living, nursing homes, skilled nursing and long-term care facilities. 

Under the updated order, all patients, staff and next of kin will be notified of any confirmed case within a facility. In the event of a cluster, the facility cannot receive new or returning patients until it is cleared to do so, and must make all staff available for testing if required.

In addition, a “strike team” of extra personnel and equipment may be deployed to assist staff.

April 25

On the afternoon of April 25, WCCHD announced the county’s first COVID-19 cluster in a nursing home, noting that 233 samples for COVID-19 testing were taken from residents and staff at this facility on April 23 and 24.

Caraday Health explained that after they learned a staff member tested positive, they arranged to have all residents and staff members tested for COVID-19. This appears to be in line with the new Williamson County control orders.

Caraday Health said the results of that first round of tests came through on April 25, finding that 30 residents and 15 team members had tested positive.

At that time, Caraday said that no residents or team members appeared to be symptomatic, though this statement doesn’t line up with the DeLeon family’s account of things.

Mike DeLeon said Saturday afternoon, his sister called Trinity Care concerned about her mom’s safety after a phone call they’d had earlier. When Mike’s sister called, he said that she was informed by a staff member Sue had tested positive for COVID-19 and had been moved to a different section of the facility for quarantine.

Late Saturday night, Mike recalls the family got another call from Trinity Care, letting them know that Sue was in respiratory distress and needed to be taken to the hospital.

April 26

The DeLeon family said they got a call saying that Sue would be taken by ambulance at around 3:30 a.m., April 26. They say she was taken to Dell Seton Medical Center, though Seton staff could not confirm this due to patient privacy.

Mike said he received calls from doctors asking about her history. He was told that Sue was taken to the ICU and that she had a fever and fluid in her lungs.

Sunday morning, Mike recalled, “we get a call from a pulmonologist, you know we have to ask the ugly question what’s her chances of survival? They’re telling you less than 10%, you know that you need to prepare for the worst. “

“They were nice and professional how they said it, but, you know, I’ll never forget the conversation,” he said.

April 27

Mike explained that he and his sister were allowed to go in one by one to say goodbye to their mother in her hospital room at Dell Seton. They had to put on protective gear before they went and received instructions from a staff member.

Mike said that his mother was not able to have her last rites administered.

April 28

Sue’s family said she passed away early on the morning of April 28 due to COVID-19 related complications.

While Williamson County could not release any specifics on this case, on Tuesday morning they did announce the county’s 7th COVID-19 related death, a woman in her 60s.

On April 28, in a message about COVID-19 updates, Caraday Health reported that one of their residents had died in the hospital.

Williamson County also confirmed that health authorities were investigating the county’s second COVID-19 cluster, also in a nursing home. The county has declined to state where this second cluster is.

May 1

Wiliamson County and Cities Health District tells KXAN that the first nursing home cluster is still being monitored and investigated. The district said it can’t release information on how many people in that first cluster (the one KXAN has independently confirmed to be at Trinity Care Center) have been hospitalized or died.

WCCHD said that all staff and residents in the county’s second cluster have been tested and are awaiting results. The district said it is working closely with state agencies to stay in contact with other long term care facilities in the county and respond as needed.

May 2

A spokesperson for Caraday Health explained to KXAN in an email that two rounds of tests had been administered to all Trinity Care residents and staff. In the second round, those who tested negative the first time were tested again, the company said in an update.

The results of those two tests showed that 43 residents and 20 team members at Trinity Care tested positive for COVID-19, the spokesperson said.

The company said that it will continue to test residents and staff and noted that “the vast majority” of Trinity residents who tested positive for COVID-19 are not showing symptoms.

Caraday Health shared the following statement about Sue DeLeon:

“We extend our most sincere and heartfelt sympathy to our resident’s family and loved ones. She was well-known in our community and highly regarded. The personal grief we share cannot be fully expressed.”

May 3

Caraday Healthcare clarified for KXAN that in addition to Sue DeLeon, that three other Trinity Care residents have passed away recently. Of those three, two tested positive for COVID-19, but Caraday said it is hard to say whether COVID-19 was the cause of death because both those people were already receiving hospice services.

In addition to DeLeon, Caraday said that four Trinity Care residents have been transferred to the hospital. Of those four, three tested positive for COVID-19, the company said. The company believes one of those four patients has been discharged from the hospital and is in stable condition.

I hope they get their act together

Sue DeLeon
A photo of the 2018 wedding photo of Mike DeLeon (second from the right) with his wife (second from left), sister (far left), and his mother Sue DeLeon (far right). Photo provided by DeLeon family.

DeLeon’s family has spent the past few days collecting Sue’s possessions and trying to find a place that will cremate someone with a COVID-19 diagnosis.

“That was a little unnerving,” Mike DeLeon said after discovered that some facilities won’t cremate someone who has tests positive for the virus, “They can’t even take care of you after in death.”

Sue’s family said that they want the companies that run care facilities and the governments who monitor them to be even stricter with the precautions taken in long term care facilities.

“I hope they get their act together and have some transparency and you know have the conversation of hammering in protocol,” Mike DeLeon said.

He believes, “it’s because of either lack of protective equipment or training or all the above, that’s why my mother’s dead.

The DeLeon family says this process has made them think about the people in long term care facilities who will die during this pandemic, and who do not have loved ones to check in or advocate for them.

“You’re seeing folks that have nowhere to go and you’re the last line of defense to take care of them,” Mike DeLeon said of these long term care facilities.

The family feels Sue DeLeon’s story is a reminder of just how serious this virus can be.

“Just pay attention to what you’re doing, you know for the people that don’t wear masks, you know, this is proof that you might want to wear a mask,” Mike DeLeon said, “you know, whether you’re carrying [the virus] and not know it or somebody is carrying it not know it.”

As the family is left to process their grief and the speed of Sue’s decline, her son said he finds himself wishing he could just have one more day with her.

“You take it for granted that you can have a conversation with a loved one and you know and more than 72 hours later, they pass away,” he said.