SOCIALLY DISTANT DYING
The patchwork system of well- being checks in some of Chicago’s public and subsidized housing was not enough to save some seniors who passed away in their homes — unnoticed amid the pandemic
Someone needed to check on Leonard Graves. The 57- year- old lived alone in a senior building on the North Side, and no one had seen him in at least two days.
Volunteers usually checked on fellow residents in the Edith Spurlock Sampson Apartments, a 394unit Chicago Housing Authority complex. But after the coronavirus began spreading in Chicago, the CHA suspended the program.
With the help of a building maintenance worker, a worried friend entered Graves’ apartment on March 14, and they found him facedown on the kitchen floor. It was clear he had been dead for some time, apparently of natural causes.
Graves’ death — and how it was discovered — offers a heartbreaking snapshot of how the coronavirus pandemic has left some seniors dangerously isolated in public and subsidized housing in Chicago, with only a patchwork support system to make sure they’re OK.
About 10,000 people live in CHA senior buildings. Another 10,000 reside in privately owned properties in Chicago subsidized by the U. S. Department of Housing and
Urban Development.
Unlike residents of nursing homes and assisted- living centers, most people in these senior buildings live independently in their own apartments. Building owners and managers — some of them for- profit companies — don’t always provide support services and aren’t required to.
As the coronavirus spread to Chicago, managers at some federally subsidized but privately owned buildings cut staffing and security. Informal systems of care that residents had organized for themselves over time were disrupted by social distancing guidelines and fear of the virus. At CHA buildings, outreach workers weren’t required to check on most residents until late April.
From mid- March through early May, at least seven senior residents were found dead in their apartments days after last being seen alive, often discovered by janitors or pest- control workers, according to Cook County medical examiner’s office reports.
Their deaths are part of a larger rise in the number of deaths in public and subsidized housing. More than 80 senior residents of these buildings died between March 14 and May 10 — four times the average over the same period each year since 2015, according to medical examiner’s data.
With the pandemic, the agency is investigating deaths it might not have in the past, so comparisons with previous years are difficult, though even non- COVID- 19 deaths appear to be on the rise.
The CHA and other owners and managers of the senior buildings note that their residents live on their own and these aren’t care facilities. Still, they say they have increased efforts to contact and assist them during the pandemic. But gaps remained.
On March 20, the day Gov. J. B. Pritzker issued his stay- at- home order, HUD officials in Illinois announced they would work remotely for the foreseeable future. William O. Dawson III, HUD’s director of public and Indian housing for the state, asked leaders of housing agencies to let him know if any employees or residents became infected with COVID- 19.
Dawson also urged local officials to handle residents’ concerns themselves, emailing them, “If you are able to resolve a complaint without referring the participant to the field office it would be greatly appreciated.”
A HUD spokesperson said the agency is “fully operational” and that “addressing issues begins at the local level, where they are usually resolved.”
By mid- March, in response to the coronavirus, some managers and owners of subsidized buildings— including UPholdings, a private company that owns Evergreen Towers, two Near North Side buildings for seniors — had cut back their on- site staffs.
“Front desk attendants will not be working temporarily,” the company said in a letter March 12 to Evergreen Towers residents. “Property Management is working to quickly implement a system so that we may efficiently and safely conduct well- being checks.”
Jackie Reynolds, 67, a resident leader at Evergreen Tower I, was troubled by the announcement. Each apartment in the building is equipped with an emergency cord, she said. When pulled, it activates a flashing- light alert at the front desk. But the system wouldn’t work if attendants weren’t on duty to see the alerts, according to Reynolds.
Residents already had set up a network to check on one another, Reynolds said.
“Last year, one of my neighbors on my floor passed away, and no one knew about it because no one was doing well- being checks,” she said. As the pandemic spread, she found fewer people willing to make the rounds with her. “Everybody was scared.”
Weeks later, on April 15, Reynolds noticed a package slip near the building’s front entrance for one of her neighbors, Emily Mandley, 88, who had health problems.
Reynolds said she put on a mask and knocked on Mandley’s door three times over the next day and a half but didn’t get an answer.
Reynolds got in touch with her cousin, a maintenance man at the building who was able to get into Mandley’s apartment. As Reynolds feared, her neighbor was dead.
A spokeswoman for UPholdings confirmed the Evergreen Towers buildings no longer had front- door attendants and said the company is upgrading security- camera systems at both buildings.
In late March, building managers organized a system of daily well- being checks, she said. Residents not wanting to be contacted were provided with door tags that say “I’m OK” or “Not Home” to let others know they’re fine.
Reynolds said she and other tenants came up with the tag system. She said that, in the week after Mandley was found, building managers called to check on residents but that she hasn’t heard of any staff wellness checks since then.
“No one has come to check on us but one time,” Reynolds said.
As many of the CHA’s employees switched to working from home, outreach workers stayed on site at senior buildings “to provide support, information and referrals” to residents, according to a March 18 email to the agency’s staff from James L. Bebley, who was the CHA’s acting chief executive officer at the time and is now its chief operating officer.
The outreach workers, called resident service coordinators or RSCs, are staffed by Catholic Charities under a two- year, $ 9 million CHA contract that has 54 coordinators working in the public housing agency’s 55 senior buildings. Some coordinators are responsible for properties with hundreds of apartments.
Before the pandemic, the coordinators focused on organizing activities for seniors and connecting those in need to social services. They also were supposed to check on residents they or building managers deemed sick or frail, especially during extreme weather.
Over the past three months, that work has become more challenging and potentially dangerous. One coordinator, who asked not to be named because she wasn’t authorized, said she initially had to get her own protective gloves and mask so she could help deliver food to residents.
Catholic Charities gave masks to coordinators starting April 2, when federal health officials began recommending their use, according to Brigid Murphy, a spokeswoman for the organization.
On March 23, coordinators were instructed to check in daily with the 1,100 residents on the frail list, either by phone or in person, according to the coordinator. A log of the check- ins was supposed to be submitted to their supervisors at Catholic Charities.
But, under the Catholic Charities contract, coordinators weren’t expected to check in with other seniors unless they had specific needs.
“CHA and Catholic Charities
“Last year, one of my neighbors on my floor passed away, and no one knew about it because no one was doing well- being checks,” said Jackie Reynolds, a resident leader at Evergreen Tower I. As the pandemic spread, she found fewer people willing to make the rounds with her. “Everybody was scared.”
really didn’t put much emphasis on checking on non frail residents” at that time, the coordinator said in an email. “However, some RSCs such as myself took the initiative to check on all residents.”
Murphy said the coordinators staffed by Catholic Charities weren’t required to do wellness checks of all residents but have stepped up to help those who need food or other special assistance.
“During the pandemic, our Resident Service Coordinators ( RSCs) have provided services without reimbursement above and beyond the duties outlined in our contract,” Murphy said in a written statement.
In late March, members of the Jane Addams Senior Caucus advocacy group, began pressuring the CHA and the city to provide more services to seniors. On March 24, an aide to Mayor Lori Lightfoot emailed Bebley a list of the caucus’ demands, which included daily wellness checks of all residents and staffing every senior building with nurses or health care workers.
All of the CHA’s buildings are managed by private companies.
Two days after the email from Lightfoot’s aide, the CHA instructed the property- management firms to post new informational flyers — in English and 12 other languages — in their buildings’ common areas.
“It is geared for our older residents to call if they have a need,” Mary Howard, the CHA’s chief resident services officer, wrote in an email to agency officials who worked with the property managers.
Howard and Eric Garrett, the CHA’s chief property officer, sent a letter to the presidents of the local advisory councils — the tenants’ groups for each CHA development — in which they said property managers were still working on site at each development and that resident service coordinators were available by phone, if not always in person. The letter didn’t mention wellness checks.
For weeks in February and March, Ald. Byron Sigcho- Lopez ( 25th) forwarded the CHA complaints that his office received about inadequate heat, security concerns and poor communication with residents of Las Americas, a 211- unit seniors building in Pilsen.
CHA officials repeatedly prom
Scarleth Lever Ortiz, director of the CHA’s office of diversity and inclusion, discouraged
Ald. Byron Sigcho- Lopez from organizing more well- being checks at senior buildings, saying the CHA already had resident service coordinators doing outreach while practicing social distancing.
ised to follow up with the building’s managers and its resident service coordinator, emails show.
On March 27, Sigcho- Lopez emailed again, proposing to organize more well- being checks at senior buildings including Las Americas.
His message made its way to Howard, who emailed her colleagues, saying the CHA already had an outreach program: “Catholic Charities is in our buildings conducting more than 1100 wellness checks a day.”
At that time, though, the coordinators still weren’t required to do regular checks of residents unless they were on the “frail” list.
Scarleth Lever Ortiz, director of the CHA’s office of diversity and inclusion, discouraged SigchoLopez from proceeding with his plan, saying the CHA already had resident service coordinators doing outreach while practicing social distancing.
“We think it may be confusing to have others do the same, and we are trying to limit the number of persons who come to our buildings,” she wrote.
Sigcho- Lopez said his office has continued to make check- in calls.
“Our seniors, if anything, need more attention, not less,” he said.
Ald. Daniel La Spata ( 1st) said CHA leaders also rejected his suggestion that they add staff to check on residents at senior buildings. La Spata said that he asked during an April 3 video conference with CHA officials whether the agency could place a nurse or other health worker at each senior residence during the pandemic. He said he was told no, that the presence of health workers at senior buildings “would only create panic.”
It was mid- April before the CHA decided to do regular checks of residents not on its sick- andfrail list.
CHA employees who were working from home were asked to start calling tenants to supplement the work of the Catholic Charities coordinators. In early May, the coordinators also were told to check in with every resident at least once a week, even though they weren’t told which residents CHA workers were contacting, according to the coordinator who agreed to be interviewed.
CHA bosses said they have worked during the pandemic to make sure seniors aren’t cut off from essential needs and that, in the past month, the agency has expanded its check- in system, which now reaches 3,000 seniors a day, including the most vulnerable.
“The health and safety of residents are the highest priorities for CHA and the city of Chicago, most notably seniors, whom we commit significant staff and resources to support their daily activities,” CHA spokeswoman Molly Sullivan said.
In the past, CHA has said the agency provides housing and isn’t a social service agency, though it offers residents some education and support programs.
Ald. Maria Hadden ( 49th) introduced an ordinance at the April City Council meeting to require managers of CHA and other senior buildings to do more wellness checks, maintain staffing levels and limit access from nonresidents during health emergencies.
Hadden said she understands that the CHA now has a system for doing those checks, “but a lot of residents haven’t heard from them. It’s not time to sit on our hands.”
CHA leaders didn’t respond to questions about deaths in their buildings.
By the time Hadden introduced her proposed ordinance, they were aware, though, of potentially deadly gaps in the work of resident service coordinators.
“Please note during this time of COVID we have begun to find residents deceased in their apartments,” Catholic Charities officials said in an April 14 email to employees working in CHA buildings. “Immediately CHA is contacting Catholic Charities to see if a wellbeing check was completed on the resident by the RSC and holding us accountable. We are held very much accountable for contact if the resident is on the sick and frail list.”
The email told workers that, if they couldn’t reach a resident with two phone calls, they should let the property managers know so they could do a well- being check.
The email was to remind the coordinators they needed to check on residents on the sick- and- frail list, according to Murphy. The people found dead weren’t on the list “and therefore our RSCs would not have made wellness phone calls to them.”
At that point, deaths in CHA and other subsidized apartments already had gone unnoticed for days before those residents were discovered.
On April 22, a resident of Hollywood House, a high- rise senior building in Edgewater, called the property manager to report that maggots were crawling out of her kitchen vent. Other residents had noticed a foul odor in the 12th- floor hallway.
A maintenance worker eventually went in to an apartment there and found 72- year- old Oscar Medina dead, seated in his kitchen, according to medical examiner’s report.
Owned and managed by the Heartland Alliance, a social services agency, Hollywood House includes market- rate and lowincome renters. Fifty- one of its 197 apartments subsidized through federal vouchers. The building also has gotten city funding.
Medina lived at Hollywood House for 13 years, according to neighbors who said he immigrated from Cuba more than four decades ago and described him as kind and friendly.
Yvonne Requena, a friend in the building, said her family, from Belize, bonded with him over their similar cultures. They liked music and dancing and sometimes ate together and talked in the building’s dining room.
“He would say hi to everyone he meets — a very nice man,” she said.
But Medina spent most of his time alone.
“He didn’t really talk about family,” said Requena, 73. “He would go and walk outside all night, even when it got cold. Or he would sometimes get on the bus and ride the bus all night.”
In recent weeks, as coronavirus infections spread, Hollywood House closed its dining room. Medina, who was diabetic and sometimes had breathing problems, rarely left his apartment except to get sandwiches from the convenience store on the first floor.
“I said, ‘ They’re high in sodium — you can’t eat that every night,’ ” Requena said. “He stopped going out. He just stopped taking care of himself because he was depressed.”
A few weeks ago, Medina told Requena he was concerned that nonresidents might be able to come in to the building because no one was working at the front door during much of the day. It was the last time they spoke.
Some Hollywood House residents said more should be done to communicate with tenants. The property manager is in the building two days a week, they said, and a social worker has been working remotely to limit person- to- person contact.
“Some people said she’s called them, but she hasn’t called everyone,” said resident Nanna Cross, 77. “She hasn’t called me.”
Cross, a member of the Jane Addams Senior Caucus, said she knows of a nearby senior building where tags outside each apartment indicate whether anyone has opened the door that day. She said Hollywood House needs a way to do wellness checks, especially during periods when many tenants rarely leave their apartments.
“That hasn’t been happening in our building, and it’s been real upsetting,” she said.
A spokesman said the Heartland Alliance has staggered work shifts at its buildings since the stay- at- home order, but “maintenance staff and security are on- site daily.
“Although Hollywood House is an independent living facility where residents may choose to seek services from outside partners, for the well- being of our residents we have elected to initiate periodic resident wellness checks. In fact, these checks have been bolstered during the COVID- 19 pandemic,” the spokesman said.
Because so many of the building’s residents are elderly, the spokesman said, “Although it is hard, it is not uncommon to experience multiple resident deaths in a year.”
Medina was last seen alive a week before his body was found, according to the medical examiner’s office, whose records show it was the second time since March that a Hollywood House resident was discovered days after dying.
Requena learned of Medina’s death from a neighbor.
“It hit me so hard,” she said.
“It’s very sad that, when you live alone, something like this can happen.”
“Please note during this time of COVID we have begun to find residents deceased in their apartments. Immediately CHA is contacting Catholic Charities to see if a well- being check was completed on the resident by the RSC and holding us accountable. We are held very much accountable for contact if the resident is on the sick and frail list.”
From an April 14 email by Catholic Charities officials to employees working in CHA buildings