Even as COVID-19 case totals continue to rise across North Carolina, one thing remains true about Rowan County: it’s the site of the state’s largest nursing home outbreak.

And results of a state investigation completed one month ago make it increasingly hard for the Citadel to explain away accusations made by current and former residents’ loved ones, employees as well as in lawsuits. All told, state inspectors substantiated 20 complaints made against the nursing home, which has 154 total COVID-19 cases and 21 deaths, according to the Rowan County Health Department. In a statement, Salisbury law firm Wallace and Graham said the investigation gave insight into “intentional and reckless practices.”

The Citadel outbreak was first noted by the Post in early April when employees reported there were at least four positives. By the time the story published in print, employees called the Post to say there were at least twice the number of cases confirmed. Meanwhile, family members complained they were unaware of the outbreak; the website of ownership group Accordius Health said there had been no COVID-19 cases at any of its facilities.

Breakdowns in communication have long been a major concern for loved ones of Citadel residents, and the investigation lends additional credence to family members complaints. 

But there were other critical complaints corroborated, too. It wasn’t until April 10, well after the outbreak came to Rowan, that the Citadel complied with Centers for Disease Control and Prevention guidelines for mitigating the COVID-19 pandemic, according to the state investigation. Masks were mandated just a few days before that, the state said. As a result, residents were placed at an increased risk of developing and transmitting COVID-19, stated the report by the North Carolina Department of Health Services Regulation.

The state also corroborated concerns about COVID-19-positive patients not being quarantined.

Every item for which the state found evidence makes the Citadel’s outbreak more tragic for those who became sick, the 21 people who lost their lives and loved ones.

Working in a nursing home is not an easy job. It’s even more difficult to do so during a global pandemic. But there are many nursing homes in Rowan County dealing with the COVID-19 crisis and avoiding the same “system failure” the state found in its investigation at the Citadel.

The website of Accordius Health also still greets visitors with a pop-up containing a mid-April letter accusing the media of making nursing homes into villains.

“I am sorry that nursing homes are being vilified by the media when our one and only purpose is to serve, love and care for those who can no longer care for themselves,” wrote Chief Operating Officer Kim Morrow. 

At a minimum, the facility needs to provide the public with new assurances it’s taking serious steps to address state concerns.