Rosa Zamanillo hadn’t left her elder-care home in 3 years. COVID-19 got her anyway

In four days, Rosa Zamanillo went from singing Cuban ballads and eating well at the Residential Plaza assisted living facility in Miami, to being unrecognizable by her youngest son.

“It’s hard to place a face on this enemy,’‘ said Jorge Zamanillo, whose mother died Saturday of COVID-19 at the facility also known as Blue Lagoon. “But seeing it firsthand was shocking. ... It’s personal now.”

Rosa Zamanillo was 90, and the plaza had been her home for eight years. Her son was told last week that his mother wasn’t exhibiting any symptoms and that “she was fine,” even after tests came back April 8 that she had tested positive for the disease caused by the coronavirus.

Two days later, his mother’s hospice doctor warned “she doesn’t have much time left.”

Her son says he understands the challenges facing the industry whose primary clients are elders who are more vulnerable to the pandemic than any other age group. But he is angry and hurt at the way his mother was treated and the absence of information he and his family received.

“We are not asking for names, we are just asking for information so we can protect ourselves,’’ he said.

Zamanillo got the surprising word April 10 that his mother was dying. Notwithstanding the current ban on visitation, he arrived at the home, put on a protective gown, brought his own N95 mask, and entered his mother’s room escorted by someone who did not work for the facility.

She was unresponsive and hooked up to an oxygen machine. Rosa Zamanillo died the next day. She had last seen her son in a FaceTime phone call four days earlier

“I’m in shock,’’ he recalled Thursday. “I didn’t recognize her, she was so far gone. This is less than 24 hours after they told me she was asymptomatic.”

It is a story that is playing out across the state as long-term care facilities are blindsided by the arrival of the coronavirus and some, with the approval of the Florida Department of Health, are not informing families, who are barred from visiting, if their loved ones have been exposed.

“This is the problem we’re all facing now,’’ Zamanillo said. “If you have family in these facilities, how do you know they’re in danger or not? How do you know they are safe?”

Zamanillo had been advised by his mom’s primary-care doctor “the place was highly contagious” and to bring her home before the state barred visitors from entering. He understands now why, he said.

“My mother hasn’t left that place in three years so it means that somebody brought it [coronavirus] in,’’ he said. “It’s just an invisible threat — and that’s why people have such a hard time following the rules.”

The Florida Department of Health disclosed for the first time Thursday that nearly 20 percent of the state’s 668 reported COVID-19 deaths have been at long-term care facilities in 22 counties.

Until Thursday, the department had reported 1,454 cases at the 3,800 nursing home and assisted living facilities in Florida but had not acknowledged the 136 deaths.

The number may be an undercount because it is not clear whether every facility has tested everyone who has died at the facilities for COVID-19 since the outbreak began. At the end of the day Thursday, there were 23,340 positive COVID-19 cases reported in Florida.

“The crisis exceeds what is expected of our facilities,’’ said Mary Mayhew, secretary of the Agency for Health Care Administration during a conference call coordinated by her office to allow the trade association for nursing homes to brief legislators.

She spoke about the “incredible strain on our facilities’’ the pandemic has caused. She referred to the financial pressures brought on by the need for increased staffing, the disruption in the delivery of services, and the demand for additional protective equipment to shield staff and residents from the virus.

Representatives for the Florida Health Care Association, the nursing home trade group, told legislators they should focus on the fact that COVID-19 has been reported in fewer than 100 of the 3,800 long-term care facilities in the state and that is because of the aggressive work staff has done to keep residents safe.

But the industry also acknowledges it faces unprecedented risks. The organization is asking Gov. Ron DeSantis to extend the state’s sovereign immunity provisions to most healthcare sectors during the course of the coronavirus pandemic. If the request is granted, hospitals, nursing homes, assisted living facilities and other providers would be protected against negligence lawsuits.

“We realize the vulnerability we have with asymptomatic staff who unknowingly brought it into the facilities,’’ said Bob Asztalos, FHCA’s chief lobbyist in the call with legislators. “That’s why we are using masks throughout the facilities.”

Because procedures have had to be modified, so does their liability, he said.

“We are changing the rules every day about how to take care of these residents,’’ Asztalos said. “We are rewriting the rule book as we try to take care of them, so we are doing things that you would not normally do in our normal situation. ... Our staff has to be protected from lawsuits when they are doing extraordinary things to keep our residents safe.”

But some legislators are urging the governor to reject the idea.

“The nursing homes already have an obligation to provide care for their patients, whether it is during difficult times or normal times,’’ said Sen. Gary Farmer, a Fort Lauderdale Democrat who is a past president of the Florida Justice Association, which represents trial lawyers. “They should not need liability protection if they are doing their job. The notion of giving immunity to nursing homes is not only outrageous, it is unconstitutional.”

“We want to protect our caregivers who are doing outside-the-box things to keep our residents safe,’’ Aszalalos said. “But at the same time, we are not trying to protect intentional misconduct.”

The governor is also under pressure by advocacy groups to allow the the Department of Health to publicly name the long-term care facilities with patients and staff that have tested positive.

The Miami Herald, joined by several other news organizations, has filed notice of intent to file a public records lawsuit over the agency’s refusal to release the data. DeSantis tried to block the suit by having his general counsel persuade the Herald’s longtime law firm, which has numerous contracts with state agencies, to withdraw from representing the paper. It worked. But the Herald has found another law firm to handle the suit.

Bill Sauers, President of the Florida Alliance for Retired Americans, describes the crisis as “a hand-grenade waiting to explode.’’

“The government is supposed to protect its people,’’ he said. “There is too much secrecy around what is happening in nursing homes, and it’s creating a lack of confidence in the people. It is morally wrong that private companies are looking for immunity in a situation where they need to take care of the patients.”

Zamanillo said he believes that if the immunity is granted, elder-care facilities will have less obligation to inform families during the crisis.

He said he watched as the staff at Residential Plaza went from being “transparent” one week, in which they were eagerly addressing questions on a conference call with family members, to acting as if they were “hiding something,’’ in a similar conference call a week later.

Before his mother had tested positive, the home’s director, Barbara Galindo, told families that four residents and four staff members — in the home that houses 280 residents — had been infected and that 91 people had been tested for the virus.

After that, his mother’s nurse, who previously had been in regular contact, dodged Zamanillo’s phone calls. Galindo and her staff ignored his emails that were seeking information and asking questions such as: “What happens if your family member tests positive?”

The final insult came after his mother died and the accounting department sent him a routine “move out” form for his mother’s “discharge,’’ with no acknowledgment that she had died.

“She was not moving out. She had not been discharged. It was completely insensitive,’’ he said.

Galindo told the Miami Herald privacy restrictions prohibited the facility from discussing the Zamanillo case but “we have been in contact with the family and have addressed any perceived shortcomings in our communication.”

As Zamanillo prepared his mother’s obituary Thursday, he recalled her love of music and painting. She was the eldest of eight siblings, six of whom are still alive, from a family that split down the middle during the Cuban diaspora. Half of the siblings came to the United States in the last of the Freedom Flights of 1966, while the others remained in Cuba, including her mother.

Rosa and Jose Zamanillo, who was a sculptor, first moved to New York and then came to Miami in 1976. They raised five children.

Zamanillo, 51, who is executive director of HistoryMiami Museum, recalled how his mother forgot many things as her dementia set in, but she always remembered the beautiful Cuban ballads of her childhood.

“She’s been through it all,’’ he said. “The first argument is going to be that my mother was 90; she had all these conditions; she was close to death. I understand that but, what kills me, was the cruelty of it and what hurts me is she had to go that way.”

Miami Herald reporter Samantha Gross contributed to this report.

Mary Ellen Klas can be reached at meklas@miamiherald.com and @MaryEllenKlas