Martin Kaplan doesn’t remember walking out of the elder-care home where he lived, one of hundreds in Pennsylvania locked down to try to contain the spread of the coronavirus.

He doesn’t remember leaving, shoeless and in shorts in 40-degree weather, or walking past thick brush and rows of condos, past stop signs and across Paoli’s busy Central Avenue, where there are bumps to slow the cars that fly over the hill at speeds well exceeding the 25 mph limit.

And Kaplan, who is 74, and whose family said shows early signs of dementia and Parkinson’s disease, doesn’t remember wandering down the road that April night toward Route 252, the busy highway that connects Paoli to the Route 202 expressway. But that’s where he was picked up by police and taken to a hospital for evaluation and treatment of cuts on his hands.

Now, Kaplan and his family are wondering: If the facility, Highgate at Paoli Pointe, was locked down, how was he able to just leave?

“I’m like, ‘How could he get out?’” said his daughter, Caroline Morris of Downingtown. “We’re on COVID lockdown. Doesn’t an alarm go off?”

It’s not uncommon for the elderly to walk out of or attempt to leave nursing homes or assisted-living facilities, whether because they’re confused, frustrated, or feeling isolated. But such places — including Highgate, a facility with 80 apartments, where the coronavirus has killed six people and infected at least 11 other residents and staff — aren’t typically in a state of lockdown.

Lori Mayer, a spokesperson for Genesis HealthCare — a for-profit company based in Kennett Square that operates 400 long-term-care facilities nationwide, including Highgate — said she couldn’t speak about individual residents, citing federal privacy laws.

Highgate is an assisted-living facility, not a nursing home, Mayer said, meaning it’s more of a personal-care setting than a clinical one. Morris said her father was designated to receive the “lowest level” of assistance. His drug regimen was managed and he was looked after by staff, she said, but he wasn’t in a ward specifically for memory care.

The intersection of East Central Avenue and Bear Hill Road in Paoli, where Martin Kaplan was found by police, walking around after 10 p.m. without shoes on while the assisted living facility where he lives was on lockdown to keep residents inside.
YONG KIM / Staff Photographer
The intersection of East Central Avenue and Bear Hill Road in Paoli, where Martin Kaplan was found by police, walking around after 10 p.m. without shoes on while the assisted living facility where he lives was on lockdown to keep residents inside.

Residents, under normal circumstances, can walk freely around the facility and sit outside for fresh air, but Mayer said that amid the pandemic, residents are to remain in their rooms “and to refrain from activities that take them into the community to public places.” She said the facility had restricted visitation and requested that families not take residents out. Pre-pandemic, when Morris wanted to take her father off the grounds, she would sign him out.

Genesis’ chief medical officer wrote in a Fox News op-ed that the group has been “stringent and aggressive with infection prevention measures,” including “no-visitation rules and residents remaining in their rooms.”

Kaplan, a Philadelphia native who spent his career working in food distribution, said he doesn’t remember leaving the facility on April 21, but recalls walking around and seeing houses he didn’t recognize. There is a housing development across Central Avenue from Paoli Pointe, which includes both the Highgate assisted-living facility and adult condominiums.

He walked toward the busy intersection with Bear Hill Road (Route 252), still less than a mile from the facility where he lived, and tried to flag down a ride, he recalled. Someone called 911 and reported seeing a man who looked confused walking along the shoulder of the road. Tredyffrin police arrived.

Sgt. James Slavin said officers found a “visibly shaken” Kaplan about 10:15 p.m. in shorts and with no shoes. After transporting him to Paoli Hospital, officers contacted Highgate, and leaders at the facility told police that Kaplan must have slipped out prior to 7 p.m., when the doors are typically locked, Slavin said.

He added that there are other local elder-care facilities where residents wear bracelets that trigger an alarm when they walk out the door. “My understanding is that’s not the case at this facility,” he said.

The incident is a window into the difficulty managing a lockdown and keeping residents inside their rooms or apartments to contain the spread of COVID-19, which has ravaged nursing homes and assisted living facilities across the country. More than half of the people who have died of the virus in Pennsylvania were associated with a long-term care facility.

The Highgate at Paoli Pointe, a nursing home in Paoli, Pa., on Monday, May 4, 2020. The nursing home was on lockdown to contain the spread of COVID-19. Then a resident walked out of the building and was found hours later, shoeless and wearing shorts in 40-degree weather by police
YONG KIM / Staff Photographer
The Highgate at Paoli Pointe, a nursing home in Paoli, Pa., on Monday, May 4, 2020. The nursing home was on lockdown to contain the spread of COVID-19. Then a resident walked out of the building and was found hours later, shoeless and wearing shorts in 40-degree weather by police

The elderly and people with underlying conditions are especially susceptible, making nursing homes and congregate care facilities for the elderly a breeding ground for the disease. Genesis officials have been vocal about their struggles to contain the spread of the virus, and the need for faster testing and more personal protective equipment.

“I’ve never been more stressed out in my whole life than being stuck with them with this stuff,” Kaplan said.

In Chester County, where Highgate is located, nearly 500 residents of 29 different long-term-care facilities or personal care homes have been infected and 118 have died, representing 80% of COVID-19 related deaths in the county. In Tredyffrin Township, eight people have died of the virus.

Chester County Coroner Christina VandePol said several long-term-care facilities in the county have had deaths in the double digits. That includes the state-run Southeastern Veterans’ Center, where at least 26 people have died from COVID-19.

Morris spent more than a week trying to find a facility accepting new residents. Some nursing homes and elder-care facilities have been wary to accept new residents, especially those discharged from the hospital. She got her father into Devon Senior Living, where he’s staying now and which uses a bracelet-alarm system.

But she’s troubled by what happened at Highgate.

“He could have been hit by a car, robbed. He could have died,” she said. “Are they really set up in the right way to handle their residents during COVID?"