From California a few days ago, Constantin Stanescu called a Buffalo nursing home hoping for an update on his mother, a diabetic who had not been eating.
He had done this a number of times since November, when Teodorina Stanescu entered the Buffalo Center for Rehabilitation and Nursing.
But this time, he said, the voice at the other end told him the home had no one with her name.
Startled, he rattled off details about his mother. Then something clicked.
"Oh her," the nursing home employee said, according to Stanescu. "She passed away over a week ago."
Days after that phone call, Constantin Stanescu told The Buffalo News that he still didn't know the whereabouts of her body, whether she died in her nursing home bed or in a hospital and what she died from. Was it complications from diabetes, Covid-19 or something else?
His story amplifies concerns expressed by a range of families and advocates that nursing homes guard information too tightly, especially in the age of Covid-19.
Nursing facilities are being called upon to publicly state the number of confirmed cases inside their walls. Few do so.
"We are in a pandemic. This is an unprecedented problem," said Helen Ferraro-Zaffram, managing attorney for the nonprofit Center for Elder Law and Justice in Buffalo. "Every facility should be reporting this for the sake of public health necessity."
Michael Balboni serves as a consultant to two local nursing homes.
"We understand the plight of the families," he said. "We want to balance the need for information against the patients' privacy and the privacy of families."
Even a representative for nursing homes acknowledges the benefits of distributing the information, at least among the homes themselves.
"If you're going to collect it, the data should be used," said Stephen Hanse, president of the New York State Health Facilities Association, which represents 450 homes. "If we can use it to protect nursing home residents and staff, that's a good thing."
Some homes have broken from the pack to publicly reveal their cases. Father Baker Manor, for example, announced more than a week ago that 41 residents and 25 staff tested positive for Covid-19. The McGuire Group days ago detailed the number of cases at its facilities around Buffalo.
On Friday, the state Health Department let loose a little more data by listing the number of Covid-19 deaths inside nursing homes. In Erie County, six have died in Father Baker Manor, nine in the Harris Hill Nursing Facility and 11 in the Garden Gate Nursing and Rehabilitation Facility in Cheektowaga. No Niagara County home made the list.
The Health Department, however, listed only homes with five or more deaths, so the total number of nursing home deaths is greater. On Wednesday, when Stanescu dialed his mother's nursing home, Erie County had seen 104 deaths from Covid-19. Forty-two of those, the state said at the time, involved patients from nursing homes or adult care facilities.
Nursing homes care for people with underlying health conditions that can make them especially vulnerable to the coronavirus. Some homes care for patients better than others.
The Buffalo Center for Rehabilitation and Nursing is among the 10 facilities in Erie and Niagara counties given just one star by the federal government. The one-star rating, which means "much below average," was reached before the state and nation were reeling from a global pandemic.
Many one-star homes, along with other facilities, have not released information about residents infected with Covid-19.
"We're following Health Department guidelines," said Allysa Olsen of the one-star Jennie B. Richmond Nursing Home, which is affiliated with Bertrand Chaffee Hospital in Springville.
Each day she writes two reports on the home's battle with Covid-19. One is an email to the families of people living there. The second goes to the state Health Department. For anyone else, including the public, Olsen will politely say she can't disclose that information because of privacy laws.
"Our position here in Buffalo is that everyone would benefit from transparency," said Todd Hobler, a vice president for 1199 SEIU in Western New York. The union on Friday held a silent vigil outside a Tonawanda nursing home, Safire of the Northtowns.
It's a one-star nursing home where, Hobler said, four workers have tested positive for Covid-19. Hobler and other union members said employees at the facility are not being provided adequate protective equipment.
"It's an unfolding crisis right now," Hobler said. "Some of the places that are being run from corporate headquarters out of town are not responding well."
Balboni, who speaks for Safire, said contract talks, not the need for safety, prompted the union's vigil. Still, the event led him to confirm that Safire of the Northtowns has patients with Covid-19.
“The facts are that there are no more than five Covid-positive residents that are in isolation in the facility," Balboni said. "The fact is that there is a 12-day supply of masks, gowns, gloves, booties and face shields with more on the way. They have 3,000 masks and N95 masks for workers that are providing direct care to Covid positive patients. Any employee who tests positive is at home and getting paid."
The Buffalo Center for Rehabilitation and Nursing, where Teodorina Stanescu was a patient, is one of two city nursing homes owned by Centers Health Care, a downstate company.
Centers Health Care spokesman Jeff Jacomowitz told The News by email that the staff at the Buffalo Center tried calling Constantin Stanescu several times during February and March to provide updates on his mother, but he "turned out to be unreachable by phone."
Emails, too, received no response, Jacomowitz said. He said the final emailed attempt to communicate with Stanescu was sent on March 27, telling him of his mother's decline.
He went on to say the home's staff remains available "to discuss anything with her family members."
Stanescu said he already knew of his mother's decline because he had talked with the staff the previous day, March 26, and learned she was not eating. He said he called her imploring her to eat so that a feeding tube would not be needed.
But whatever was done to inform him his mother died comes down to one person's version against another.
"The day your mother passed you were called four times," Mia Tyler, a unit manager at the home, told him in an email that Stanescu gave The News. "I would not tell someone that their family member died over email or voicemail," she added.
Stanescu, who lives in Sonoma County, Calif., said his cellphone record shows no missed calls from the nursing home. "Perhaps you can generate a phone record log from your telephone provider," he responded to Tyler. "Why would I not want to know about my mom's well being, and why would I not call you back?!"
Constantin Stanescu reached out to the Center for Elder Law and Justice for help in obtaining information on his mother's death. But the center could not represent him because he does not reside in New York.
"The devastating part here is that he has no information," said Kelly Barrett Sarama, another of the center's lawyers. "He reported to us that when he contacted the nursing home, he was told there was no one there by his mother's name. That's how that communication began, which is unacceptable."
Teodorina Stanescu had emigrated from Romania and worked for years as a paid housekeeper. She had been living in Queens when her failing health made a nursing home necessary. The best option the family could find on short notice was in Buffalo.
She was 83 when she died. Apparently, the cause was not Covid-19. A nursing home source said that because she never showed symptoms, she was never tested.