The rising toll of sickness and death at nursing homes from coronavirus outbreaks has been breaking news, but much of what is known has not come from the state or federal agencies responsible for safeguarding public health.
Instead, it is being leaked to reporters and discussed on social media courtesy of nursing home staff, family members of victims and whistleblowers.
At least 19 states do, however, contribute to the information flow by publicly naming nursing homes that have reported positive COVID-19 infections to authorities, The Brew has found.
But others, like Maryland, refuse to name the nursing homes unless there has been a major outbreak, typically including deaths, at the facility.
Fear and Anxiety
Advocates for nursing home residents say the silence only exacerbates the risks to a population that is highly vulnerable to the disease.
“Not making that information public is not helpful to anyone,” says Toby Edelman, a senior policy attorney with the nonprofit Center for Medicare Advocacy.
“It creates more fear and anxiety” for the families of nursing home residents and for the residents themselves, she says.
The absence of public lists of nursing homes with confirmed cases also subjects healthcare providers to potential exposure to the virus.
What’s more, the news blackout hamstrings reporters and researchers tracking the pandemic and trying to determine how prepared – or not – nursing homes and state regulators were to deal with the pandemic.
(The Los Angeles Times today reported that 89% of the nursing homes with coronavirus in Los Angeles County had previous infection control violations “ranging from mishandling patients with highly contagious bacterial infections to not properly cleaning ventilators and other equipment.”)
Privacy Prevails in Maryland
In Maryland, Gov. Larry Hogan disclosed last week that 90 nursing homes have reported COVID cases among residents or staff.
This includes an outbreak at the Pleasant View Nursing Home, where 97 residents and staff have tested positive for coronavirus and 24 people have so far died.
But neither the governor’s office nor the Maryland Department of Health will name the facilities at the request of news organizations.
Hogan’s chief spokesman, Mike Ricci, has not responded to our requests for the names.
MDE spokesman Charles L. Gischlar said last Friday that the agency “cannot release a detailed list of nursing homes and other long-term care facilities affected by COVI-19 due to HIPAA [the Health Insurance Portability and Accountability Act] and state laws surrounding confidentiality.”
On the same day, the names of virus-impacted nursing homes were released to the media by the Tennessee Department of Health “in an effort to become more transparent.”
Besides Tennessee, 18 other states have disclosed the names of virus-affected nursing homes, The Brew has found.
They are Arkansas, Colorado, Connecticut, Delaware, Georgia, Iowa, Kentucky, Louisiana, Minnesota, Montana, Nevada, Oklahoma, Oregon, Rhode Island, Texas, Vermont, Washington and Wyoming.
At least one large local jurisdiction, Los Angeles County, has also identified nursing homes with COVID-positive cases.
The Oregon Health Authority is at the forefront of transparency. It posts the names of nursing homes with outbreaks, the type of facility impacted and whether the victims were residents, staff, both or unknown. It also notes the date of restricted admissions to the homes.
Other states post online nursing home information with varying degrees of specificity.
Connecticut, for example, regularly posts the names of nursing homes with laboratory-confirmed COVID cases, while Delaware only discloses a facility with “multiple positive cases.”
Health departments in several states with the largest COVID-19 cases have disclosed, in broad numbers or percentages, how seniors have been affected by the outbreak.
But they have refused to identify facilities with positive cases among residents or staff. Prominent among these are New York, New Jersey, Illinois, Florida and California.
Most of them, when questioned, cite privacy like Maryland.
Illinois, for example, told USA Today it was not disclosing the names of nursing facilities “to protect the residents’ private health information.” Two certified nurses, meanwhile, told the newspaper they weren’t informed by management of COVID cases in their own workplaces.
Calling for a National List
A partial listing of nursing homes impacted by the virus is maintained by two federal agencies – the Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC).
But neither agency has made this list public, which prompted U.S. Senators Bob Casey (D., Pa) and Ron Wyden (D., Oregon) to request that this information be made public.
“While the privacy of individual residents must be protected, it is imperative that the names of the facilities with a positive COVID-19 case be made available to help prevent further spread of this terrible virus,” they wrote on April 2 to the directors of the agencies.
The letter notes that last month’s CARES Act provided $100 million to the CDC “for surveying and certification activities” involving nursing homes in locations, like Maryland, where the virus had spread rapidly.
What’s more, the agencies need to restart nursing home inspections, which were suspended since the outbreak, and to respond to complaints “of immediate harm unrelated to COVID-19” at nursing facilities, the senators wrote.
So far, their demand for disclosure has been in vain.
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