Under mounting public pressure to increase transparency, more states are now releasing information about the scourge of the coronavirus on nursing homes and long-term care facilities. The data paints a grim picture: more than 16,000 residents and staff have died, roughly a quarter of the nation’s overall deaths.
In Maryland, which released a list of facilities with positive cases for the first time this week, 97 residents are infected and 34 have died at the facility with the highest number of fatalities, Sagepoint Nursing and Rehabilitation. In New Jersey, where the virus has reached 86% of the state’s 575 long-term care facilities, outbreaks at two veterans’ homes have left 97 dead. In multiple states, including Kentucky, Colorado and Pennsylvania, more than half of the state’s fatalities are from nursing homes.
Two months after the first death from the virus in a U.S. nursing home, advocates and industry leaders say long-term care facilities still face a dire shortage of personal protective equipment and access to testing.
“More needs to be done. The number of deaths is appalling,” said Rhonda Richards, senior legislative representative at AARP. “We can’t overstate the gravity of this situation.”
On Thursday, President Donald Trump announced that the Federal Emergency Management Agency would send protective supplies to all of the nation’s nursing homes. Governors in Maryland, Tennessee and West Virginia have said they will test all residents and staff of long-term care facilities, something advocates have called for nationwide.
More than 2 million Americans live in long-term care settings, including the nation’s approximately 15,600 federally-regulated nursing homes and 28,900 assisted living facilities, according to the Centers for Disease Control and Prevention.
More than 60,000 Americans have died of COVID-19, but the long-term care industry has been particularly ravaged by the virus.
Nearly 97,000 residents and staff from nursing homes and long-term care facilities have tested positive, according to the numbers gathered by USA TODAY from state agencies. More than 5,700 facilities in 46 states have acknowledged having either a resident or staff member contract the virus. The numbers are an undercount, given that many states have not released full data and testing has been limited.
Thirty-two states and the District of Columbia have released either full or partial lists of facilities with COVID-19 cases. Eighteen states – including Arizona, Alabama, Texas and Pennsylvania – have not released facility names. USA TODAY has created a searchable database of nursing homes that have been named.
Advocates have continued to press states and the federal government to release more information because the patchwork of data that has been released has left some not knowing what is happening at their loved one's nursing home.
New York has only named facilities with five or more deaths. North Carolina, Tennessee and Kansas named only those with two or more cases. California lists facilities that have reported cases over the prior 24 hours, meaning one day a facility could appear to have an outbreak only to disappear from the state’s public list.
The Centers for Medicare and Medicaid Services (CMS) last week said it would require nursing homes to inform residents and their families within 12 hours of the virus being detected in a facility. Under the regulations, facilities are also required to report cases directly to the CDC, which had not previously tracked the spread of the virus in nursing homes at a national level.
“That’s going to be important to our efforts around surveillance going forward as we reopen the country,” CMS Administrator Seema Verma said Thursday at a White House briefing.
CMS on Thursday said the agency will be releasing the names of nursing homes that report outbreaks on a weekly basis, but did not say when that would start.
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Without federal tracking, nursing home residents and families in some states say they have been left in the dark. Missouri is one of the states that has not named facilities with COVID-19 or said how many residents have tested positive or died.
Peggy Kennedy said the St. Louis nursing home where her 76-year-old mother lives, Green Park Senior Living, provided updates early in the pandemic to say the facility was coronavirus-free. Then a few weeks ago – when her mother learned that someone there had tested positive – the updates to family members stopped, Kennedy said.
She said she called the facility and was told the virus was contained, then called the county health department for details but was told they could not release any information about her mother’s home due to patient privacy laws. Kennedy said she has left voicemails at Green Park but no one calls back. The facility’s failure to keep her informed has left her distrustful.
“They’re lying,” she said. “They’re lying to everybody about the virus being in that home.”
Frederick Stratmann, general counsel for CommuniCare, which owns 86 nursing homes in eight states, including Green Park Senior Living, said the facility sent a letter to family members on April 9, when the first case was confirmed at the facility. He said CommuniCare recommended the facility send an updated letter when additional cases emerged, but that letter wasn’t sent. He said CommuniCare’s chief medical officer has sent additional letters to family members, but the letters did not provide any information on specific facilities. Kennedy said she received none of them.
Stratmann said the company would be “looking into what happened” at Green Park and making changes to ensure residents and families are kept informed.
The American Health Care Association and National Center for Assisted Living have encouraged widespread testing and recommends that facilities notify all residents, families and staff as soon as a positive case is confirmed. This week, the group's president and CEO, Mark Parkinson, doubled down on the need for additional resources, saying long-term care settings have been a low priority for too long.
“Our profession has been sounding the alarm for weeks and weeks, but we have largely been forgotten by the public health sector,” Parkinson said on a call with reporters. “If we are not made a top priority, this situation will get worse with the most vulnerable in our society being lost.”
In Illinois, workers at 64 nursing homes this week voted to strike later this month unless their employers provide hazard pay, additional paid sick leave and adequate personal protective equipment, among other demands.
Barb Appel, a certified nursing assistant at Elevate Care Irving Park, one of the facilities under a strike notice, said employees are using one gown to a room, taking it off when they exit and leaving it for the next worker. Elevate Care did not respond to a request for comment.
“I’m scared,” Appel said, holding back tears. “Don’t get me wrong. I love what I do, and I’ll help my patients go through whatever they have to go through because they don’t have families here. But I’m scared. We just need them to give us the proper stuff so that we can take care of ourselves so that we’re not dropping like flies. Like our patients are dropping like flies.”
Tricia L. Nadolny is a reporter on the USA TODAY investigations team. She can be reached at firstname.lastname@example.org or @TriciaNadolny.
Marisa Kwiatkowski is a reporter on the USA TODAY investigations team, focusing primarily on children and social services. Contact her at email@example.com, @IndyMarisaK or by phone, Signal or WhatsApp at (317) 207-2855.