By Anna Wilde Mathews and Jon Kamp Wall Street Journal April 12, 2020
Federal health regulators are expected to push the nursing-home industry to inform residents, their families and staff quickly when facilities confirm Covid-19 cases, according to people with knowledge of the matter.
The Centers for Medicare and Medicaid Services could announce the move as early as this week, the people said.
It isn’t clear whether CMS will order facilities to disclose cases to family, residents and staff, or strongly recommend it. Nor is it clear whether the federal government will take action to gather all the data and release total figures on the spread of the virus in nursing homes.
CMS is working with other federal agencies to explore actions that would improve transparency about the pandemic, a CMS spokesman said. “The agency remains committed to greater transparency,” he said.
Ahead of a CMS move, two leading industry groups put out statements this weekend urging members to disclose cases to families, staff and residents.
“Long-term care facilities support transparency to our residents, families and other stakeholders because knowledge is pivotal during a pandemic and our public health officials need to know where to send urgently needed resources,” the American Health Care Association said Sunday.
The CMS move would follow a report in The Wall Street Journal highlighting the limited public information available about cases inside the facilities, and the patchwork of rules governing release of the information.
More than 2,100 facilities across the country were hit by Covid-19 by April 10, and there were more than 2,300 deaths, according to data supplied by 37 states.
The virus’s impact on nursing homes, assisted-living centers and other elder-care facilities was far greater than the most recent tally released by the Centers for Disease Control and Prevention. In late March, the agency reported more than 400 facilities had been hit by the virus, but it said the figure represented a snapshot and it doesn’t keep a list of affected locations.
And experts say the true numbers are likely significantly higher than the Journal’s tally. Not every state provided information. Some of the states that reported a number for senior-care facilities with Covid-19 cases didn’t say how many people from these places have died.
Families of nursing-home residents want the names of affected facilities in order to know if a loved one is at risk, while staff would like to know in order to protect themselves, according to family members, consumer advocates and lawmakers.
Yet family members sometimes can’t get full or fast information about coronavirus infections in facilities housing their loved ones, according to families and advocates.
CMS has a longstanding requirement that nursing homes must report cases of communicable disease, such as Covid-19, the illness tied to the coronavirus, to state or local health departments.
The federal government, however, hasn’t been formally tracking or regularly releasing data on coronavirus infections in nursing homes and other elder-care facilities.
Some lawmakers and elder-care resident advocates have called for public disclosure of the names of facilities hit by Covid-19. Only a small number of states, including Minnesota and Oklahoma, currently post such details on a state health website.
Some states, like Virginia, have declined to make this information public, citing privacy concerns.
LeadingAge, which represents nonprofit providers of aging services, put out a statement Saturday urging members to be transparent about positive coronavirus cases.
Katie Smith Sloan, the group’s chief executive, said Sunday that better national data is vital to ensuring that senior-care facilities get access to coronavirus testing and protective equipment for employees.
“Some places can’t get testing at all, some places it’s spotty,” she said. Government authorities and the industry need “the ability to prioritize and understand where it’s happening, so we can prevent the spread and aggressively intervene.”
The American Health Care Association, which represents nursing homes and assisted-living facilities, updated its guidance on Saturday and urged members to notify all residents, family and staff about their first case of Covid-19. For additional cases, the group said, the facility should inform state and local health authorities, as well as the family of the affected resident.
Nursing homes and other elder-care facilities house some of the people most vulnerable to the coronavirus due to age and underlying health issues.
Among the places hardest hit by Covid-19 were a nursing home outside Seattle, which experienced an outbreak in February that has killed at least 40 people. In Massachusetts, an outbreak at a state veterans’ home that authorities learned about in late March has left at least 31 residents dead.