Saturday, April 25, 2020

Maryland won’t detail nursing home coronavirus outbreaks, saying ‘disclosure serves no public health purpose’

By Scott Dance

Maryland health officials have denied a request from The Baltimore Sun for a list of nursing homes across the state with confirmed coronavirus outbreaks, saying “the disclosure serves no public health purpose."

Though states including California, Florida, Massachusetts and New Jersey recently began sharing such information, Maryland will not follow suit out of concern for patient privacy, wrote Heather Shek, assistant director of the state health department’s office of governmental affairs, in a letter to The Sun.

She said providing the list “could lead to the identification of specific persons who have tested positive.”

State health officials also say disclosure “would not contribute to preventing the further spread of the disease,” Shek wrote, because nursing homes are restricting visitor access under an executive order by Gov. Larry Hogan.

“Public disclosure of the information about positive test results at nursing homes does not help to protect the public since visitors have not been permitted at these facilities for several weeks,” Shek wrote. “Only staff and residents are affected by the presence of persons with positive tests in the nursing home.”

There are now confirmed COVID-19 cases in 169 of Maryland’s 226 nursing homes, state officials said Thursday. About three-fourths of the at least 680 people the virus has killed in the state are age 60 or older.

Nursing home leaders say they requested a list of those facilities from the state earlier this month and also were denied. They say it is necessary to help them identify staff who work in multiple nursing home facilities, and could be exposed to the virus in one and spread it to another.

Kevin Heffner, president of LifeSpan Network, a nursing home industry group, said transparency is key to protecting the many contractors who are still coming in and out of nursing homes, including pharmacy, dining services and medical equipment staff.

“If the positive test information were more readily available, those contractors could take steps to limit the employees and drivers who are potentially exposed to the virus,” he said.

LifeSpan and other nursing home groups also are pressing the state to conduct universal coronavirus testing of all nursing home residents and staff, citing the 500,000 new tests the state acquired from South Korea.

Family members of nursing home residents also have called for more information about outbreaks as they try to monitor their loved ones’ well-being from afar.

“As each day of the pandemic passes, family members, staff and communities are becoming increasingly worried about the health and safety of those inside long-term care facilities,” wrote Hank Greenberg, director of AARP Maryland, in letter to the editor of The Sun. “The lack of transparency from state health officials and facilities only adds anxiety.”

Anna Palmisano, co-founder of Marylanders for Patient Rights, called it “outrageous” for the state to suggest the information would not serve public health. Families need it to make decisions on how to keep their relatives safe, including potentially bringing them home, she said, adding that not all nursing homes have been transparent about outbreaks in their facilities.

“You don’t know how at risk your beloved family member is,” Palmisano said. “You don’t have the opportunity to act in a responsible manner for someone you love.”

The Sun requested the information under the Maryland Public Information Act. In the state’s response, Shek cited a state health law that says reports on infectious disease at hospitals and other health facilities are not subject to public inspection.

The federal government is seeking to make the information more public, however. The U.S. Centers for Medicare and Medicaid Services this week proposed requiring all nursing homes report COVID-19 outbreaks to residents, residents’ families and staff within 12 hours of confirming cases, and to report them directly to the U.S. Centers for Disease Control and Prevention. But federal regulations imposing that requirement are not yet in place.

Shek said the state “expects full compliance by all nursing home operators” in providing that information.

Shek added that state and local health departments “are closely monitoring outbreaks at nursing homes and other congregate living facilities, assessing facility practices and resources, and engaging on-site ‘go teams’ to provide additional support when indicated.”

As the nursing homes continue to try to contain or prevent outbreaks, they are asking for more state help testing residents and staff for the virus.

Heffner, of the LifeSpan Network, and the leaders of LifeSpan and two other nursing home industry groups, the Health Facilities Association of Maryland and Leading Age Maryland, are urging Hogan to use some of the 500,000 coronavirus tests the state recently obtained from South Korea to conduct universal testing on all of their residents and staff.

In a letter to the governor, they said the lack of coronavirus testing has made it difficult for nursing home administrators to “proactively manage their communities.” Testing availability has remained limited for those not showing symptoms of COVID-19 infection but believed to have introduced the virus to vulnerable elderly populations.

“While we understand the challenges associated with testing asymptomatic individuals, waiting for both employees and residents to develop symptoms almost guarantees additional infections,” they wrote in a letter to Hogan.

Hogan spokesman Mike Ricci said “all options are under consideration” as the state moves to roll out increased testing, noting that the governor said Monday that the surge of new tests would go to “high-priority areas, such as nursing and group homes.”

The nursing home officials say increased testing could help prevent more outbreaks like some of the worst known to hit the state.

Health officials have said it was an asymptomatic staff member who sparked the outbreak at Pleasant View nursing home in Mount Airy, where at least 26 of the 98 residents have died from COVID-19.

And it was universal testing of residents and staff, sought out by nursing home operator FutureCare over concern about possible asymptomatic spread of the virus, that revealed an outbreak infecting at least 129 residents and 41 staff members at FutureCare Lochearn. At least two residents there have died, according to family members.

Baltimore Sun reporter Phil Davis contributed to this article.

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Maryland won’t detail nursing home coronavirus outbreaks, saying ‘disclosure serves no public health purpose’

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