Analysis: State withholds data on virus in nursing homes
BATON ROUGE, La. (AP) — Nursing homes, where many medically fragile patients spend their days, have become a hot spot in the coronavirus outbreak around the country, but details that could help families understand the scale of Louisiana’s problem at those facilities aren’t released.
Nursing homes are particularly vulnerable to the virus, because of their close confines of elderly people with the underlying health conditions that put them at a higher risk to infection and death from the COVID-19 disease caused by the virus.
The Louisiana Department of Health says 93 nursing homes have reported someone onsite tested positive for COVID-19, about 21% of Louisiana’s adult residential care facilities. The nursing homes reported 557 confirmed virus patients, 130 of whom have died.
But Gov. John Bel Edwards’ administration, which is working with nursing homes on their virus response, started refusing to list names of individual facilities where confirmed coronavirus infections exist or the number of cases by facility.
Why that policy exists isn’t entirely clear.
Dr. Alex Billioux, head of the state Office of Public Health, said the politically powerful nursing home industry, which has donated millions to Louisiana elected leaders over the years, didn’t ask for its facilities not to be named. Billioux suggested the policy was developed in consultation with the U.S. Centers for Disease Control and Prevention. But the CDC told The Advocate newspaper it doesn’t issue guidance on whether to name facilities.
With no public accounting of nursing homes where people have tested positive for COVID-19, that raises questions about whether family members of residents who aren’t infected are told. Louisiana has no mandate on the books that nursing homes must notify all families of residents if someone onsite tests positive, according to the health department.
“Each individual facility manages communication with families differently,” said agency spokeswoman Aly Neel.
The Louisiana Nursing Home Association said federal regulations require a facility to notify a resident’s family or other representative when there is “a significant change in the resident’s physical, mental, or psychosocial status.” What that means in this pandemic wasn’t clarified.
For most people, the coronavirus causes mild or moderate symptoms, such as fever and cough. But for others, especially older adults and people with existing health problems, the highly contagious virus can cause severe symptoms like pneumonia and be fatal.
Denise Bottcher, state director of AARP Louisiana, the advocacy group for older people, sent Billioux a letter asking about “the state’s rationale” for refusing to release facility names. She said she hasn’t received a response.
“Families need to know if their loved one lives in a facility where there’s a diagnosed case and make decisions based on that exposure,” Bottcher said.
As Louisiana’s outbreak began, the health department released detailed information on the “cluster” of virus cases that developed early at the New Orleans retirement home and nursing facility Lambeth House, where COVID-19 killed multiple residents. As additional nursing homes saw their own cases, the health department confirmed virus infections and deaths by named locations.
Then the Edwards administration stopped releasing statistics for the sites, instead listing only the names of the nursing homes.
The health department reversed course again in early April, now providing a twice-weekly update on how many nursing homes have COVID-19 cases, how many patients have tested positive and how many have died. No facility is named — and no breakdown by nursing home is provided — making it unclear if the most severe clusters of COVID-19 are only at a handful of nursing homes or if smaller outbreaks are widespread across facilities.
Billioux said the policy was developed with “guidance and advice” from the CDC, whose officials “felt that while it’s laudable that we were sharing a lot of information, they were concerned about what that would mean for the nursing homes sharing as this continues.”
A CDC spokesman told The Advocate it “has never issued guidance on whether state health departments should name facilities.”
Asked if he was suggesting nursing homes threatened to withhold information if names were released publicly, Billioux replied: “The nursing homes never said anything like that to me at least.”
Louisiana Nursing Home Association Executive Director Mark Berger said the group “has never requested, suggested or implied” the health department should stop publicly releasing facility names.
The department said it doesn’t intend to reverse course.
EDITOR’S NOTE: Melinda Deslatte has covered Louisiana politics for The Associated Press since 2000. Follow her at http://twitter.com/melindadeslatte