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Nursing Homes Ordered to Disclose COVID-19 Cases, Deaths

Residents, family members and CDC to be notified of outbreaks in facilities by the end of May

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Steve Skjold/Alamy

As soon as even one case of COVID-19 is confirmed at a nursing home, the facility will have to alert its residents and their families or representatives within 12 hours, the Centers for Medicare and Medicaid Services (CMS) announced late Sunday. The information will also have to be reported to the Centers for Disease Control and Prevention (CDC) and be made public.

"It's important that patients and their families have the information that they need, and they need to understand what's going on in the nursing home,” CMS Administrator Seema Verma said at a recent White House briefing. CMS issued a regulation on Thursday that will require the country’s 15,000 nursing homes to report their first week of COVID-19 data to the CDC no later than May 17. CDC expects to begin making information about nursing home coronavirus cases public by the end of May. Nursing homes are already supposed to be informing residents and their family members of any cases in the facility.

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Nursing facilities have had to report such information to state and local public health authorities, but those reports have not generally been made public and have not been shared with federal health officials. Nursing homes have been particularly hard hit by the coronavirus, and communication in and out of these facilities has been sporadic, according to family members across the country. In more than 4,100 nursing homes in the United States, over 36,500 residents and staff members have been infected with the virus and more than 7,000 have succumbed to it, according to reporting by the New York Times.

"Nursing homes have been ground zero for COVID-19,” Verma said in announcing the new rules, which she said are designed to provide “transparent and timely information to residents and their families."

According to the CDC, residents of nursing homes and long-term care facilities are among those most at risk of severe illness from COVID-19, the disease caused by the coronavirus. Also at high risk are Americans 65 and older, and anyone with a compromised immune system or with underlying medical conditions, such as severe obesity, moderate to severe asthma, chronic lung disease, a serious heart condition, diabetes, liver disease, and chronic kidney disease being treated with dialysis.

AARP has been calling for increased transparency of nursing home illnesses and also for more personal protective equipment for staff and testing of residents and staff within these facilities. CMS has increased reimbursement for coronavirus tests in nursing homes and given labs the authority to go into these facilities to do tests in an effort to increase surveillance.

"Care facilities are ground zero in the fight against the coronavirus, representing a shockingly high share of deaths,” says Bill Sweeney, AARP senior vice president for government affairs. “Even more terrifying is that we are fighting this fight without the facts. The guidance from CMS will provide more transparency, but with such a fast-spreading disease, the reporting of facility names with confirmed COVID-19 cases needs to be made public and happen daily. Families have a right to know what is happening to their loved ones.”

Verma said during a Monday conference call with reporters that she expects nursing facilities to begin reporting the COVID-19 cases and deaths to residents, family members and their representatives right away. Nursing homes will also have to tell the CDC within 72 hours when three or more individuals develop respiratory symptoms. The CDC, she said, will then provide that information to CMS, which will make the data public, probably on the agency's Nursing Home Compare website. 

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"There's now a recognition based on the data and based on what's happened in this country that nursing homes could be an early predictor [of the virus] for communities,” Verma told reporters. Nursing homes will have to report to the CDC weekly on the status of infection in their facilities, she said, or face fines of about $1,000 a week.

Editor’s note: This story has been updated to reflect new information

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