Pennsylvania Releases Data On Nursing Home Outbreaks

May 19, 2020

Nearly 50 Pennsylvania nursing homes have reported 20 or more deaths related to COVID-19, according to preliminary data released Tuesday by the state Department of Health.

After weeks of delay, state health officials released a list of 557 long-term care facilities in Pennsylvania reporting cases of the novel coronavirus among residents or staff.

Nursing homes and personal care homes have struggled for months to contain the virus, with residents of the facilities accounting for more than two-thirds of the state’s overall death toll of 4,624 — a higher proportion than in most other states.

The administration of Gov. Tom Wolf has faced criticism that it didn’t do enough, soon enough, to keep the virus from spreading among some of Pennsylvania's most vulnerable residents.

“There is no question, in Pennsylvania and all across the world, long-term care facilities have been places where this virus has wreaked absolute havoc. And we keep trying to figure out what we can do better as we move along in this pandemic," Wolf said at a video news conference. “I think in hindsight there are a lot of things that maybe we’ll learn, and I hope we do, that we can do better."

Pennsylvania’s top prosecutor, Attorney General Josh Shapiro, has opened criminal investigations into several nursing homes. The attorney general’s office has not said how many facilities it is investigating, or revealed their names or provided any other details about the specific allegations. In general, the attorney general’s office has jurisdiction in manners of criminal neglect.

The state’s worst nursing home outbreak — and one of the worst nationally — is at Brighton Rehabilitation and Wellness Center in Beaver County, near the Ohio border, where 358 residents and 25 workers have contracted the virus, and 76 have died. The Health Department has installed a temporary manager at Brighton, and the National Guard has been sent there and to other nursing homes with severe outbreaks.

Brighton had no immediate comment Tuesday.

Most of the other homes reporting 20 or more deaths are clustered in the eastern half of the state, where the virus has been more prevalent in the population as a whole.

Some facilities reporting a relatively large number of deaths said that raw numbers don't tell the whole story.

Gracedale, a county-run facility in Northampton County, calls itself the largest nursing home under one roof in Pennsylvania. More than 200 residents and 40 staff members there have been infected, and 44 have died — the third-highest death toll in a nursing home.

“We feel every death poignantly. The residents are family to the people who work at Gracedale,” said Northampton County Executive Lamont McClure, who called each death “heartbreaking." That said, McClure added, about 6.3% of Gracedale's population has died of COVID-19, a percentage that “compares very favorably with many much smaller homes."

Another county-run nursing home, Neshaminy Manor outside Philadelphia, which has reported 39 deaths, said it is the fourth-largest nursing home in Pennsylvania. Bucks County spokesman Larry King said the facility prohibited visitors from the outset of the pandemic, takes employees' temperatures and has taken other preventive measures. All residents and staff have been tested for the virus, he said.

“It has an excellent reputation: if you look at the regular state inspections done at Neshaminy Manor, it gets top evaluations every time out,” he said.

Health officials had been under mounting pressure to name long-term care facilities with virus cases, with the state’s chief fiscal watchdog, Auditor General Eugene DePasquale, urging greater transparency. Health Department officials had said they were weighing the public’s right to know against patient privacy and the dictates of state law.

The Health Department still held back some information from Tuesday's release, redacting data from facilities reporting 1 to 4 infections or deaths. Officials cited patients' right to privacy for the decision.

Wolf's health secretary, Dr. Rachel Levine, said Tuesday: “We have been reacting from the very beginning to challenges in long-term care living facilities."

Public health officials say nursing homes largely lacked the trained staff, testing supplies and personal protective equipment to contain outbreaks.

Wolf in March ordered all visitation to nursing homes stopped. Still, the Wolf administration has faced criticism that it fueled the outbreak in nursing homes by allowing coronavirus-positive nursing home residents to be readmitted from the hospital.

However, guidance from the U.S. Centers for Disease Control and Prevention never discouraged such a practice, and advised nursing homes to create a plan for managing readmissions of residents who contracted the virus and admissions of new residents who were infected. Nursing homes were told to place those residents in a single-person room or in a separate observation area to be monitored for evidence of the virus.

The practice of admitting virus-positive patients to nursing homes appeared to be routine across states.

A national nursing home trade group, the American Health Care Association, advised nursing homes in March to create separate wings, units or floors to handle admissions from the hospital. It said that discharging infected residents from hospitals to nursing homes that could not create separate units, equipment and staff is a “recipe for disaster.”

The American Health Care Association also asked states and public health officials to explore asking nursing homes to clear out entire facilities and designate them for infected residents being discharged from hospitals.

Only two states did, according to the group: Massachusetts and Connecticut. Meanwhile, only one state, Louisiana, barred nursing homes from taking readmissions or new admissions who were infected, it said.