Public in dark on some nursing home outbreaks

The Cincinnati Enquirer asked experts to respond to some of the coronavirus questions flying around the internet. Here’s what it found:

Why doesn’t the public know more about coronavirus outbreaks at nursing homes?

Almost 64% of coronavirus deaths in Ohio have occurred in nursing homes or long-term care facilities, but public disclosure of outbreaks in those facilities is complicated and often incomplete.

That’s because the system of reporting cases of COVID-19, the disease caused by the coronavirus, is built around notification of individuals rather than the public.

Here’s how it works: Nursing homes and long-term care facilities must report cases and deaths to their local health departments, which then must report to the state Health Department. The facilities also are required, since May 17, to report cases and deaths to the federal Centers for Disease Control and Prevention.

When a case is confirmed, the facilities are supposed to notify the resident who tested positive, their family and others who might have been exposed. The local health department then attempts to track down anyone who had contact with the infected person in an effort to stop the spread of the disease.

No one, however, is required to announce outbreaks to the public.

When 16 people died at Cincinnati’s Mercy West Park nursing home, also known as Mercy Franciscan at West Park, it was the largest known toll among nursing homes in southwestern Ohio. But the public didn’t know about it until The Enquirer reviewed state inspection reports. A spokeswoman for the Cincinnati Health Department declined to comment when asked how it responded to the deaths at West Park.

Public-health officials have said that they often are hamstrung by privacy protections and, therefore, are reluctant to release information about outbreaks at specific locations because infected individuals could be identified. The Enquirer sued last month for the release of more information about deaths and other records, arguing that given the more than 2,500 nursing home deaths in Ohio, the public has a right to know more.

Some information about the spread of the disease in nursing homes and other care facilities eventually becomes available to the public, but it’s often not easy to find.

The state health department reports weekly on the number of COVID-19 cases in nursing homes and assisted-living centers, but death counts are reported only by county.

The federal Centers for Medicare and Medicaid Services keeps a national database of cases and deaths in nursing homes, but it does not track deaths at other care facilities such as assisted-living centers.

And some of the data that is available is incomplete because nursing homes didn’t have to report deaths before May. The national database, for example, shows 13 deaths at Mercy West Park rather than 16. The federal data is missing deaths from at least three Hamilton County nursing homes because of that delayed start, The Enquirer reported last week.

Although local health officials aren’t obligated to report outbreaks and deaths to the public, they aren’t forbidden from doing so, either. When dozens of residents of the Newark Care and Rehabilitation nursing home fell ill with COVID-19 in July, the Licking County Health Department announced the outbreak to the public.

Mike Samet, spokesman for the Hamilton County Health Department, said health officials encourage facilities to be as open as possible about outbreaks. He said that if a facility, or any place of business, was uncooperative during an outbreak, health officials might consider a public announcement to alert anyone who might have been exposed.

“We strongly recommend transparency,” Samet said.