What Data’s Missing; What Action is Needed Now?California Advocates for Nursing Home Reform (CANHR), April 18, 2020
Californians finally got a partial glimpse of COVID-19’s epidemic impact within the state’s nursing homes on April 17th when state officials released an incomplete list of nursing homes that have residents or staff who are infected with the virus. Released on a Friday evening, the list identifies 261 nursing homes that have reported COVID-19 infections involving either a resident or a staff member. In total, those facilities reported that 1,740 residents and 1,290 workers have tested positive for COVID-19.
Most likely, many nursing homes with COVID-19 outbreaks are not included on the state’s list. Some facilities are in the dark about the presence of the virus due to lack of testing. Other nursing homes are not on the list because they have failed to report outbreaks. California has no system to ensure that nursing homes are reporting outbreaks as required. Even Magnolia Rehabilitation and Nursing Center, the Riverside nursing home that had all 83 of its residents evacuated last week due to a major outbreak, is not on the list.
The state’s reporting system has other gaping holes. The newly published list gives no information on the rapidly escalating death toll in California nursing homes, no information on outbreaks in assisted living facilities and no information on any facilities in Kern, Fresno and other counties.
What Does the List Tell Us about the Safety of California Nursing Home Residents?
California nursing home residents are in grave danger right now. Despite its limitations, the state’s list identifies nearly 50 California nursing homes that have between 11 and 91 residents who are infected with the virus. Many nursing homes are woefully unprepared to keep residents safe due to their lack of leadership, staff, testing, attention to infection control protocols, personal protective equipment and other resources.
Actions Needed Now to Save Residents’ Lives in California
Public health officials throughout the world have expressed alarm that COVID-19 spreads like wildfire in long term care facilities. It is critical that California start treating outbreaks in long term care facilities with the same urgency it does for wildfires. The state should deploy multi-agency strike teams that have command of all available public and private resources to every facility with an outbreak and appoint commanders to lead efforts to save residents lives and to keep the public well informed about their actions and outcomes on a daily basis.
Beyond containing tragedies, California officials must do much more to prevent them. First and foremost, the state should order long term care facilities without COVID-19 patients not to admit outside patients with infectious COVID-19. Equally important, the state should assign a CDPH surveyor to conduct daily onsite monitoring visits at each facility with residents or staff who have COVID-19 and at each facility with a history of poor care to ensure infection control practices and staffing levels are safe and to sound the alarm on the need for immediate intervention if they are not. CANHR’s Emergency Action Plan to Save Lives of Residents of California Long Term Care Facilities gives other critically important recommendations.