Federal agency orders nursing homes to alert residents, families to coronavirus cases

Massachusetts lists long-term care facilities with multiple infections

The Life Care Center of Kirkland, outside Seattle, where two-thirds of residents and dozens of staff members tested positive for the coronavirus.GRANT HINDSLEY/NYT

The top US regulator of nursing homes ordered them Monday to alert residents and families to COVID-19 outbreaks.

Starting this week, skilled nursing facilities — serving an old and frail population at highest risk for the novel coronavirus — also will be required to report cases and deaths to the Centers for Disease Control and Prevention, where they’ll be used as an “early predictor” of regions where the disease is spreading.

Massachusetts for the first time Monday released data about the number of cases in specific long-term care facilities. Out of 218 facilities that have at least two positive cases, 78 had more than 30 cases, the state reported. The new state data, however, didn’t list the total number of cases or deaths in long-term care facilities, something it had been doing since earlier this month.

Its site-specific data listed a range of cases for each facility, without specifying how many had been confirmed at each, or how many residents and staffers had died.

The moves come three months after the first confirmed COVID-19 case in the United States. Families in Massachusetts and across the country have clamored for better information about what’s happening inside nursing homes, which have been hard hit by the pandemic and have been mostly closed to the public for the past six weeks to keep the virus from spreading.

News about nursing home deaths and infections has been trickling out day by day in Massachusetts and beyond.

On Monday, Briarwood Rehabilitation & Healthcare Center in Needham confirmed 18 residents have died and an additional 32 have tested positive for the coronavirus.

Spokesman David Ball said 16 new residents who are positive were recently moved into Briarwood from a local hospital following treatment for COVID-19.

Meanwhile, two additional veterans at the Holyoke Soldiers’ Home, site of the deadliest known outbreak in Massachusetts, passed away Sunday, bringing the total to 62. There have also been 16 deaths at the Chelsea Soldiers’ Home, according to state officials.

Federal officials haven’t previously tracked the number of virus cases in nursing homes, even though they appear to be a magnet for the disease. The new order by the Centers for Medicare and Medicaid Services (CMS), which regulates the homes, is “unprecedented in its transparency,” CMS administrator Seema Verma told reporters.

“Now more than ever, nursing home residents and their families have a right to know what’s happening in their facilities,” Verma said at a press briefing. She said nursing homes that fail to report COVID-19 cases within 12 hours will face fines of $1,000 a week.

The federal move is “overdue,” said Alison Weingartner, executive director of the Medford-based Massachusetts Advocates for Nursing Home Reform. She said families have been kept in the dark by many institutions since visits by relatives and state ombudsmen were halted in early March.

“Why did it take [CMS] until today?” Weingartner said. “The families have been calling and making noise for weeks.”

The American Health Care Association, which represents more than 13,000 long-term care facilities nationally, applauded the CMS move and said nursing home managers stand ready to provide the information.

"This announcement reinforces much of what long-term care providers are already doing and are currently required to do in their states,” the trade group’s president, Mark Parkinson, said in a statement.

Nursing homes in Massachusetts already are required to report virus cases to their local health departments and the state Department of Public Health, which licenses the homes. But many families have complained that they are only notified if their loved one tests positive for the virus, not if others in their facility are infected.

Verma said the CMS will consult with its attorneys about making the outbreaks at specific sites public and will likely post the information on its website after families are notified. Several states, including New York and Connecticut, have begun doing that. Massachusetts public health officials have been providing daily updates on the number of nursing home cases but until Monday were not breaking out the data by sites.

COVID-19′s danger to nursing home residents, especially those with underlying health conditions such as heart or lung disease, was laid bare in late February when the virus ripped through the Life Care Center in Kirkland, Wash., where it’s killed more than 40 residents. Since then, thousands of residents in nursing facilities across the country have succumbed to the respiratory disease, including more than 800 in Massachusetts.

Verma said nursing home infection data will prove valuable to health officials as they consider whether, and when, to begin recommending reopening parts of the country to normal life and commerce.

“Nursing homes have been ground zero” for the coronavirus pandemic, Verma said. “We recognize that in communities across the county, that’s where we see the first indication of spread.”

To view state data on the COVID-19 pandemic, visit www.mass.gov/doc/covid-19-dashboard-april-20-2020/download.

This story has been updated to clarify the services provided by Briarwood Rehabilitation & Healthcare Center in Needham.