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Warren, Markey demand data from assisted-living operators on coronavirus impact

Lawmakers respond to reports of outbreaks in senior care sites

Senator Elizabeth Warren spoke with Senator Ed Markey at the Greater Boston Labor Council's Annual Labor Day Breakfast in 2018.Jessica Rinaldi/Globe Staff

Amid growing alarm over the spread of COVID-19 at senior care sites, US Senators Elizabeth Warren and Edward J. Markey of Massachusetts are demanding information from assisted-living operators about coronavirus infections and deaths at their facilities and the steps they are taking to fight the pandemic.

The push for scrutiny of a sector not currently regulated by the federal government is also coming from a key House Democrat, Carolyn Maloney of New York, who chairs the House Committee on Oversight and Reform, as reports surface of virus outbreaks at assisted-living sites in Massachusetts, New York, and other states.

State data show more than half of the 260 assisted-living residences in Massachusetts have had multiple COVID-19 cases, including at least a dozen with 30 or more. But state officials haven’t broken out the number of deaths at those sites or included them in their tally of fatalities at nursing and rest homes, which account for nearly 60 percent of Massachusetts deaths from the virus.

Lawmakers on Capitol Hill, focused on the health crisis at hospitals and the devastation to the economy, were initially silent about the threat to long-term-care facilities. The sites house many of those at highest risk of COVID-19, old and frail residents with chronic health conditions such as heart and lung disease who live together in close quarters where the virus can spread quickly.


But this week, the three lawmakers simultaneously sent letters to the CEOs of 11 large assisted-living corporations nationwide, including Newton-based Five Star Senior Living, demanding to know the full extent of the coronavirus outbreak and what steps the operators have taken to prevent and mitigate it in their facilities.

“Assisted-living facilities deserve particular scrutiny in this pandemic because they share several of the same characteristics that increase risk at nursing homes … but they face a significantly less stringent regulatory environment,” the letter to the CEOs said.


Rachel Reeves, a spokeswoman for the National Center for Assisted Living, said operators “will certainly make every effort to be responsive to this request [from lawmakers] while we are still in the midst of this pandemic.”

She said her organization “supports transparency concerning reporting COVID-19 cases to our residents, families, and other stakeholders, because knowledge is pivotal during a pandemic and our public health officials need to know where to send badly needed resources.”

Brian Doherty, president of the Massachusetts Assisted Living Association, said his group is reviewing the lawmakers’ letter.

“While assisted living is a residential model and the services it provides residents are not medical in nature, we nonetheless recognize the unique challenges COVID-19 presents to our older residents,” he said. “Our members remain committed to working collaboratively with public officials on this matter.”

Unlike nursing homes, which serve patients who require almost constant care, assisted-living facilities cater to people who are largely independent but may need help with some daily activities. Nursing homes are more heavily regulated by the federal government because they depend largely on Medicaid funding, whereas seniors in assisted-living facilities more often pay out of their own pocket.

There is not reliable national data on the number of cases, or deaths, in long-term-care facilities, because each state collects and reports that information differently. Massachusetts only recently began collecting, and releasing, data about cases in assisted-living sites.

The lawmakers’ letter pointed out that the Centers for Medicare and Medicaid Services, which regulate nursing homes, last month ordered them to report to the federal government data about their number of COVID-19 infections, and required them to notify residents and their families of such cases. But the new CMS requirements did not apply to assisted-living facilities.


In the five-page letter to assisted-living operators, there were 2½ pages of questions about the extent of outbreaks in their facilities. They included questions about how many cases and deaths had occurred among staff and residents and at which facilities, as well as questions about whether the facilities conduct routine daily or weekly testing of residents, staff, and visitors.

The letter also asked whether the facilities have restricted access for visitors, whether staff are required to wear protective gear, and whether that equipment is provided free of charge.

Lawmakers asked how the facilities report cases to state, local, and federal officials, family members, and other residents and about whether there has been training or new policies to reduce potential transmission between facilities.

The letter also asked whether the companies provide paid sick leave or hazard pay to employees.

This story’s headline has been updated to remove an incorrect reference to the regulatory status of assisted living facilities.

Robert Weisman can be reached at robert.weisman@globe.com. Follow him on Twitter @GlobeRobW.