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Officials, Data Put Nursing Homes' COVID-19 Numbers in Context
By Stephen Dravis, iBerkshires Staff
11:53AM / Thursday, April 23, 2020
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BOSTON -- The governor and secretary of health and human services Wednesday each attempted to put the number of COVID-19 deaths linked to nursing homes in context.
 
At their daily press briefing, the state officials were asked two questions about nursing homes: why the commonwealth's fatality numbers at the facilities are on a par with neighboring New York when Massachusetts' total number of deaths from COVID-19 trails the Empire State and why the Legislature has advanced a bill requiring the Department of Health to "report weekly the number of COVID-19 positive cases and mortalities at assisted living residences, elderly housing facilities and long-term care facilities to the house and senate committees on ways and means."
 
Gov. Charlie Baker asked HHS Secretary Marylou Sudders to put in context the fact that more than half of the commonwealth's total deaths from COVID-19 are linked to long-term care facilities. According to Tuesday's DPH report, 1,059 of the state's 1,961 confirmed COVID-19-related deaths have been in long-term care facilities.
 
Sudders said that over the last five years, between 1,000 and 1,700 deaths per month have occurred in Massachusetts' nursing homes.
 
"I've been collecting that data because sometimes, I think the reporting is, 'There's never been a death  in a nursing home,' based on some of the reports I've been reading," Sudders said. "People are suggesting we're starting at zero deaths in nursing homes."
 
Baker noted that no one ever asked or showed interest in the pre-outbreak fatality rate at facilities. 
 
As for the comparison to New York, Sudders indicated it may be tied to the relative sizes of the per capita nursing home populations in each state.
 
"Massachusetts has one of the greatest numbers of nursing home beds in comparison to other states," she said. "I don't actually know the answer of what New York's per capital utilization of nursing home beds is in comparison to rest homes, assisted living, elder housing and the like."
 
The data released by the DPH on Tuesday also helps contextualize Berkshire County's best known COVID-19 "hot spot," the Williamstown Commons nursing home.
 
The DPH statistics released on Tuesday list 220 Massachusetts nursing homes, rest homes and skilled nursing facilities with at least two known cases of COVID-19 among residents and staff. The report classifies the facilities as having fewer than 10 confirmed cases, between 10 and 30 confirmed cases or more than 30 cases.
 
Of the 220 on Tuesday's report, about 81, or more than a third, are listed as having more than 30 cases.
 
Williamstown Commons' which is in that group of more than 30, Tuesday reported that it has, "35 active cases in-house, which is 5 down from last week, and 21 additional residents are recovering and improving every day." The Williamstown facility also has reported 17 COVID-19-related deaths, including three new deaths reported Tuesday.
 
Of the 81 facilities on DPH's list with more than 30 cases, the majority, 67, are listed as having fewer licensed beds than Williamstown Commons, which has 180. The most striking statistic on the list is the German Centre in West Roxbury, which is listed as having 31 licensed beds but on Tuesday reported 34 confirmed cases and 13 deaths.
 
Tuesday's data from the Department of Public Health also identifies Great Barrington's Fairview Commons (146 licensed beds) and Lenox's Mount Carmel Care Center (69 beds) as having fewer than 10 confirmed COVID-19 cases among staff and residents.
 
Sudders said Wednesday that there are characteristics of the nursing home industry in Massachusetts that have made it particularly susceptible to transmission of the novel coronavirus.
 
"There's no question we have a high degree of spread in our nursing home facilities," she said. "Many of our nursing homes are old nursing homes that were waivered in in terms of the new regulations; when I say 'new,' it was early 2000s, where everyone has single rooms. Our nursing home industry is older in Massachusetts, the physical plants. So you were waivered in if you had two or three people per room. As we know, the more social distancing you have, the better."
 
Last week, the president of the Massachusetts Senior Care Association called on the commonwealth to ramp up testing of residents and employees, prioritize delivery of personal protective equipment and funnel and an additional $130 million per month into the industry to avoid "death and devastation" at nursing homes across the state.
 
In a letter to state officials, the trade group warned that under a "worst-case scenario," half of the state's nursing home population would become infected and 10 percent, or 3,800 people, would die.
 
Baker's own father is a resident at one of those facilities, and the governor has talked repeatedly about his personal frustration at not being able to visit his parent since the start of the COVID-19 outbreak in the commonwealth.
 
On Wednesday, he defended the industry as a whole.
 
"I know a fair number of people who operate in that industry, and some of the folks who suffered some of the most dismaying, disturbing and destructive outbreaks are terrific operators and folks who literally have never had a demerit or an issue at any point in time with respect to the work they do," Baker said. "I mean Belmont Manor (156 beds, more than 30 cases) is a good example of that. That's a five-star nursing home.
 
"And even in the assisted-living space, some of the folks who battled their way through some of the worst examples of COVID-19 penetration represent organizations that, prior to that, were considered by most to be among the very best players in the space."
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