By Carol J. Bova
Updated July 6
Long Term Care Facilities (LTCF), have had 242 LTCF outbreaks, 6,889 cases, and 1,099 deaths that represent 60.5 percent of all COVID-19 deaths in Virginia according to the Virginia Department of Health (VDH) report as of July 1. But VDH won’t release the names of 52 facilities.
Back on May 1, there were 132 LTCF outbreaks responsible for 311 of Virginia’s 581 COVID-19 deaths. When Julie Carey from NBC4 in Washington asked at Governor Northam’s press conference why the number of deaths had increased from 118 to 311 in one day, the governor said, “Well first of all, that’s not the state of Virginia. Is that nationwide?” She told the governor, “No, that was in our data today.”
Heath Commissioner Dr. Norm Oliver turned to Dr. Laurie Forlano, the deputy commissioner of population health at the Virginia Department of Health, and Virginia’s Office of Epidemiology public health director, and asked, “Do you want to take that, Laurie, or do you want me to take it?”
Dr. Forlano didn’t explain beyond saying “…numbers of cases, et cetera, associated with an outbreak are added as quickly as possible to that file, so-to-speak. And so sometimes, there is a lag in capturing that and entering the data. I’d have to go back to the team to fully understand he jump, but that’s what I think it’s likely to be.”
Roger Watson from the Farmville Herald followed up saying that North Carolina reversed its decision on identifying individual longterm care facilities with outbreaks. He asked, “Is changing that rule in Virginia something that you will consider in the coming days?”
Dr. Oliver repeated the question and then said, “As I’ve stated before, this is not a decision that was made by the health department. It is actually something that’s incorporated into the Virginia code, which first of all identifies facilities and corporations, businesses as persons. And then requires us to protect the anonymity of person. So unless the code changes, I don’t see how we could do that.”
On June 19, Governor Northam announced he was “directing VDH to release the names of individual long-term care facilities (nursing facilities and assisted living facilities) that have experienced a COVID-19 outbreak.”
He said, “VDH has previously released aggregate data about outbreaks in long-term care facilities, given their responsibility to protect patient and facility anonymity under the Code of Virginia. However, due to the widespread nature of this pandemic, it is now unlikely that releasing facility information would compromise anonymity or discourage facilities from participating in a public health investigation.”(1)
No one from the Northam administration has cited exactly what section of the Code of Virginia barred the release of the facility names and numbers of cases. The Virginia Code discusses privacy of patient records, not hiding the identity of health care entities.
When the governor’s Long Term Task Force posted the list of nursing home and assisted living facilities with COVID-19 cases, they omitted 52 facilities from their list.(2) When contacted, their spokesperson, Brenden Rivenbark, explained that the Task Force only reported nursing home, assisted living and multicare facilities, but the VDH Outbreaks report includes two other categories: group homes and residential behavioral health facilities.
The only way to see what kind of facilities are in each outbreak category was to go to the VDH COVID-19 website, go to the Outbreaks tab, then go to the category in the list beneath the total outbreak and cases numbers, and then, click on the number of outbreaks. A list then appeared showing what the category includes. The information is now available under Data Downloads as of July 6.
But that’s not the complete answer. Nineteen Virginia nursing homes reported two or more confirmed cases to the Centers for Medicare and Medicaid (CMS), so they should have been in the VDH Outbreaks numbers and on the task force list. They were not on the June 30th list, but we have no way to know if they have been included in the outbreak numbers. As of July 6, two have been added to the list and one more identified using a name variation, leaving sixteen still to be posted.
At the tele-press briefing on July 2, Laurie Forlano said some of the facility names were withheld because of the small size of some facilities and the need to protect their anonymity.
Since the Task Force suppresses any number of cases or deaths fewer than five, exactly what does small mean, and why should they be exempt from public disclosure? And where is that authorized in the Code of Virginia?
The Task Force spokesperson sent an email on July 2 that he was scheduled that afternoon to discuss updates in facility name reporting and would be in contact after that so he could provide up to date information.
July 6 Update
Brenden Rivenbark advised today that the Task Force list of nursing homes, multiicare and assisted living facilities with COVID-19 outbreaks is now available to download under Data Downloads on the VDH Coronavirus site, https://www.vdh.virginia.gov/coronavirus/
The list includes 192 facilities and there are 16 more from the CMS reports. That accounts for 208 of 254 total outbreaks, and at least 61 are currently active.
He also said, “In addition, we are working to clarify definitions on our pages to better outline which types are included in our various data sets. Lastly, Dr. Oliver was instructed to release the names of nursing homes, assisted living facilities, and multi-care settings by Governor Northam due to the increasing rate of outbreaks in these types of facilities. Our leadership team continues to evaluate outbreaks in other facility types and the public health benefits that may be associated with sharing the names of other types of facilities.”
The VDH changes and response are appreciated.
This post will be updated as new information comes in.
- https://www.governor.virginia.gov/newsroom/all-releases/2020/june/headline-858302-en.html7
- https://www.baconsrebellion.com/wp/where-are-the-other-52-nursing-homes-with-outbreaks/