Despite the mounting death toll from the novel coronavirus, Minnesota state health officials continue to conceal vital information that could affect thousands of state residents: the names and locations of the growing number of long-term care facilities where residents and staff have tested positive.
The Minnesota Department of Health has repeatedly declined to disclose the information, citing concerns that releasing the names of facilities would violate state privacy laws by potentially exposing the identities of those infected with the virus. The agency has insisted on keeping the facility names confidential even as officials in other states — including California and Colorado — have provided the names and locations of long-term care facilities with confirmed cases of COVID-19, the disease caused by the virus.
State health officials face growing pressure to release the information as the number of confirmed cases and fatalities accelerate in senior care facilities, which have scrambled to quarantine infected residents. So far, 11 of Minnesota’s 17 coronavirus fatalities have occurred among residents in nursing homes and assisted-living facilities. Statewide, 38 residents and 22 staff of long-term care facilities have been infected — exceeding any other setting. One facility, which has not been identified, has six confirmed cases, state officials said.
Minnesota’s limited disclosure of facility data has been criticized by some public health experts, who say the information would help people make more informed decisions about where to place their loved ones. The information could also help the public detect patterns, such as whether particular facilities or nursing home chains have multiple COVID-19 cases and should be avoided, and find possible links between the cases and facilities with poor infection-control records.
Families are also clamoring to know whether any particular senior living facilities have become hot spots for the virus, so they can determine whether they should bring their loved ones home. Such dangerous clusters of cases have become more common. Among the first contagion hot spots was a nursing home in Kirkland, Wash., where two-thirds of the residents fell ill and at least 37 have died. A nursing home near Nashville had to be closed this week after an outbreak left two dead and more than 100 sickened.
More than 400 long-term care facilities nationwide have at least one infected resident, according to the U.S. Centers for Disease Control and Prevention.
“This is literally about life and death. I cannot imagine a more dangerous place for an elderly and vulnerable person to be than to be in a facility that has experienced an outbreak,” said Jennifer Wright, an elder law attorney from Roseville whose mother lives in a senior care facility. “It’s absolutely critical for the public to know which facilities have [COVID-19 cases] or this could jump from facility to facility like wildfire.”
Since the outbreak began, the state Health Department has encouraged nursing homes and assisted-living facilities to notify residents and their family members of any confirmed cases of COVID-19, and provided them with a one-page form to do so. Even so, there are still no consistent, industrywide standards for disclosure. The result is that communications have varied, which has contributed to growing public paranoia over the virus’ spread, elder care advocates say.
Administrators at several home care agencies in the Twin Cities said they have become reluctant to send nurses or other caregivers into long-term care facilities because they are unsure which sites have infected residents, and they do not want staff to get infected and spread the disease elsewhere.
In a statement, a spokesman for the Health Department said the agency cannot release the names and locations of the facilities because doing so would violate Minnesota’s data practices act, which says that public agencies cannot provide data in a way that identifies an individual. The agency also said it is concerned that disclosing facility names could give a “false sense of security” to the public that facilities without COVID-19 cases are protected from the disease.
“People may be tempted to want to move someone out of a facility into another facility or setting that they deem ‘safer’ when in fact it might not be and doing so could increase the risk of COVID for everyone,” an agency spokesman said.
So far, the Health Department has revealed only the type of long-term care facilities where residents and staff have tested positive for COVID-19 and the counties where they are located.
Officials in some other states are more forthcoming. For instance, the Colorado Department of Public Health and Environment said it releases the names and locations of long-term care facilities with confirmed COVID-19 cases to any member of the public who requests the information. Many counties in California and Washington state also release names and locations of facilities. But disclosure policies vary: State health officials in Florida, Michigan and Oregon, for instance, said they still withhold names of the facilities.
“The public health of the community and state should take precedence over potential violations of privacy in an emergency pandemic situation such as this one,” said Joseph Gaugler, a professor who focuses on long-term care and aging at the University of Minnesota’s School of Public Health. “If the naming of facilities can help with surveillance and management efforts of COVID-19 to manage outbreaks both within and beyond these facilities and redirect scarce resources then this should occur with all haste.”
Some long-term care providers see it as beneficial to disclose cases as quickly as possible.
For instance, Roseville-based Presbyterian Homes & Services, which operates 48 senior living communities in Minnesota, Wisconsin and Iowa, said it has had three confirmed cases in its facilities in the past two weeks. These include two cases at a single facility, Johanna Shores in Arden Hills. Within 24 hours after each positive test result, the nonprofit provider has notified residents in each facility of the cases, the health status of the infected residents, and the measures it is taking to prevent further spread of the virus. So far, none of the residents who have been infected with the disease have died.
“We’ve found that this approach helps mitigate anxieties, fosters cooperation and reinforces the trust they hold in us,” said Cindy Ray, a spokeswoman for Presbyterian Homes & Services.
But the absence of a consistent, statewide standard around disclosure has sown confusion among many family members and caregivers.
Cathy Lauring, a nurse practitioner and vice president at Lifesprk Health, a company in St. Louis Park that provides health services in a dozen senior living communities, said facilities should, at a minimum, be posting signs in their entryways when they have residents with COVID-19. Lauring said such signs have been a common safety precaution during influenza outbreaks, but she has not seen them being used in response to the coronavirus.
“At times like this, transparency is critical,” Lauring said. “When facilities share nothing, it heightens that sense of confusion and fear.”
Suzanne Scheller, an elder law attorney from Champlin, said the lack of location-specific information has served to “compound fear and paranoia” among residents and families, at a time when facilities across the state have imposed unprecedented restrictions on personal visits.
“Disclosure becomes so much more important when you realize how quickly this virus can spread,” Scheller said. “If families feel that information is being withheld, they tend to assume the worst.”