Continuing to focus on long-term care facilities

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The article below indicates that there are 418 long-term care facilities in the state. Can the state consultant ECRI that we wrote about earlier have much impact on such a great number? The Northampton County long-term care facility infection rate is more than double Lehigh County’s. More than 30 nursing homes and assisted living facilities in the Lehigh Valley have been affected by the coronavirus, but the state Health Department doesn’t list cases by facility. 37 people have died at long-term care facilities in Lehigh County; Northampton County would not release information about coronavirus deaths in its long-term care facilities.

Eugene Tauber, Peter Hall and Anthony Salamone, “New data: Nursing home residents are 7 to 15 times more likely to get coronavirus than others in the Lehigh Valley.”  Morning Call, April 24, 2020.

Nursing home and assisted living residents in the Lehigh Valley and other parts of Pennsylvania are many times more likely to be infected with coronavirus than the rest of the population, an analysis of state Health Department data shows.

In Lehigh County, residents of long-term care facilities were more than seven times as likely to be infected. In Northampton County, the infection rate was more than double Lehigh’s, at 14.5 times the infection rate in other residents.

David Grabowski, a Harvard Medical School expert on aging and long-term care issues, said it’s no surprise that coronavirus infection rates are higher among nursing home and assisted living residents, given the ease of transmission that close quarters with shared living spaces allows.

He cautioned that the higher rates could be a result of more testing among nursing home patients, but said there’s also anecdotal evidence of residents who have died of coronavirus-like symptoms who were never tested.

Nonetheless, Grabowski said the data supports the alarms raised by public health officials on the need for greater efforts to control infections in long-term care facilities.

More than 30 nursing homes and assisted living facilities in the Lehigh Valley have been affected by the coronavirus. Although the state Health Department doesn’t list cases by facility, two operators have acknowledged large numbers of cases in their facilities.

The Lehigh County coroner’s office said that as of noon Friday, 37 people have died at long-term care facilities. Northampton County Coroner Zachary Lysek would not release information about coronavirus deaths in long-term care facilities.

HCR ManorCare Inc., which owns six skilled nursing facilities in the Lehigh Valley, said Friday it had 166 people infected in four of its facilities, up from 108 earlier this week. They included four at ManorCare in Salisbury Township, which the company had not previously reported.

In addition, cases have risen at ManorCare facilities in Palmer Township (89) and at 2021 Westgate Drive, Bethlehem (45). Some 28 people have been listed as positive at a ManorCare in Bethlehem Township. The company is not releasing the number of deaths caused by the virus, said spokeswoman Julie Beckert.

She said not all deaths at ManorCare can be directly linked to the virus, since residents typically have significant underlying health issues or may be in hospice.

With the state preparing to reopen regions with comparatively low infection rates, Sen. Pat Toomey, R-Pa., this week said reopening a county or region should not be delayed if most of the cases are contained at long-term care facilities, arguing that those outbreaks require extra care for residents but do not endanger the broader community.

But Pennsylvania Health Secretary Dr. Rachel Levine said Friday that long-term care facilities will be included in the counts of new cases to determine when to relax mitigation measures. Gov. Tom Wolf and Levine announced this week that the state’s business and social restrictions will be eased only when there are fewer than 50 new cases per 100,000 people in a region over a 14-day period. “Those long-term care living facilities do exist within a county, and the staff go back and forth,” Levine said.

Beckert, the ManorCare spokeswoman, said the company has been moving toward testing throughout a facility when possible and encouraged other facilities to do the same. The company has found residents who test positive without showing symptoms who are then kept in isolation, she said.

Others in the long-term care industry said testing remains scarce. “We feel like we’ve been ignored,” Parkinson said. “Certainly now that the emphasis has gone away from hospitals to where the real battle is taking place in nursing homes, we should be at a priority level one.”

Greater transparency is necessary to understand the full scope of the coronavirus’ impact on nursing homes, he said, adding that many coronavirus cases that begin in nursing homes aren’t being correctly attributed.

The 37 deaths in Lehigh County does not include residents who died after being transferred to a hospital, Coroner Eric D. Minnich said.

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