CDC is pressured to start keeping a formal tally of nursing homes with coronavirus cases

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By Laura Strickler, NBC NEWS, April 6 2020

Democratic senators are pressing the CDC to keep a national tally of long-term facilities with coronavirus cases. There were at least 400 a week ago.

Image: Lori Spencer visits her mother, Judie Shape, who tested positive for coronavirus at the Life Care Center of Kirkland nursing home near Seattle, on March 11, 2020.
Lori Spencer visits her mother, Judie Shape, who tested positive for coronavirus at the Life Care Center of Kirkland nursing home near Seattle, on March 11, 2020.Jason Redmond / Reuters fileApril 6, 2020, 2:48 PM PDT By Laura Strickler

WASHINGTON — As the number of coronavirus cases in nursing homes continues to skyrocket, the Centers for Disease Control and Prevention is now considering whether or not to start keeping a formal tally of nursing homes with ongoing cases according to an agency spokesperson.

This internal decision-making comes amid criticism from Democratic senators who want the agency to not only keep tabs on the number of long-term care facilities with cases but also to provide them with the names of those nursing homes.

During the pandemic, the CDC has never kept a formal tally, but has computed totals on at least two occasions. On March 23, the Centers for Medicare and Medicaid Services Administrator Seema Verma said that 146 long-term care facilities across the country had a case of coronavirus. Both CMS and CDC are part of the Department of Health and Human Services, and Verma was using numbers provided by CDC.

One week later, on March 30, the CDC told NBC News that there were more than 400 facilities battling the illness, an increase of 172 percent.

But on Sunday, April 4, agency spokesperson Kristen Nordlund said CDC had no updated figures, and that in order to get the previous tallies of long-term care facilities with cases the agency had to query individual state agencies.

The CDC did not say how many states had provided data for its previous tallies. On March 30, the same day that CDC said it had counted more than 400 facilities with coronavirus cases nationwide, NBC News counted nearly 300 facilities in just three states and one county.

In a statement Monday, CDC spokesperson Nordlund confirmed that CDC “is not keeping a ‘master list’ of coronavirus cases in long term care facilities or keeping track of how many facilities have infected residents.”

“The number referenced in the CMS press release [of March 23] and updated a week later [on March 30] reflected a snapshot from state health departments responding to informal outreach about their sense of how many nursing homes they were aware of with at least one COVID-19 positive resident.”

David C. Grabowski, a professor of health care policy at Harvard Medical School, told NBC News that he believes the CDC is “completely reliant on state departments of health right now to report this information. Some health departments are able to track and report this accurately while others are not.”

Grabowski says CDC needs to make the collection and reporting of the facilities a priority to answer some key questions: “How do we identify and contain COVID-19 in nursing homes if we can’t even measure it accurately? How do we learn and implement best practices if we aren’t studying the existing cases?”

Toby Edelman, senior policy attorney for the Center for Medicare Advocacy, said, “If we don’t know where the virus is, how can government focus resources where the need is greatest? The public (and residents, families, and staff in particular) need accurate, comprehensive, and timely information. I see no justification in the CDC’s putting its head in the sand.”

Cases continue to climb rapidly in nursing homes nationwide. In Maryland alone 81 facilities now have cases of the illness. And within facilities the virus is spreading fast. At one state-run facility outside of Dallas there are 89 cases.

Democratic Sens. Ron Wyden and Bob Casey, who sent a letter to CMS and CDC last week demanding a list of facilities with infections from the agency, wrote, “At a time when this information could be vital to the health and safety of Americans, it is imperative that the list of facilities with a COVID-19 case, among residents and staff, be made public and shared with relevant health care providers, authorities and Congress on a real-time basis.”

Laura Strickler is an investigative producer in the NBC News Investigative Unit based in Washington.