Feds: More than half of Minnesota nursing homes have COVID-19 cases

Editor's note: Previous versions of this story reflected deaths from all causes reported to federal regulators, not just COVID-19 deaths, and therefore inaccurately reported which facilities had the highest numbers of COVID-19 deaths.

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Nearly 60% of Minnesota's nursing homes have reported a suspected or confirmed case of the novel corona­virus, including resident deaths.

Those are some of the findings from a trove of federal data released this week that provides the most detailed look yet into the extent of the pandemic's deadly reach inside Minnesota's nursing homes. The numbers indicate that large and deadly clusters of the virus are more widespread than previously thought, with 12 nursing homes statewide reporting 10 or more deaths and one facility reporting 61 fatalities from the virus.

The virus has spread so widely that a clear majority of Minnesota's population of nursing home residents now live in facilities that have been infected by the virus. The data show that 216 of the state's 368 nursing homes have had at least one confirmed or suspected case of COVID-19, the deadly respiratory illness caused by the virus; 48 of these facilities have reported a death from the disease.

All told, 74% of the state's nursing home residents live in a facility that has had at least one death, or a confirmed or suspected case of the virus, federal data show.

The data also shed new light on a widespread but controversial practice: Hospitals discharging patients who have tested positive with COVID-19 to nursing homes. The state's policy of allowing such discharges has come under fire from state lawmakers and public health experts, who warn that such transfers endanger residents who aren't infected with the virus.

The coronavirus has been especially deadly in nursing homes, where a combination of factors — a frail and sick population, chronic understaffing, shortages of protective gear and close living quarters — have contributed to its rapid spread. In many larger nursing homes, people share rooms, bathrooms and bathing areas, with staff moving from one room to another.

In a legislative hearing Friday, Health Commissioner Jan Malcolm said that COVID-19 "has amplified these difficulties and made them many times more significant and visible to us all." She stressed that the state was committed to addressing the crisis.

"We couldn't agree more that the focus on long-term care facilities needs to continue," she said. "Given the degree of community spread ... all facilities should be prepared for this and just assume it's a matter of 'when' they get a COVID case and not 'if' they get a COVID case."

Amid mounting public concern, Gov. Tim Walz last month unveiled a "battle plan" to address the rising COVID-19 death toll in long-term care facilities, including more aggressive testing and more support for facilities with staffing shortages. The health department has even deployed the Minnesota National Guard to help with testing. In the past few weeks, the agency has tested nearly 26,000 residents and staff in more than 200 facilities statewide, officials said Friday. The department has also shifted its inspection priorities toward infection control and is conducting more visits of facilities with past problems, officials said.

The data released this week by the federal Centers for Medicare and Medicare Services (CMS) provide the first breakdown of COVID-19 cases and deaths by facility. Until now, the public has had to rely on individual providers to report such numbers, and reporting has been inconsistent.

Now, members of the public can search by provider name on the federal website Nursing Home Compare to identify the scope of the outbreaks in specific facilities. In some cases, the death counts from COVID-19 have been staggering. North Ridge Health and Rehab in New Hope reported 61 deaths — the most in the state — and Catholic Eldercare on Main in northeast Minneapolis had 37 deaths.

However, the actual death toll in Minnesota's senior care communities is much higher than is reflected in the new data. That's because the numbers do not include assisted-living and independent living facilities, and nursing homes are required only to report cases dating to May 8 — two months after the first case was reported in Minnesota. Even the limited nursing home data released this week are incomplete: About 16% of Minnesota's nursing homes did not report the required information. Facilities that fail to report are subject to potential fines, the CMS said.

"It's frustrating that we are three months into this pandemic and we still don't have an accurate picture of what's happening in long-term care facilities," said Toby Edelman, a senior attorney for the Center for Medicare Advocacy in Washington, D.C. "Still, this is the most in-depth information we've had so far and [it] will go a long way toward understanding this how this virus spreads."

As the data make clear, the practice of discharging COVID-19 patients to nursing homes is widespread. More than 450 patients infected with the virus have been admitted into 60 nursing homes across the state, the federal data show. Even facilities with large outbreaks have been admitting more COVID-19 patients: North Ridge Health and Rehab has admitted 66 patients with the virus and Catholic Eldercare has admitted 25 patients, the data show. Both facilities recently earned "below average" ratings from the federal government for health inspections.

State health officials have said there is no evidence that discharging COVID-19 patients to long-term care facilities has caused infections to spread, and the practice is allowed under federal guidelines.

Still, as the death toll in nursing homes mounts, some lawmakers are calling for tighter guidelines around transfers of COVID-19 patients to nursing homes, or some have called for the practice to stop.

"I don't know why we're putting COVID-19 patients into nursing homes with our most vulnerable," said Rep. Glenn Gruenhagen, R-Glencoe, during Friday's legislative hearing. "To tell you the truth, whoever made the decision to stick these COVID-19 patients into nursing homes, I'd fire them."