In the Bay Area alone, 97 skilled nursing facilities and 18 residential care homes for the elderly have reported outbreaks of COVID-19, part of a national trend that has seen the coronavirus taking a heavy toll on the frail and elderly, and creating stress and anxiety for their loved ones. You can see which Bay Area facilities have reported infections in the map below. Scroll over each one to see the extent of the outbreak, which or may not be current, through the month of May.
Statewide, as of May 31, at least 2,184 residents and staff of nursing homes and assisted living facilities have died of COVID-19, according to data reported by the California Department of Public Health and the California Department of Social Services. That total makes up around half of the state’s coronavirus deaths.
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State health officials have acknowledged that published case and death totals are less than exact. COVID-19 cases and deaths are self-reported by facility representatives, and regulators do not systematically verify them. Where facilities report under 11 infections or related deaths, the totals are reported as "10 or fewer," a practice the agencies say is necessary in order to protect patient privacy.
Nursing homes are medical facilities overseen by the Department of Public Health, while assisted living facilities are managed by the Department of Social Services. CDPH has recently created a dashboard with all outbreaks in nursing homes across the state, including both a daily snapshot and cumulative totals. The CDSS data is harder to track; the agency shares daily reports about outbreaks in assisted living facilities housing more than six patients in a PDF file on its website.
Advocates for residents in long-term care facilities have been concerned about a lack of transparency around coronavirus outbreaks and management since the beginning of the pandemic. Charlene Harrington, professor emeritus at UCSF and an expert on long-term care, says the data has been inconsistent. “I'd like to see [CDPH] do a better job with oversight,” she says. “And trying to verify what's going on in the nursing homes, not just letting nursing homes self report.”
Both CDPH and CDSS say they're in close contact with all facilities via televisits and in-person inspections to verify some of the reported outbreak numbers.
Federal and state regulators offer guidelines, which include testing and infection control, for dealing with COVID-19 in nursing homes. Some guidelines also apply to assisted living facilities. County health departments don't regulate long-term care homes, but many offer guidelines to both skilled nursing and assisted living facilities.
Pat McGinnis, executive director of California Advocates for Nursing Home Reform, says that families of residents in long-term care facilities with coronavirus outbreaks should be in contact with those facilities to ensure their loved ones are safe. Here are some questions she suggests asking:
- Have all residents and staff been tested?
- How often are tests given?
- Isolation of positive cases
- How is the facility keeping residents who do not have the virus safe from those who do?
- Infection control
- Who is the infection preventionist?
- What changes have been made in the facility to enhance infection prevention?
- How is the facility monitoring to ensure staff are consistently following infection control standards?
- How many staff members are in quarantine?
- Who is replacing them?
- Are replacement staff qualified?
- How do staffing levels now compare to levels before the outbreak?
- Does the facility have extra staff assigned to replace the care and support visitors provided before the lockdown?
- Communication with families
- Who is assigned to keep families updated on an outbreak and what is the facility is doing to fight it?
- How can families contact this person or persons to seek information or share concerns?
- By what means and how often will facilities communicate with families?
- What is the facility doing to help residents stay in frequent contact with residents or patients via telephone, video visits, window visits and other means?
If you have a complaint or concern about the care of a loved one in a long-term care facility, you can reach out to a local ombudsman for assistance. The long-term care ombudsmen are representatives from the California Department of Aging who help residents and their families with issues related to day-to-day care, health, and safety.