Why NC’s list of COVID-19 outbreaks at nursing homes paints an incomplete picture


RALEIGH, N.C. (WNCN) — Only 19 of the more than 200 nursing homes on the state’s most recent list of outbreaks in congregate living settings showed more COVID-19 cases or deaths than they did on the previous biweekly report, a CBS17.com analysis of state data found.

The state Department of Health and Human Services issues those lists on Tuesdays and Fridays, and the report issued Tuesday showed 235 nursing homes with a cumulative total of 14,474 cases and 1,214 deaths among them.

But the overwhelming majority of them on Tuesday’s report— 92 percent — effectively remain in a holding pattern with the same number of cases and deaths as they did last Friday.

It’s clear that nursing home residents have been among the hardest hit by COVID-19, with those facilities accounting for more than a third of the 11,622 coronavirus deaths in the state. But the big numbers on those reports could paint an incomplete picture of how the pandemic is affecting the residents and employees at those homes in real time.

“I don’t want to say it’s not accurate information, but it does give the general public a different perspective of what’s going on in nursing homes,” said Ginger Baker, an administrator at UNC Rex Rehabilitation and Nursing Care Center in Raleigh. “Because again, that’s a cumulative total.”

Baker’s facility is one of those waiting to drop off the list. It showed up on the DHHS list on Feb. 12 with 66 cases and five COVID-19 deaths but has had none of either in nearly a month since.

DHHS says an outbreak — defined as having two or more cases — is considered over after 28 days pass since the most recent positive test or the last day an infected person shows symptoms.

When a home has an outbreak, it is reported to its county health department for investigation. That agency then reports the outbreak to DHHS, which includes it on its biweekly list.

Being on the list comes with a stigma, and could lead to other issues as well.

“The 28-day outbreak does leave an image in the public’s eyes — ‘Well, you know, do we want to come there even as an admission, you know, even if you had one positive case?’” Baker said.

And the Wake County Health Department didn’t allow the facility to take admissions while it was previously on the outbreak list, Baker said.

“So you can imagine the financial strain that it puts on nursing facilities as a whole,” she said.

That can lead to a domino effect: Fewer residents can mean the homes might not need as many workers, who then face an uncertain job status. It also could create a backlog for hospitals discharging patients to nursing homes with fewer options to place them.

“Almost a month — that’s a long time for a facility to go and not potentially be able to take admissions,” Baker said. “So financially, that just takes a huge toll on the facility as a whole.”

Copyright 2021 Nexstar Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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