DCH isn’t tracking cases and deaths of hundreds of long-term care facilities across the state — those with fewer than 25 beds. Thousands of Georgians live in those facilities.
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Plus, The Atlanta Journal-Constitution found that even though the DCH numbers are supposed to be cumulative — capturing and adding up all the positive cases over time — some facilities have appeared on the list with confirmed cases one day and drop off the next. One assisted living facility that has reported 17 deaths — Arbor Terrace at Cascade — now shows up on the state's list with zero deaths from COVID-19. The Arbor Company said it has continued to report the 17 deaths to the state.
Other facilities told the AJC they have gotten positive results that turned out to be false and changed their reports. DCH doesn’t independently verify information from the facilities.
DCH said it “reports data as it is communicated to us by the facilities.” In some cases, DCH said, “corrections were quickly made to information from the few facilities that reported incorrectly.”
Incomplete testing also makes it difficult to determine the extent of the pandemic in long-term care facilities. So far, about 78 percent of nursing home residents and 43 percent of staff have been tested, state officials said. Assisted living communities and personal care homes have lagged behind nursing homes in testing, but data on the percentage tested was not immediately available.
Melanie McNeil, the state’s long-term care ombudsman, said that incomplete, inaccurate or outdated testing muddies the picture for facilities that are reporting numbers to the state every day.
“This is such an unknowable situation,” she said.
Still, it’s clear that residents of senior care facilities make up a significant share of the overall COVID-19 deaths statewide. The Georgia Department of Public Health, which reports the official coronavirus statistics, put the state’s overall death toll at 2,102 as of Tuesday, though its numbers lag behind what facilities report to DCH, which regulates long-term care.
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And the large number of confirmed coronavirus cases and deaths raises questions about whether the state’s senior care facilities are doing everything possible to prevent the spread of the virus, McNeil said.
“Even with COVID, if you’re following the right infection-control procedures, it shouldn’t have gone like this. It shouldn’t have been so rampant,” McNeil said. “For going forward, what was the failure in infection control that let this get so serious? I think that’s really what we should be working on.”
Turning a corner
The data released Monday shows that at dozens of Georgia facilities, no residents were reported to be infected, though some workers tested positive. Other facilities reported only a single resident had tested positive. But in some facilities, infections seemed to move quickly through a building.
More than 40 facilities across the state have reported 50 or more of their residents testing positive. Five Georgia homes each have reported more than 100 coronavirus cases, and together account for 86 deaths. Westbury Medical Care and Rehab of Jackson has reported the largest numbers of deaths, with 31.
Marshall, of the Georgia Health Care Association, said the good news is that the number of deaths being reported is declining, as is the percentage of long-term care residents who have positive test results. What’s more, many of the residents who tested positive at some point during the pandemic either never exhibited symptoms or have recovered from COVID-19, including some fragile residents in their 90s.
“There are definite signs we are beginning to turn the corner, but we certainly know we have an extended fight ahead of us,” he said.
Still, he said, “Our members are heartbroken.”
”They have lost family members because those residents are their family,” he said. “But at the same time we also recognize that this virus has disproportionate negative impacts on seniors and those that have underlying health conditions which we represent.”
Nationwide, the toll of the coronavirus in senior care facilities is also unclear.
"Even with COVID, if you're following the right infection-control procedures, it shouldn't have gone like this. It shouldn't have been so rampant." —Melanie McNeil, Georgia's long-term care ombudsman
A new national count of coronavirus deaths among residents of skilled nursing facilities reached nearly 26,000, according to a report Monday from the U.S. Centers for Medicare and Medicaid Services (CMS). That was the first national tally after the Trump administration in May ordered nursing homes to start reporting figures to the U.S. Centers for Disease Control and Prevention in Atlanta.
That tally doesn’t include assisted living facilities or personal care homes. It’s also incomplete even for nursing centers, since only about 80 percent of the nation’s 15,400 nursing homes that participate in Medicare and Medicaid had reported the required data to the CDC by the deadline.
To address the outbreaks, the Trump administration announced Monday it wants states to conduct inspections of all nursing homes for infection control by July 31. Violations related to infection control can result in increased fines, the announcement said.
Nationally, the inspections have been conducted in just over half of nursing homes. But in Georgia, the checks have been done in about only 18 percent of facilities, according to a report released Monday. States that don’t meet the July 31 deadline could face a reduction in federal coronavirus payments through the federal CARES Act.
Georgia converted to remote reviews of infection control in long-term early in the pandemic because of a shortage of masks, gowns and other protective equipment. But DCH said Tuesday it was beginning to schedule in-person surveys now required by CMS.
“The department is aware of the information CMS released and is working to increase onsite activity,” DCH spokesman Chas Strong said.