Amid revelations of alarming and deadly COVID-19 outbreaks at nursing homes, the Pritzker administration on Sunday released for the first time details of the number of cases and deaths tied to each long-term care facility in Illinois.
The data highlights the extent of the pandemic’s reach inside the state’s nursing homes, showing at least 186 long-term care facilities in 22 counties reporting at least one case. In all, at least 1,860 cases can be tied to nursing homes, with 286 deaths. That’s nearly a fourth of all coronavirus deaths reported in Illinois.
The data — which can be searched here — provides the first comprehensive account of the largest outbreaks recorded so far among residents and staff: 81 confirmed cases at Will County’s Symphony of Joliet and Carol Stream’s Covenant Living at Windsor Park, with 54 cases at Willowbrook’s Chateau Center Nursing & Rehabilitation.
Those three also have the most deaths associated with the virus. The state has recorded 21, 11 and 10 deaths at each facility, respectively, although those tallies may not be up to date.
Nationwide, a New York Times report last week documented at least 6,900 COVID-19 deaths tied to nursing homes, about a fifth of all deaths. That same trend appears to be happening in Illinois, with about 23% of coronavirus deaths tied to nursing homes.
In releasing the latest data, Illinois officials said they planned to boost testing and shore up staffing at nursing homes, while also defending their initial efforts to try to stem the virus.
“We have a toll here that is higher than I think anybody anticipated or guessed, even with all the lockdown procedures that we do,” Gov. J.B. Pritzker said Saturday.
The nursing home data will be released once a week, according to the state. Because of how reports filter from local to state health officials, what’s released may not be the most up to date. And there can be wide variations. For example, the state reports one case and two deaths at Cicero’s City View Multi Care Center. But the town of Cicero website reports 12 residents and 26 staffers testing positive, with six residents dying.
In many ways, the data reflect what has trickled out about outbreaks in several homes. Beyond the Symphony at Joliet, there has been news coverage of outbreaks at Windsor Park and Chateau Center Nursing & Rehabilitation — the latter a stark example of how the virus could decimate a facility.
Chateau didn’t immediately respond to a request for comment. In the most recent update posted on its website more than two weeks ago, it said: “As we reported in our last update, life here at our home is slowly returning to ‘normal,’ although there is probably a ‘new normal’ but things are moving and getting better each day.”
The data also reveal the depth of the problem: 61 facilities recording at least 10 cases. While most are in the Chicago metropolitan area, at least 10 others made the list. They include two facilities outside St. Louis: Memorial Care Center in St. Clair County, with 54 cases, and Garden Place Independent & Assisted Living, with 49 cases.
Also hit hard has been Manor Court of Carbondale, with the most deaths — four — outside metro Chicago.
Closer to Chicago, the data shows 15 facilities have had at least five or more deaths. At least 20 facilities in the metropolitan area had 20 or more cases. And that is likely an undercount of the true number of cases.
The state had told nursing homes they didn’t need to test anyone else once someone has tested positive at a facility. There are other ways residents and staff can — and have — gotten tested, explaining the multiple cases reported at so many facilities.
Symphony of Joliet, for example, attributes its high number of deaths and cases to the fact its residents have been widely tested.
The company called on state and federal authorities to increase access to personal protective equipment and “aggressively increase testing capabilities,” spokeswoman Natalie Bauer Luce said in an email. “That’s why Symphony believes it is so important to get more testing across the board — so there is a full accounting of the spread.”
A consortium of Illinois industry trade groups said in a statement that it supported the release of the data and agreed that more testing is needed to know the true scope of the problem.
“Expanding rapid coronavirus testing will help us control the spread among our medically fragile residents and protect the healthcare professionals on the front line who are working around the clock to care for them,” said Dr. Rajeev Kumar, medical director for two west suburban homes and board member of AMDA, the Society for Post-Acute and Long-Term Care Medicine.
On Sunday, the head of the Illinois Department of Public Health said it will now do just that.
Referring to “heightened attempts” to contain the spread in nursing homes, Dr. Ngozi Ezike said the state will be sending more test supplies to the facilities to catch infections earlier and curb the spread, including “aggressive testing of staff.”
Her agency later told the Tribune it will prioritize testing residents and staff in homes without any known cases to more quickly isolate those found with the virus. For homes already with known cases, the agency will test staff to see who can continue to care for residents, while treating symptomatic residents as if they have the virus, even if not tested yet.
The state is also trying to get more workers to the facilities to shore up thinning staffs. In addition, the state is looking at facilities located in “hot zones” where coronavirus infections have been the greatest, and the agency said it has stocked all counties with protective gear that nursing homes can tap.
Kumar said he was encouraged by the new measures: “We welcome an expansion of testing so that crucial information is available for each facility to better control the spread of the virus, quarantine patients properly and protect our heroic staff.”
The crisis for long-term care facilities has further exposed a rift between advocates and workers, on one end, and the industry on the other.
Advocates and workers have long complained the industry has relied on low-wage workers stretched thin to the point that patient care suffered even before the pandemic. They have complained that equipment shortages are now hampering workers.
The industry has countered that it has always been patient-centered and has managed the crisis as well as any health care system could, given the unique circumstances. As with all health care providers, it’s been difficult to get the necessary personal protective gear, it has pointed out.
Ezike said her agency will continue working to get supplies to homes that need them, part of a broader effort to allow homes to set up COVID-19 wings or institutions. “We’re really trying to be proactive, giving everyone the support they need,” she said. “This is a multipronged effort.”
Her agency is the state’s main enforcer of regulations for nursing homes, but for now, the state has said it’s focused on guidance, not sanctions, to correct any violations.
“That said, if warranted, IDPH will use all enforcement tools available to hold facilities with uncorrected or egregious violations accountable,” the agency said late Sunday, in response to Tribune questions.
The agency said its efforts have included ending family visits, monitoring patients and workers for symptoms, and sending in “strike teams” to review homes with outbreaks and ensure workers followed best practices.
So far, the state said, its strike teams have visited 14 facilities and consulted with dozens more places and local health departments.
But the state — before this weekend — had hesitated to release the number of infections at each nursing home, offering varying reasons. A state spokeswoman told the Tribune last week it would violate state rules. On Saturday, Gov. J.B. Pritzker said the state had feared “stigmatizing” people who lived or worked at a nursing home if it was publicly identified as having an outbreak.
As other states began to release nursing homes tallies, Illinoisans largely were left to rely on homes themselves to publicly acknowledge outbreaks. The spotty disclosure led advocates and nursing home staffers to complain last week to the Tribune that workers, residents and their families were being left in the dark — in a state whose homes had a troubled record.
A Tribune investigation last month found Illinois ranked among the worst states in the country for how often its homes had been cited for failing to follow rules for stopping the spread of infections — with nearly 9 out of 10 cited at least once for breaking the rules in the past four years.
The Centers for Medicare & Medicaid, which largely funds and pays states to help oversee the industry, directed states on March 4 to increase inspection efforts.
On March 20, the state issued new guidance to nursing homes. Among other things, it told homes to check residents at least three times a day for signs of illness, to separate those with the virus from other patients and to disinfect frequently touched surfaces every two hours, while also screening staff, offering proper protective gear for those who can work and sending home those with symptoms.
Five days later, the state suggested any resident who had or could have the virus should eat in their rooms, as should anyone else who was able to feed themselves. The rest could eat, at least 6 feet apart, in dining halls, with staff wearing face masks to help and — if pushing residents in wheelchairs — only pushing one at a time.
The state has since updated the guidance again, including more details on how to handle employees who come in contact with someone with the virus up to 48 hours before the patient shows symptoms. Even in cases where exposure was the likeliest, the guidelines allow workers to continue on the job if they don’t show symptoms themselves.
“Exposed HCP (staffers) should be asked to wear a face mask at work for the 14 days after the exposure event, if there is a sufficient supply of face masks,” states a chart accompanying the latest guidelines.
When asked about the Joliet facility, Ezike said it provided “direct assistance” to the home, including ensuring workers were being checked and knew how to use equipment, along with calls between the state’s infection-control experts and the home’s medical staff.
“There’s a full survey that can be reviewed to make sure you identify the areas of weakness and then try to identify where IDPH can specifically support,” she said.
