Does MN have the nation’s highest rate of COVID-related deaths in long-term care facilities?

Minnesota has the highest percentage of deaths tied to long-term care facilities as a share of total state deaths attributed to Covid-19 according to currently available date from 30 states posted by the Kaiser Family Foundation, a national clearing house tracking the impact of the virus.

Through Sunday, some 80 percent of Minnesota deaths attributed to the new coronavirus–338 out of 419 fatalities–were connected to long-term care facilities or nursing homes, according to the Minnesota Department of Health (MDH). The next closest states were Rhode Island (71%), Massachusetts (63%), Delaware (61%) and Pennsylvania (60%).

State health officials say the majority of assisted-living and other facilities are prepared and doing a good job of combating the virus. Yet Minnesota’s high percentage of virus-related deaths in nursing homes and assisting  living facilities has drawn increasing attention at the state’s daily online media briefings.

“We know that long-term care facilities present a special set of considerations and risks because they are congregate care settings serving residents who generally are of advanced age and often have one or more underlying health conditions,” Kris Ehresmann, MDH Director of Infectious Disease said at last Friday’s update. “Given the nature of this pandemic one would expect that these settings would have a heavier burden of disease and death.”

National reporting of coronavirus deaths at long-term care residences remains spotty and incomplete with a “wide variation in the types of data that states are reporting,” according to Kaiser.  For example, the website does not list any statistics for long-term facilities in Washington, the state where the first known outbreak occurred in a nursing home.

Until recently, however, there was no federal requirement for nursing homes to report coronavirus outbreaks and COVID-19 deaths, leading to an information gap for families, residents, and policymakers. On April 19, 2020, CMS released guidance that would require nursing homes to report cases of coronavirus directly to the Centers for Disease Control and Prevention (CDC). This data is not yet available, but there are a number of states that are already reporting data on long-term care facilities.

While a handful of facilities account for many of Minnesota’s deaths, some 244 long-term care facilities across the state report at least one Covid case with 135 of those residences reporting one or two cases as of Friday.  The state’s infectious disease director claims the wide discrepancy between Minnesota and many other states in long-term care deaths may be methodology.

We’re not in a position to fully analyze what has happened nationally or in 49 other states but there are a variety of approaches  being used in other states to elevate and track Covid deaths in long-term care facilities. And here in Minnesota, we are being very aggressive about monitoring for them.

Yet reports persist about staff shortages, lack of testing and other problems said to be straining many Minnesota long-term care facilities. When pressed about how the state plans to respond, Minnesota Health Commissioner Jan Malcolm put the onus on an apparently newly assembled long-term care facilities response team at the State Emergency Operations Center.

“A team that can be more immediately in touch with facilities and able to mount more of a rapid response,” Malcolm said at the Friday online media briefing. “I think they are actually in contact with people in the field to know what might be coming in terms of a staffing crisis situation and they do work to try to anticipate and support that, on a pretty real time basis.”

Nearly two months into Gov. Tim Walz’s state emergency declaration, Malcolm needs to be more aggressive than that to reassure those whose loved ones live and work in the assisted living facilities on the front lines of the threat.