NC health officials release locations of nursing home outbreaks, reversing stance
Under pressure from advocacy groups and media organizations, North Carolina health officials released details for the first time Monday afternoon on the locations of dozens of nursing homes and other group living facilities with COVID-19 outbreaks across the state.
The move marks a significant policy reversal for the N.C. Department of Health and Human Services, which for weeks has maintained that identifying facilities with outbreaks would reveal confidential health information for particular patients.
As of Monday, DHHS reported more than 2,500 cases of COVID-19 and more than 150 deaths from the disease in so-called congregate living settings, which include nursing homes, prisons and residential care facilities. Infections in those settings account for more than one-quarter of the state’s total cases, and more than half of all deaths.
In its first report with the new data, DHHS identified more than 70 facilities as settings with outbreaks. Among the new details:
▪ Rowan County has the biggest outbreak — with The Citadel at Salisbury, a nursing home, reporting 144 cases.
▪ Pruitt Health-Carolina Point in Orange County, which is also a nursing home, is reporting 108 cases — the second most in the state. The facility also has 11 deaths, according to DHHS.
▪ Louisburg Healthcare and Rehab Center in Franklin County has seen the most coronavirus-related deaths so far. Fourteen deaths have been reported at the facility.
Durham reported 111 cases at Durham Nursing and Rehabilitation Center on Sunday. DHHS is reporting 95 cases, indicating there might be a lag in the state’s numbers.
Coalition threatened a lawsuit
In releasing the data, North Carolina joined a handful of other states, including Georgia, California, Ohio, Illinois and New York, that disclose at least partial details about the locations of deaths and cases in nursing homes and other group facilities.
The state’s reversal came days after a letter from the AARP urging Gov. Roy Cooper to release the information in the interest of public health.
It also followed discussions between attorneys for DHHS and a 20-member media coalition, which last week threatened to file a public records lawsuit over the issue. The coalition, which includes The News & Observer, The Charlotte Observer, WRAL, WTVD, WNCN, WBTV and several national media organizations, argued that releasing the names of the facilities — and not personally identifying information about patients — would not violate federal or state confidentiality rules.
“We cannot express in words the exigency of this matter as our clients stand in the shoes of North Carolinians statewide who need this critical information – especially in light of the Governor’s forecast of a plan to begin a phased approach to return to normal life,” attorneys Amanda Martin and Mike Tadych wrote.
After conversations between media coalition lawyers, as well as attorneys for DHHS, the governor’s office and Attorney General Josh Stein, state officials say they’ll use a “public health exception” at their discretion to allow release of the information. DHHS plans to update the figures twice a week through its existing COVID-19 data portal.
Reporters from a collaborative of six North Carolina newsrooms asked DHHS for the names of nursing homes and other congregate care facilities with outbreaks three weeks ago, and news organizations have repeatedly questioned the state’s position on disclosure at daily briefings with Cooper and DHHS Secretary Dr. Mandy Cohen.
At one such press conference April 14, Cohen said the department decided to “strike the right balance” between the privacy of the facilities and public health interests by not releasing details on the locations of outbreaks.
Changing advice to counties on disclosure
Although the state hadn’t previously provided the locations of outbreaks, some county health departments had.
The result, as the collaborative reported last week, was a patchwork of disclosure that varied from county to county, leaving the public in the dark about the identities of more than a half-dozen nursing homes with outbreaks of the deadly virus.
But that inconsistency appears likely to change as well.
DHHS’ planned release of outbreak locations follows new guidance the agency issued to county health departments by email Sunday night.
Mark Benson, assistant DHHS secretary for public health, noted in the email that the agency had so far advised counties not to provide details of COVID-19 outbreaks at nursing homes but that DHHS was changing its advice, effective immediately.
“But the unique characteristics of this pandemic (e.g., national public health emergency declaration, evidence of widespread/statewide community transmission, need for extensive community mitigation measures, etc.) suggest that a one-time modification is warranted to the long-standing practice of not releasing facility-specific details in outbreaks,” Benson said.
Previously, both DHHS and many county health departments had said releasing the information would be a violation of the law.
However, in his email to counties with the new guidance, Benson said releasing the information actually complies with the law.
“Doing so is in alignment with GS 130A-143(4) and allows us to achieve standardized reporting regarding COVID-19 outbreaks in congregate living settings at both the state and county level,” he said.
This story was jointly reported and edited by Kate Martin and Frank Taylor, of Carolina Public Press; Gavin Off and Ames Alexander, of The Charlotte Observer; Lucille Sherman and Jordan Schrader, of The News & Observer; Nick Ochsner, of WBTV; Emily Featherston, of WECT; and Tyler Dukes of WRAL.
This story was originally published April 27, 2020 at 12:46 PM.
