ST. LOUIS COUNTY — More than 300 residents of nursing and assisted-living homes in St. Louis County have died of COVID-19 and more than 1,400 others have been infected, according to county data released Friday.
The death toll represents about two-thirds of all COVID-19-related deaths in the county, records show.
The St. Louis County Department of Health is the first Missouri government agency to release such information, identifying 71 care homes that self-reported COVID-19 infections or deaths among residents, including seven Delmar Gardens nursing locations that together reported dozens of COVID-19 infections. The Chesterfield-based firm, the largest for-profit provider of long-term care in the St. Louis region, previously declined to publicly confirm COVID-19 infections, citing privacy concerns.
While several other St. Louis area care homes independently have disclosed dozens of COVID-19 cases and deaths, state and local officials largely have declined to release the information, frustrating families of residents and their advocates.
What data has been released, meanwhile, varies widely, depending on the number of tests nursing homes have conducted and the authority different government agencies have to require nursing homes to report COVID-19 cases.
But the records released Friday by St. Louis County — Missouri’s most populous county — indicate the number of COVID-19 infections at residential care facilities in the state could be much higher than previously publicly known.
The Missouri Department of Health and Senior Services (DHSS) has reported that least 176 residential care facilities across the state have confirmed at least one COVID-19 infection, but the agency has declined to identify the facilities, citing state medical records laws. Local authorities can release what information they have obtained, according to DHSS.
Officials in St. Charles County told the Post-Dispatch the same statutes and regulations that prevent DHSS from releasing information also apply to local health authorities. The city of St. Louis has not responded to repeated requests for comment.
Meanwhile, DHSS doesn’t have a tally of the number of residents infected or killed by COVID-19, spokeswoman Lisa Cox said Friday. A state order issued May 18 required nursing homes to tell DHSS if they have confirmed at least one COVID-19 infection, but didn’t require them to report more details, she said. The agency is working on collecting more data, she said.
The federal Centers for Medicaid and Medicare Services on Thursday reported that 253 nursing Missouri nursing home residents died of COVID-19 and that 1,100 residents were infected, identifying at least 50 nursing homes that reported at least one COVID-19 infection. But the data only included federally licensed nursing homes. It did not include assisted-living communities and other types of residential care facilities, as St. Louis County and Missouri state data have.
Nationwide, nearly 32,000 residents and 683 employees of federally licensed nursing homes have died of COVID-19, which is particularly dangerous to older adults and people with preexisting medical conditions. More than 95,000 other residents were infected.
The numbers are expected to change as local, state and federal officials collect and verify more data, which can very depending on how much COVID-19 testing each state or nursing home has done. At least 18% of Missouri nursing homes regulated by the Centers for Medicaid and Medicare Services have not reported data. Other homes reported incomplete data.
The number of COVID-19 deaths and infections among residential care facilities in St. Louis County “should not be seen as an indictment of the care residents receive at the facilities,” Spring Schmidt, acting co-director of the St. Louis County Department of Public Health, said in a written statement Friday.
County health authorities and volunteers have offered assistance to residential care facilities, including providing free protective equipment such as masks and gloves and increased COVID-19 testing, Schimdt said.
“We understand how difficult fighting the pandemic has been for these facilities, and we support them,” Schmidt said. “These cases are not a result of any flaws — they are the result of a relentless pandemic.”
Officials of St. Louis area homes that publicly have disclosed COVID-19 infections said they took precautions recommended by federal and local health officials to prevent the spread of the virus, including barring visitors, screening employees and residents daily for symptoms including fevers and coughs, closing common areas, canceling group events and maintaining appropriate distances between residents.
Many homes also were at a disadvantage because of longstanding issues, including a lack of protective equipment and staffing shortages because of difficult working conditions and low pay, said Marjorie Moore, executive director of VOYCE, a Creve Coeur-based nonprofit group that advocates for nursing home residents. Union employees at several homes have protested working conditions and complained that owners did not provide protections or sick pay for employees infected at work and forced to quarantine.
“The way we have treated nursing homes in our society is as an afterthought,” Moore said. “Our national culture is probably what caused this as much as any one individual did.”
The number of homes reporting COVID-19 infections, however, was not surprising, Moore said. VOYCE “assumed early on that nearly every facility” had COVID-19 or would have it, Moore said. The homes provide hands-on, intimate care to patients, who particularly are vulnerable to the coronavirus, which is highly contagious, she said.
“This has been a disease that, especially in a nursing-home setting, really is set up to run wild,” she said.
But the lack of transparency and widely varying data on COVID-19 infections makes it harder to figure out what could have prevented further spread, Moore said. Information released by other states, including Illinois, has shown trends including a disproportionate impact on homes serving mostly black residents, for example, she said.
“We’re trying to see what ties some of these facilities together where we’ve seen high reports of COVID-19,” Moore said, “but we can’t do too much with this data. It’s frustrating.”
“We can keep hammering specific facilities for not doing the right thing,” Moore said. “But what I’m interested in now is what can we learn to make sure this doesn’t happen again.”
The lack of public transparency about nursing home infections also frustrated St. Louis County Council member Tim Fitch, R-3rd District, who has criticized County Executive Sam Page for implementing a county-wide social distancing order without more public information on the virus.
In email exchange May 4 and May 5 with Schmidt, Fitch asked for the number of COVID-19 deaths at nursing homes. Schmidt said the county health department did not have that information because it was required to be reported to the state.
“Unfortunately, this is not data that we currently possess with completeness,” Schmidt wrote. “The State has mandated this data go to them and they are the primary reporter of this information.”
I started asking for this information 2 months ago when CE Page was shutting down our economy. Our Health Dept. said they had no idea. Two-thirds!— Tim Fitch (@ChiefTimFitch) June 5, 2020
More than 300 nursing home residents in St. Louis County have died of COVID-19, county says https://t.co/p9DkhyQGBa via @stltoday
The county health department — which does not regulate nursing homes — attempted to get the information from DHSS, but eventually issued a local order requiring residential care facilities to report directly to county health authorities, spokesman Chris Ave said Friday.
Still, the information that did come to county authorities was reported by health clinics and hospitals where nursing home residents received treatment, not from the homes themselves, Ave said. The order did not require homes to specify the number of COVID-19 deaths at each facility, so the county only has an estimate of the total number of deaths, he said.
Doug Moore, spokesman for Page, on Friday said health experts recommended an expansive stay-at-home order to prevent further spread of the coronavirus.
“We followed and will continue to follow the advice of our public health experts, medical professionals, and the pandemic task force,” he said in a written statement.
Cox, the state health agency spokeswoman, did not clarify Friday what information on COVID-19 infections at nursing homes, if any, DHSS has provided to local authorities.
“We are still working to enhance our reporting processes,” she said in a written statement, “and our data is still incomplete.”
Updated at 8:25 p.m.
St. Louis County facilities with 40 or more COVID-19 cases
A dozen residential care facilities in St. Louis County had 40 or more COVID-19 cases, accounting for more than half of all cases reported by such facilities in the county. (Source: St. Louis County Department of Public Health)
|Residential care facility name||Address||COVID-19 case count|
|Christian Extended Care & Rehabilitation||11160 Village North Drive, north St. Louis County||40|
|Crystal Creek Health and Rehabilitation Center||250 South New Florissant Road, Florissant||56|
|Delmar Gardens North||4401 Parker Road, Florissant||74|
|Delmar Gardens of Meramec Valley||1 Arbor Terrace, Fenton||73|
|Florissant Valley Health & Rehabilitation Center||1200 Graham Road, Florissant||40|
|Green Park Senior Living Community||9350 Green Park Road, Green Park||54|
|Lutheran Senior Services at Meramec Bluffs||1 Meramec Bluffs Drive, Ballwin||40|
|Nazareth Living Center||2 Nazareth Lane, Mehlville||76|
|NHC HealthCare Maryland Heights||2920 Fee Fee Road, Maryland Heights||102|
|Oakwood Estates Nursing & Rehabilitation||5303 Bermuda Drive, Normandy||46|
|St. Sophia Health & Rehabilitation Center||936 Charbonier Road, Florissant||65|
|Stonebridge Maryland Heights||2963 Doddridge Avenue, Maryland Heights||67|
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