Iowa withholding names of nursing homes with COVID-19 cases

Published: Apr. 21, 2020 at 4:35 PM CDT
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UPDATE: The Centers for Medicare and Medicaid has now issued an order that long-term care facilities must notify staff and residents of a COVID-19 case within 12 hours and provide weekly updates afterwards. It also now requires nursing homes report cases to the CDC. This rule came after reports nationally of nursing homes failing to report cases to staff and families. The Trump Administration also noted the importance of transparency in reporting COVID-19 cases at nursing homes.

“Nursing homes have been ground zero for COVID-19. Today’s action supports CMS’ longstanding commitment to providing transparent and timely information to residents and their families,” said CMS Administrator Seema Verma. “Nursing home reporting to the CDC is a critical component of the go-forward national COVID-19 surveillance system and to efforts to reopen America.”


As of Tuesday, nursing home residents account for 51% of Iowa's 84 deaths from COVID-19. But Iowa health officials refuse to identify all facilities with a confirmed case, like several other states are doing.

allows health officials to name facilities "when the state epidemiologist or the director of public health determines such a release of information necessary for the protection of the health of the public." However, Iowa has only identified facilities with at least 3 positive cases among residents. As of Thursday,

State epidemiologist Caitlin Pedati did not directly explain why the state is choosing not to identify all long term care facilities with a COVID-19 case, only saying the state is working with facilities as soon as a single case is reported.

Bickford Senior Living Center has taken a different approach. It is publishing the cases at each of its 69 facilities in 10 states, including 13 in Iowa,

. That includes 3 cases, 1 active, at it's Iowa City location.

"Just because a community has COVID-19 doesn't mean that community did something wrong or is a bad community," Andy Eby, Bickford co-owner, said.

Eby said the leadership opted for transparency after putting themselves in the shoes of residents and their families.

"Viruses like this create a great sense of fear in the public," Eby said. "So people start telling stories of what may exist when that may or may not be true. They are able to settle that fear, go to the website and have the most accurate information."

Publishing all facilities with COVID-19 cases, Eby argues, will call attention to the desperate need for protective equipment and what he calls the heroic efforts of staff.

"That's why I think being transparent with the information so we know how big of a deal it really is will help us get more support at a state and national level," Eby said.

Iowa is not alone in hiding the identity of nursing homes with COVID-19, but many others do not hide it. Two of Iowa's neighbors,


, publish each facility with a positive case along with the total count at each facility.

Last weekend, facing the threat of a lawsuit and pleas from AARP, Florida Gov. Ron DeSantis ordered its state to publish all facilities with a positive COVID-19 case. That list does not give a count at each home. Desantis cited transparency and public health as a reason for the reversal, along with added pressure of public scrutiny to ensure nursing homes follow state regulations.

"I don't want to be in a situation where the families don't know," DeSantis said.

Iowa nursing homes are required to alert health officials to a positive COVID-19 case but we could not find any requirements to notify other residents or families.

Linn County Public Health this week refused to name two facilities it was investigating for a possible outbreak.

"We would not be naming that facility as that would put undue stress on that facility as it cares for their staff and their residents," Heather Meador with Linn County Public Health, said, at a news conference Monday.

Eby said the opposite has been true at Bickford, saying the transparent information made less work for his staff.

"By putting cases online, becoming transparent with the public, that lessens the burden for them of all the questions they have to answer because so many families have so many questions," Eby said. "If you put all that information online it makes it easier for our people to respond appropriately."

After asking several follow-up questions, the department cut-off our requests for more information during the news conference.

Eby saidhe hopes more nursing homes and health officials follow their lead in transparency on COVID-19 cases.

"National, local and state health care agencies need to step up communication and the transparency of the information because the only way we get through this situation is to deal with what we know," Eby said.