42% of nursing home residents test positive

Some facilities still struggling with infection control

NEW DATA RELEASED on Wednesday indicate 42 percent of the state’s nursing home residents have tested positive for COVID-19 and nearly 14 percent of the facilities where they reside are continuing to have problems complying with infection control procedures after two rounds of audits.

The data indicate nearly 14,000 of the 33,151 residents of long-term care facilities tested positive for the coronavirus during baseline testing conducted between April 8 and May 25. Of the 43,102 staff members at the facilities, 16 percent tested positive.

The numbers provide the first glimpse of how wide the virus has spread in long-term care facilities, which are filled with elderly residents who are particularly vulnerable to the disease. The positive testing rate – positive tests as a percentage of total tests – is off the charts compared to almost any other setting.

The death rate is also unusually high. As of May 25, the day the baseline testing effort ended, 3,924 people at nursing homes had died. Presumably, nearly all of those who died were nursing home residents, with relatively few staffers dying. Assuming that’s the case, more than one in five of the residents at long-term care facilities who tested positive ended up dying,

Deaths at nursing homes are continuing to mount. Since May 25, another 523 people have died at nursing homes, bringing the total to 4,447, which means 62 percent of all those who have died from COVID-19 statewide died in nursing homes. On Wednesday, 68 new COVID-19 deaths were reported statewide and all but three of them were at nursing homes.

The state is trying to improve infection control procedures at nursing homes using a four-part audit process. In the initial audit, 360 facilities were audited for compliance with a 28-point checklist and 37 percent failed. The results of a second audit of 230 facilities were announced Wednesday, with 180 in compliance, 49 not in compliance, and one (Town and Country Health Center in Lowell) sort of on the edge – receiving a passing grade but with enough question marks to warrant a reinspection.

The second audit targeted facilities that failed the first audit as well as facilities with historic infection control issues and some just randomly selected. All facilities will be tested at least twice during the four-phase audit process.

Of the 49 that failed to pass this second audit, 32 failed for the second time, while 17 failed this time while passing the first time.

Marylou Sudders, the secretary of health and human services, said many of the facilities deemed not in compliance were having problems with the handling of personal protection equipment, specifically complying with requirements for taking it on and off safely.

Tara Gregorio, president of the Massachusetts Senior Care Association, said many facilities have been complying with guidelines issued by the US Centers for Disease Control but are required to meet more stringent standards set by the state of Massachusetts.

Gregorio said the audits are showing that the reimbursement system used by state and federal agencies for nursing care needs to be revised to place more emphasis on infection control. She said hospitals have staffs devoted to infection control, while most nursing homes assign that duty to a staff nurse who may have other responsibilities as well.

Recognizing nursing homes needed additional funding to deal with COVID-19, the Baker administration steered $130 million to the facilities in April and then another $130 million later that month. The initial $130 million was distributed to all of the facilities. The second $130 million is being distributed in four equal installments. All facilities received an initial share of the money after the first audit. After the second audit, those that failed received 90 percent of their allotment. Gregorio said receiving 90 percent means the loss of about $27,000.

Sudders said the withholding of funds is designed to incentivize nursing homes to come into compliance. “Hopefully it’s a motivation to improve,” she said.

Asked if the audits uncovered any serious problems at nursing homes, Sudders didn’t answer directly.

“There may be a small number of nursing homes which we need to have a different strategy about, whether they continue to be nursing homes in Massachusetts and the like,” she said.

The 32 long-term care facilities that failed both audits include Bear Mountain at Sudbury, Blaire House in Tewksbury, Blue Hills Health and Rehab in Stoughton, Brandon Woods of Dartmouth, Brush Hill Care Center of Milton, Dedham Healthcare, Den-Mar Health and Rehab in Rockport, Fairhaven Healthcare, Fall River Healthcare, Hellenic Nursing and Rehab in Canton, Life Care of West Bridgewater, Maristhill Nursing and Rehab in Waltham, The Meadows of Central Mass in Leominster, Merrimack Valley Health Center in Amesbury, Nevins Nursing and Rehab in Methuen, Northwood Rehab and Healthcare in Lowell, Odd Fells Home in Worcester, Waterview Lodge in Ashland, West Revere Health Center, Wingate at Needham, Wingate at Weston, Woburn Nursing Center, and Seaview Convalescent and Nursing Home in Rowley.

The others were spread among the following municipalities:

Brockton: Brockton Health Center, Guardian Center

Boston: Marion Manor, Mattapan Health and Rehab, Preservation Rehab

Meet the Author

Bruce Mohl

Editor, CommonWealth

About Bruce Mohl

Bruce Mohl is the editor of CommonWealth magazine. Bruce came to CommonWealth from the Boston Globe, where he spent nearly 30 years in a wide variety of positions covering business and politics. He covered the Massachusetts State House and served as the Globe’s State House bureau chief in the late 1980s. He also reported for the Globe’s Spotlight Team, winning a Loeb award in 1992 for coverage of conflicts of interest in the state’s pension system. He served as the Globe’s political editor in 1994 and went on to cover consumer issues for the newspaper. At CommonWealth, Bruce helped launch the magazine’s website and has written about a wide range of issues with a special focus on politics, tax policy, energy, and gambling. Bruce is a graduate of Ohio Wesleyan University and the Fletcher School of Law and Diplomacy at Tufts University. He lives in Dorchester.

About Bruce Mohl

Bruce Mohl is the editor of CommonWealth magazine. Bruce came to CommonWealth from the Boston Globe, where he spent nearly 30 years in a wide variety of positions covering business and politics. He covered the Massachusetts State House and served as the Globe’s State House bureau chief in the late 1980s. He also reported for the Globe’s Spotlight Team, winning a Loeb award in 1992 for coverage of conflicts of interest in the state’s pension system. He served as the Globe’s political editor in 1994 and went on to cover consumer issues for the newspaper. At CommonWealth, Bruce helped launch the magazine’s website and has written about a wide range of issues with a special focus on politics, tax policy, energy, and gambling. Bruce is a graduate of Ohio Wesleyan University and the Fletcher School of Law and Diplomacy at Tufts University. He lives in Dorchester.

Haverhill: Penacock Place, Wingate at Haverhill

Cape Cod: Royal Nursing Center in Falmouth, South Dennis Healthcare