ROCHESTER, Minn. — The Centers for Medicaid and Medicare Services on Tuesday, June 2, released figures showing skilled nursing facilities in Minnesota have far fewer cases and deaths of COVID-19 than the national average.
According to the previously unmeasured findings, the average number of cases of COVID-19 in skilled nursing facilities in the U.S. is 62 per 1,000 residents.
The state-by-state data ranged from 0 cases of COVID-19 per 1,000 skilled nursing facility residents in Vermont, to 255 cases of COVID-19 per 1,000 skilled nursing facility residents in the District of Columbia.
Massachusetts has 244 cases per 1,000 residents, Connecticut has 236 cases per 1,000 residents and Illinois has 100 cases per 1,000 residents.
In Minnesota, there are 39.9 cases of COVID-19 per 1000 residents of skilled nursing facilities.
The CMS data also reveal that the average number of deaths from COVID-19 in skilled nursing facilities in the U.S. is 27.5 per 1,000 residents, while in Minnesota the comparable number is less than half that amount, 12.7.
The numbers were the first items discussed at a virtual hearing of the Minnesota Senate committee on Family Care and Aging chaired on Tuesday by assistant majority leader Sen. Karin Housley, R-St. Mary's Point.
Housley opened the hearing, which was broadcast on the Senate YouTube channel, stating she had considered rescheduling the event, given the outbreak of protests over the killing of George Floyd while in custody of the Minneapolis Police Department, but decided the issue remained critical.
The vast majority of deaths from COVID-19 in Minnesota have occurred among residents of long-term care facilities, a statistic that has fed a division over the wisdom of formal health department guidance supporting the discharge of hospitalized patients with COVID-19 into long-term care.
Before Tuesday's CMS report, Minnesota appeared to have an outsized proportion of deaths from COVID-19 in long-term care, an impression that health officials had countered by asserting the state included far more facilities in their reporting than did neighboring states.
Whereas most states count only skilled nursing facilities as representative of all nursing homes, Minnesota has included group homes, residential treatment centers, half-way houses and similar residences in its reporting. In her opening comments, State Commissioner of Health Jan Malcolm took the new CMS data as a vindication.
"I think it applies to the question of 'Do we have something different going on in Minnesota rather than in other states?'" Malcolm said. "We've taken a really inclusive look at congregate care settings, by including adult foster care, group homes, mental health treatment and similar facilities.
"The narrative that's emerged has not been accurate," Malcolm said of the notion that two-thirds of all deaths from the outbreak in the state have occured in nursing homes. "That's not to say there aren't issues where we can get better. . . . But if we are only looking at nursing homes, the percentage of total deaths in the state coming in those sites is 54%."
The health department was not able to present some data requested by state senators, including the percentage of those who have died from COVID-19 in nursing homes who had made an end-of-life determination, or even how many Minnesotans have been discharged from a hospital with COVID-19 and into long-term care.
When Housley asked Malcom why the state couldn't support giving hospitalized seniors with COVID-19 longer stays to recover, Malcolm countered that the health department is concerned about the risk of infection in hospitals.
"It's hard for me to talk to a family member," Housely later said. "They're so frustrated. They tell me 'Just get us universal testing and let me see my mom. Let my mom see her hairdresser, it's been 10 weeks.'"
"We're talking about getting families back with their loved ones. There's real urgency to this. We're three months in and we're still where it was in the beginning. Something has to change here."
"I have to disagree that nothing's changed," Malcolm countered. "We are in a very difficult situation, but we now know which facilities have an issue, and we have helped them solve their issues."
Twelve of the 22 deaths reported Tuesday were among residents of congregate living.
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Minnesota Department of Health COVID-19 hotline: 651-201-3920.
COVID-19 discrimination hotline: 833-454-0148
Minnesota Department of Health COVID-19 website: Coronavirus Disease (COVID-19) website.