More than 40% of Indiana’s COVID-19 deaths can be traced back to the hundreds of long-term care facilities that care for the most vulnerable Hoosiers, but the state doesn’t breakdown the information by type of facility or track testing of facility staffers.

“Health care workers don’t always get tested in the same way that residents get tested,” said Dr. Kris Box, the state health commissioner. “They may go out and individually get tested [with state contractor] Optum [Serve Health Services] or with their own local health care providers. So consequently, I may not have that information show up in my data.”

The state’s COVID-19 data portal combines deaths in nursing facilities, skilled nursing facilities, residential facilities, assisted living facilities and prisons under longterm care facilities, providing weekly updates.

As of Monday, the latest information available, 732 Hoosiers in long-term facilities had died.

The Indiana Department of Correction maintains its own list of deaths in cases, reporting 19 confirmed and presumed COVID-19 deaths of offenders and staff across 22 facilities.

The state’s care facilities look after some of the most vulnerable Hoosiers. While many patients recover from the virus, those with underlying health conditions, the same populations living in long-term care facilities, are more likely to die from complications related to COVID- 19. Despite this, the state doesn’t track staff testing at these facilities, aside from the Department of Correction data. Box said the state conducted its own staff testing after deploying a strike team, provided tests to facilities or connected staffers with local testing sites.

“There are individuals that go out and get tested on their own and there’s no data that comes back,” Box said. “Going forward, our goal is to test every employee of a long-term care facility — I’m hoping by mid-June.” Last week, the White House recommended that states test all nursing home residents and staff members for COVID-19 during a call to governors. “We really believe that all 1 million nursing home residents need to be tested within next two weeks as well as the staff,” Dr. Deborah Birx, the White House’s coronavirus task force, said according to The Associated Press.

“I can assure you, unfortunately, that that is not going to happen [by the end of the month],” Box said.

In contrast to many states, the Indiana State Department of Health doesn’t name specific facilities where outbreaks have occurred or release aggregate data by region, instead relying on the facilities to inform the families of residents.

“I’m not trying to protect anybody. What I am trying to do is emphasize the importance of that communication occurring between the facility with the residents and with their representatives,” Box said. Box said the families struggling to communicate with their loved one’s care facility about COVID-19 cases should report noncompliance with the state, putting the onus on family members. “We personally are looking into every one of these. I can tell you that I’ve received emails about this … and we look into every single one of those,” Box said. The Joint Information Center said the Department of Health “continues to gather and analyze addition data but does not have data broken down by type of longterm care facility at this time.” The Centers for Medicare and Medicaid Services, which oversees nursing home regulations, requires facilities to report confirmed and suspected COVID-19 cases among residents and staff — information the state said it didn’t have.

“This national requirement provides standardized information to assist with national surveillance on the status of COVID-19 in all nursing homes,” the memo said. “State and local health departments are also able to submit the required data on behalf of nursing homes, although this does not relieve facilities of their accountability to report in accordance with the regulation.”

The federal department also said it would post that data publicly by the end of the month. Box said the state would comply with that requirement.
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