Iowa agency keeps secret the number of COVID-19 staff deaths in nursing homes

Iowa Department of Public Health has refused to disclose how many long-term care workers have died from COVID-19. (Photo by Getty Images)

The Iowa Department of Public Health is refusing to disclose the number of Iowa nursing home workers who have been infected with, or died from, COVID-19.

For months, the department has released only combined staff-and-resident numbers for both infections and deaths in Iowa nursing homes.

The agency has refused requests to separate the number of staff deaths and infections from the number of resident deaths and infections.

The department’s COVID-19 Communications and Emergency Preparedness Planner Alex Carfrae told the Iowa Capital Dispatch Thursday the agency would not provide requested information on staff deaths “due to privacy concerns.”

After being asked to cite the specific law that allows the agency to withhold non-identifying statistical information of that sort, an agency official said the department intends to review its policies and the applicable state laws.

The pandemic’s effect on caregivers is considered particularly important in terms of tracking the spread of the virus in nursing homes. The facilities are home to some of Iowa’s most vulnerable citizens, and yet they often make use of temp-agency workers who are deployed to multiple facilities over the course of a week.

Diane Findley is executive director of Iowa CareGivers.

Di Findley, who heads Iowa CareGivers, a nonprofit dedicated to building a strong direct-care workforce, said her organization has been unable to obtain staff-specific data on infections and deaths.

“The nursing home industry may not want the number of positive cases or deaths of nursing home workers to be part of the news because it can make it even more challenging to recruit and retain workers, which was a problem before COVID-19,” she said. “However, knowing how many nursing home workers have become infected, hospitalized, or even died from COVID-19, would help to inform the state’s mitigation efforts.”

One indicator of how heavily nursing homes rely on temporary or shared workers: The National Bureau of Economic Research recently reported that 7% of smartphones appearing in a U.S. nursing home also appeared in at least one other senior-care facility, even after visits by residents’ family and friends were restricted.

The typical nursing home has, on average, staff connections with 15 other care facilities, the report concluded.

“What our research is suggesting is that the real culprit here, epidemiologically, appears to be shared staff,” Keith Chen, professor of behavioral economics at UCLA and a lead author of the report, told the New York Times last month.

“There’s a tremendous number of staffing agencies that spring up to spread workers across nursing homes,” Chen told the Times. “But that’s exactly what you don’t want in the middle of a respiratory pandemic.”

Although IDPH isn’t releasing staff-specific or resident-specific data, four other governmental agencies — two federal, two state — have disclosed some of that same information, often in far greater detail than what’s requested of IDPH.

For example:

  • In July, the Iowa Department of Human Services disclosed that 34 residents and 51 staffers at six state-run facilities had tested positive for COVID-19 since the beginning of the pandemic. The agency took the additional step of reporting the precise number of staff infections within each of the facilities.
  • In June, the federal Centers for Medicare and Medicaid Services published a state-by-state tally of nursing home staff deaths. At that point, CMS, reported, nine workers in Iowa nursing homes had died — but CMS has since acknowledged that the database from which that information was drawn is seriously flawed.
  • Like DHS, the Iowa Department of Inspections and Appeals routinely discloses staff-specific data, and even ties those deaths to the specific care facilities where the individuals worked or lived. The agency also discloses the workers’ job titles and, in some cases, the exact date they tested positive for the virus. The problem with the DIA data is that it’s only disclosed in relation to verified regulatory violations in those same homes, so the information remains unavailable for the vast majority of Iowa care facilities.
  • Currently, the federal Centers for Disease Control and Prevention shares CMS-collected data on resident-only deaths in every state. The agencies report that in Iowa nursing homes, 643 residents have died. IDPH says there have been a total of 704 deaths among Iowa nursing home residents and staff, which suggests 61 Iowa nursing home workers have died of COVID-19 since the pandemic began. But that’s assuming the state and federal agencies define deaths and nursing homes in the same manner and are equally up to date in their reporting.
Randy Evans
Randy Evans is executive director of the Iowa Freedom of Information Council. (Photo courtesy of Iowa Freedom of Information Council.)

Randy Evans, executive director of the Iowa Freedom of Information Council, questioned IDPH’s rationale for keeping secret the number of staff deaths.

“Once again, the Iowa Department of Public Health is showing that its first inclination is secrecy, rather than sharing information that helps the people of this state understand the scope and danger of the coronavirus,” Evans said. “The IDPH does not cite these supposed privacy concerns when it tells Iowans how many babies are born in this state each year, or how many marriage licenses are granted. So there is no legitimate reason for the department to trot out this bogus privacy reason for refusing to tell Iowans how many employees in care centers have died from coronavirus.”

Findley noted that for the nurse aides who provide 80% of the direct, hands-on care in nursing homes, social distancing at work is not an option, and that places the workers at even greater risk of contracting and spreading the virus.

“Knowing the occupations of those who are infected or dying from COVID-19 is also important to shed light on wage and other equity disparities that exist with the pandemic,” Findley said. “We should all care about and pay tribute to the nursing home and other health care workers who have literally put their lives on the line under sometimes horrific conditions.

Editor’s note: Story has been updated to correct that Iowa Department of Public Health’s figure of 704 deaths represents long-term care residents and staff.