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Low-rated nursing homes in Cook County fare worst in COVID-19 deaths

They’re more likely to have residents die of the coronavirus than highly rated facilities, a Sun-Times investigation found. A Cook County commissioner is calling for people in the worst-rated nursing homes to be moved.

A 90-year-old nursing home resident touches her window to make contact with a caregiver.
A 90-year-old nursing home resident touches her window to make contact with a caregiver.
Getty

The worst rated nursing homes in Cook County have the highest concentration of deaths from the coronavirus — and some have failed inspections during the pandemic, a Chicago Sun-Times investigation found.

The newspaper studied about 120 longterm-care facilities listed by the state as having at least one resident who came down with the disease or died.

About 28% of the deaths from COVID-19 complications have happened in nursing homes with the lowest federal rating and only 6% in the facilities with the highest rating.

That disparity shows the state should focus testing and inspections in poorly rated nursing homes, experts said.

Cook County Commissioner Brandon Johnson
Rich Hein/Sun-Times file photo

Cook County Commissioner Brandon Johnson said residents of poorly rated nursing homes should be transferred to field hospitals, like the one at McCormick Place, that have been built during the pandemic but haven’t been fully needed.

“Move people into temporary locations until we get a real good handle over this disease,” said Johnson, a Democrat from the West Side. “In this immediate crisis, I’m proposing using those facilities and transforming them into spaces so social distancing as well as other [U.S. Centers for Disease Control] guidelines can be maintained.”

The state should form a commission to study long-term improvements to nursing homes, he said.

As of Friday, 1,553 COVID-19 deaths in Illinois were tied to nursing homes — nearly half of the 3,241 deaths in the state from the disease, according to the Illinois Department of Public Health.

Nursing homes have captured the public’s attention in Illinois and nationally because of the large clusters of coronavirus cases appearing in many of them.

Last month, Gov. J.B. Pritzker vowed to step up testing at nursing homes, including those that don’t report any cases. He pledged to focus on nursing homes in minority communities, which have been hardest hit by the virus.

But the state hasn’t released details on testing in nursing homes, and the governor’s office didn’t reply to an email Friday asking for information about how that testing is being carried out.

As the death toll rises in nursing homes, they’ve become a target of labor unrest and lawsuits in recent weeks in Illinois.

SEIU Healthcare Illinois, a union with 10,000 workers in nursing homes — threatened to strike over wages but reached a tentative agreement Thursday with a proposed contract that includes a pay increase of $2 an hour for workers during the pandemic.

In Cicero, where nine coronavirus-related deaths have been reported at the City View Multi-Care Center, officials in the west suburb have sued the nursing home and state, saying they didn’t do enough to contain the disease.

City View Multi-Care is one of many poorly rated nursing homes that have become cauldrons of the coronavirus in Cook County.

A Sun-Times investigation has found that coronavirus deaths in nursing homes in Cook County are concentrated in low-rated facilities. The federal Medicare program rates nursing homes from one to five stars, with one star being the lowest mark.
A Sun-Times investigation has found that coronavirus deaths in nursing homes in Cook County are concentrated in low-rated facilities. The federal Medicare program rates nursing homes from one to five stars, with one star being the lowest mark.
Caroline Hurley and Frank Main / Sun-Times

The newspaper examined 122 nursing homes that have reported coronavirus cases or deaths and have received a quality rating from Medicare, which oversees and inspects them.

They have a combined average daily population of about 18,000 people.

Medicare gives one star to the worst-ranked nursing homes and five stars to the best.

The one-star nursing homes had 28% of all the coronavirus deaths and the two-star facilities had 30% of them.

In contrast, the five-star facilities had 6% of the deaths.

Measured a different way — the rates of deaths for the average daily populations of the nursing homes — the one- and two-star homes both had rates of nearly 5%, while the rate for the five-star homes was about 3%.

Tamara Konetzka, a professor and health economist in the Department of Public Health Services at the University of Chicago, says she has completed a similar study that looked at reported coronavirus cases and deaths at nursing homes in 11 states, including Illinois.

She also found higher death rates in the lower-ranked nursing homes in Cook County. Of all the places she evaluated, the disparity was the greatest in Cook County.

“It’s actually pretty dramatic . . . a meaningful magnitude of difference,” she says. “So in Cook County, we see this relationship between the star rating and the probability of having a case. But on average, across the states, there is a small relationship.”

Konetzka says she also found that nursing homes with larger minority populations were more likely to have a death or a reported case.

She says public-health officials need to focus their attention on the lowest-rated nursing homes in Cook County.

“I think they’re just less equipped than a five-star facility to put things in motion to protect their residents,” Konetzka says.

“It’s not like the other nursing homes probably don’t need help. But you know, we have to prioritize,” she says. “In terms of focusing resources, it’s got to be about testing and separation, whether that means moving patients elsewhere or limiting traffic between a COVID wing and a non-COVID area of the facility.”

Health economist Tamara Konetzka.
Health economist Tamara Konetzka.
University of Chicago

Johnson points to one of those low-rated nursing homes — Westchester Health and Rehabilitation — as a place that needs intervention. The one-star facility had 47 reported coronavirus cases and 12 deaths — about 14% of its average population of residents.

“This one really jumped out,” Johnson says, adding that he had asked the governor to order a state inspection of the facility.

On Wednesday, Johnson held a news conference outside the Westchester nursing home to highlight its problems.

Afterward, a spokeswoman for the facility released a statement saying workers’ health was being evaluated after each shift, visits were being restricted to limit the spread of the virus and personal protective equipment was being provided.

Other low-rated nursing homes in Cook County have been found to have continuing problems during the pandemic.

For instance, during a COVID-19 focused inspection on April 14, Medicare and Medicaid inspectors found the one-star Bridgeview Health Care Center failed “to follow practices to contain the spread of COVID-19 by proper use of personal protective equipment and proper handling of clean and soiled linen.” Inspectors found no harm so far but a potential for “more than minimal harm.”

That nursing home has seen at least a dozen residents die of complications from the coronavirus — about 10% of its average daily population of 125 people.

Bridgeview’s administrator declined an interview request, saying by email that nine staff members have tested positive for the coronavirus.

Lynnette Jones, a cook at the nursing home, said she and other staffers have been given masks. She said she has no contact with residents, who no longer dine together in the dining room and have meals sent up on carts.

Still, as the mother of a daughter with asthma, she said she’s nervous. And she doesn’t know how many staffers have the virus.

“Hopefully, they’re trying to do the right thing for us,” Jones said. “But it’s scary going home to my daughter.”