If Marylanders have to make a quick decision about where to place an aging loved one, the state health department website lists how assisted living and nursing homes have fared during the pandemic.
More than 60% of Maryland's COVID-19 deaths are linked to long-term care facilities. But the News4 I-Team found many of those deaths have vanished from the state's website, making it look like far fewer homes have had serious outbreaks.
"It's just unacceptable," said Leni Preston, a health consumer advocate. "If you're going to make an informed decision, you don't want somebody else deciding what information you need. You want all of the information."
The I-Team began keeping track of the outbreaks in Maryland's long-term care facilities in late April when Gov. Larry Hogan mandated that the list be made public. In mid-June, the weekly number of reported deaths began dropping, as homes where dozens of people died and hundreds became infected were removed from the outbreak list.
"It leads me to think, well, there are only a hundred sites with a problem," said Preston. "That is not full transparency."
Coronavirus Cases in DC, Maryland and Virginia
COVID-19 cases by population in D.C. and by county in Maryland and Virginia
To date, the state has removed at least 120 outbreak facilities and the deaths of more than 1,000 residents and staff from the online list. In the fine print, the state explains that facilities are removed from the list when 14 days have passed with no new cases. Never mind if existing residents are still infected or if dozens have died in the past few weeks or months.
News updates for Washington, D.C., Maryland and Virginia
"I mean, when that little caption says in very small font, 'Oh, you know, sites get taken off after 14 days.’ I mean, that's not particularly useful," Preston said.
Sagepoint Senior Living in La Plata, where health inspectors issued $380,000 in fines for COVID-related deficiencies, is no longer on the publicly posted outbreak list. To date, at least 144 residents and staff have become infected and 37 have died.
Last Tuesday, Potomac Valley Rehabilitation and Healthcare in Rockville was on the list with 144 cases and 32 deaths. On Wednesday, it was removed from the list. Yet Brookdale Towson, with just one infected staff member and no deaths, is on the public list.
"It's not a level playing field," Preston said.
Joe DeMattos, president of the Health Facilities Association of Maryland, agrees and says he's not aware of any industry leaders requesting that outbreaks be removed from the state website.
"We won't know how to beat this until we know where we are now, and so we advocate for transparency and knowledge," DeMattos said.
DeMattos reiterated the need for fairness, since many of the long-term care facilities compete for customers. Those shopping around might not interpret the numbers correctly, if they can locate them at all.
"We're still struggling with it in one respect because we still don't have the context of reporting. You know, most people can't frame those numbers," said DeMattos.
There have been some homes where everyone has recovered and the COVID outbreak is over. A health department spokesman said the website is meant to offer a "point-in-time picture" and that if someone new tests positive, the home goes back on the list along with all of its cases and deaths to date.
The state posts the lower numbers in bold print at the top of its nursing home data web page next to the list of corresponding facilities from that week. Three weeks ago it added summary data to the bottom of the page, revealing the much higher total counts of cases and deaths. There is no corresponding list of cumulative outbreak facilities to match those numbers.
The U.S. Centers for Medicare and Medicaid Services has a federal website which tracks COVID cases and deaths, but its data is also incomplete. The CMS site only requires homes to submit cases and deaths since early May, and it does not include assisted living facilities, since those are state-regulated.
Preston says Maryland leaders must be transparent if they want to build trust from the public.
"We would want to know what's been happening at that site from the beginning of the pandemic," said Preston. "And those sites should not be taken off the list."
Reported by Jodie Fleischer, produced by Rick Yarborough, and shot and edited by Steve Jones and Jeff Piper.