Care facility

After weeks of providing only basic information, the Colorado Department of Public Health and Environment released a database on COVID-19 outbreaks at non-hospital health care facilities on Wednesday.

It includes the facility name, county, type of healthcare setting, when the outbreak was investigated, and most important, the number of cases and deaths.

The facilities listed are skilled nursing homes, assisted living centers, independent living (such as senior-only apartments), group homes that serve the disabled and rehab centers. 

Colorado Politics has also added in several facilities listed as having outbreaks by local county public health agencies, and will continue to add that information as it is reported.

The data shows that out of the 357 deaths from COVID-19 reported on April 15, 176, or about 49%, are taking place at the 86 non-hospital facilities with outbreaks. Almost half of the outbreaks are in facilities in Denver and Arapahoe counties, a total of 37. 

Those deaths also make up at least 63% of the deaths for those 70 years old and older, according to CDPHE's April 15 data.

In addition, at least 510 staff at these facilities have tested positive for COVID-19, according to the database.

The Cherry Creek Nursing Center in Aurora has the largest number of confirmed cases, at 45, with 11 deaths. Centennial Healthcare in Greeley has 32 confirmed cases and 18 deaths; the most in the state.

In a conference call with public health officials Thursday, state epidemiologist Dr. Rachel Herlihy said the CDPHE is working with these facilities to manage the outbreaks, which have more than doubled in the past 10 days.

Herlihy discussed strategies for dealing with outbreaks on the call. Once an outbreak is reported, the CDPHE works with the facility to understand why the transmission of the virus is occurring, and what risk factors are in play. They make sure infection control practices are adequate to prevent additional cases. That's work that has been ongoing for a long time, she said.

"Unfortunately, these are really high-risk settings, and we are working diligently and investing in new strategies to prevent these outbreaks from occurring," she said.

On Wednesday, Gov. Jared Polis said there was a "problem with compliance" on safety guidelines. The only executive order to date on non-hospital health care settings was issued on March 12, which directed the CDPHE to "issue all public health orders necessary to protect individuals who reside or are cared for in a Colorado licensed or certified skilled nursing facility, intermediate care facility, assisted living facility, or similar entity." 

Public Health Order 20-20 restricts visitors to skilled nursing facilities, assisted living residences and intermediate care facilities.

Public Health Order 20-20 on nursing homes and related facilities.

Those with identified outbreaks are required to take additional steps:

  • Consult with the county’s local public health agency.
  • Notify CDPHE as the licensing authority.
  • Further restrict visitation after consultation with the local public health agency.
  • Maintain a log of visitors and staff interacting with a patient who is isolated for presumptive or confirmed COVID-19.
  • Be able to identify the staff who interacted with the resident and resident’s environment.
  • Restrict all internal group activities to prevent infection exposure to other residents.

Some  facilities with outbreaks have enacted total bans on visitors, in accordance with guidelines issued March 13 by the Centers for Medicare and Medicaid Services. Those stricter guidelines ban non-essential visitors except in end-of-life situations. 

"Facilities are expected to notify potential visitors to defer visitation until further notice (through signage, calls, letters, etc.)," the CMS guidelines said.

Visitor guidelines issued by the Centers for Medicare and Medicaid Services, issued March 13.

The state is also now reporting data on outbreaks at correctional facilities and meat-packing plants in northeastern Colorado.

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