Dr. Mandy Cohen addresses outbreaks in nursing homes.
Dr. Mandy Cohen, NC Secretary of Health and Human Services, discusses the release of information on outbreaks at individual nursing homes and other long-term care facilities. Screen grab from UNC-TV

While outbreaks of the new coronavirus in congregate living settings have been a known factor in confirmed cases in North Carolina and make up the majority of deaths, until Monday the state was not identifying long-term care facilities with outbreaks and not saying how large the outbreaks were.

Thanks to legal pressure from a coalition of news organizations, including Carolina Public Press, the Department of Health and Human Services began revealing that information Monday afternoon, indicating the state will update it at least weekly. DHHS also gave new guidance to counties, which will allow them to share up-to-date information on congregate outbreaks.

The new information begins to fill in the blanks about the substantial role that long-term care facilities have played in spreading COVID-19, the disease caused by the new coronavirus, in North Carolina.

[The latest: North Carolina coronavirus daily updates]

Based on the newly available information, the state’s largest nursing home outbreaks were at:

  • The Citadel at Salisbury in Rowan County with 144 cases and 10 deaths.
  • Pruitt Health-Carolina Point in Orange County with 108 cases and 11 deaths.
  • Durham Nursing & Rehabilitation Center in Durham County with 95 cases and seven deaths.
  • Five Oaks Manor Rehab in Cabarrus County with 74 cases and six deaths.

There were also substantial outbreaks at adult care homes and other types of residential care facilities. Adult care homes are licensed to house adults of any age, typically with cognitive or mental disabilities. These homes cannot provide the type of medical care that nursing homes do, with staff limited to providing medication in most cases.

The largest residential care facility outbreaks were at:

  • Cherry Springs Village in Henderson County with 53 cases and seven deaths.
  • Woodridge Assisted Living Facility in Union County with 27 cases and two deaths.
  • Pine Forest Rest Home in Northampton County with 27 cases and one death.
  • The Social at Cottswald in Mecklenburg County with 23 cases and three deaths.

In some counties with substantial outbreaks, congregate settings have not been a factor. In others, they have played a significant role within a larger outbreak, such as in Durham County with 137 congregate cases out of 539.

But in some counties, the congregate outbreaks are the story, such as in Henderson County, with 109 congregate cases out of 156 total, and in Burke County, where congregate cases make up 62 of the county’s 88 cases.

The state’s full weekly report on all congregate living settings with outbreaks, other than state and federally owned sites of incarceration, can be viewed online.

The congregate facility with the most deaths has been Louisburg Healthcare and Rehab Center in Franklin County with 14. Overall, most known coronavirus-related deaths in North Carolina have been among those living in congregate settings.

So far, DHHS has not broken down outbreaks by residents and staff, so it’s not always clear how many of each are infected.

One mystery the new data resolved was the meaning of a congregate living category that DHHS had been including in its case count of “other.”

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It turns out to be something of a catchall category, including both the eight-person outbreak among residential migrant labor staff at Rudd Strawberry Farm in Guilford County and the two-person outbreak at the Salvation Army Homeless Shelter in Cabarrus County.

The new numbers also fill in information that some facilities had not wanted to make public, even though they were required to give the information to the state

As reported last week, Linda Howard, at Alston Brook in Lexington, said she would not release information publicly and would not say whether that location had a positive COVID-19 case. Data released Monday by the state shows 41 people associated with Alston Brook in Lexington have tested positive for COVID-19, and two people have died. The facility is licensed for 100 residents.

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Frank Taylor is managing editor of Carolina Public Press. Email ftaylor@carolinapublicpress.org to contact him. Kate Martin is Carolina Public Press lead investigative reporter. Email kmartin@carolinapublicpress.org to contact her.

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