When it comes to nursing homes, virus doesn’t see stars

CONCORD — The overwhelming majority of coronavirus deaths in New Hampshire have occurred in long-term care settings, and one-fifth of those who died were in three nursing homes run by Genesis Healthcare, according to new state statistics.

The for-profit company, based in Kennett Square, Pennsylvania, has had 46 people die in its nursing homes in Franklin (10 deaths, 70 cases), Bedford (20 deaths, 85 cases) and Manchester (16 deaths, 72 cases). It also operates the Burlington Health and Rehab Center in Vermont, where 11 residents died.

Also, eight COVID-19 cases, all involving staff, were recorded at a Genesis nursing home in Portsmouth. No deaths were reported there.

Overall, there have been 286 coronavirus deaths in the state, 235 in long-term care.

The Centers for Medicare and Medicaid Services reports that nationwide there have been more than 31,000 COVID-19 deaths among nursing home patients, or almost a third of the total pandemic death toll.

Dr. Richard Feifer, the chief medical officer at Genesis, said Monday his company is the largest long-term care provider in New Hampshire with 31 affiliated facilities and more than 3,200 beds. He said Genesis is one of the nation’s largest post-acute care companies. It has more than 350 centers across 25 states.

"All centers follow the same stringent visitation restrictions and a whole host of other precautions,” Feifer said. “As the Centers for Disease Control and Prevention (CDC) and Centers for Medicare and Medicaid Services (CMS) began providing protocols and guidelines for the coronavirus, centers have diligently followed them and in many cases, have gotten out in front of public health guidelines, adopting even more stringent infection precautions than were recommended at the time. We also continue to follow to the letter the direction of the New Hampshire Department of Public Health.”

Medicare.gov has an online tool for comparing nursing homes. It relies on clinical data, health inspections and claims data.

Mountain Ridge Center, run by Genesis in Franklin, gets an overall ranking on the site of one star out of five, or “much below average.”

The company’s Bedford nursing home, Ridgewood, also received a single star.

Its Hackett Hill facility in Manchester received a four-star, or "above average" ranking.

Feifer said new research out of Harvard and Brown universities said that if all precautionary measures are equal, two key factors have been identified regarding a virus entering and spreading in a facility.

"First, the size of a facility – the bigger it is, the more traffic in and out, no matter how many restrictions are in place,” he said. “Second, its location – whether the surrounding community is a high-density area heavily affected by COVID-19."

He noted that most of its facilities with more than five cases of COVID-19 are in the Manchester and Portsmouth areas.

Most coronavirus cases in New Hampshire have occurred in southern counties closer to Massachusetts, which is among the states hardest hit by the disease. 

"The reality is the virus does not distinguish between five-star and one-star facilities. In addition, nursing home residents are inherently more vulnerable to any virus – much less a complex, highly contagious and deadly one like COVID-19," Feifer said. "Again, it comes back to location—whether the surrounding community is dense with COVID-19 (which these communities are) – and size of the facility (more traffic, more cases)."

On the Web:

New Hampshire COVID-19 dashboard: https://tinyurl.com/yd5n5dra

Medicare nursing home comparison: https://tinyurl.com/nm6xom8

New Hampshire COVID-19 outbreaks: https://tinyurl.com/ybrrooon