Maricopa County Department of Public Health is reporting for the first time that a staffer at a long-term care facility has died from COVID-19. The death comes as nursing homes and assisted-living facilities struggle to stay fully staffed as they're hit by the pandemic.

Since the outbreak, 161 long-term care staffers in the state's largest county have been confirmed to have COVID-19, the respiratory disease caused by the new coronavirus. Of those, nine have been hospitalized.

The county would not release information on the person's identity, age, or name of the care facility where the person worked.

Long-term care facilities — which include nursing homes, assisted living, rehabilitation and hospice facilities — are already struggling to stay fully staffed. The COVID-19 pandemic has forced employees with coronavirus symptoms, or other illnesses, to have to stay home and miss work. Others have quit because they worry they will catch the highly infectious virus and infect their families.

"I expect this to get worse, quite frankly," said Pam Koester, the CEO of Arizona LeadingAge, an association that represents about 60 nonprofit long-term care facilities.

She said some companies are providing extra pay to employees during the pandemic, calling it "appreciation pay" or "COVID-incentive pay" or "hero pay." They are trying to avoid any negative connotations, such as terms like "hazard pay," she said.

David A. Voepel, executive director of the Arizona Health Care Association, an association that represents long-term care facilities, said there were staffing shortages before the COVID-19 pandemic.

"It’s a mission-driven business," he said. "So you really have to want to be in long-term care. And now with COVID coming into some of the buildings, you see a depletion of staff, and it becomes a struggle," he said.

He predicted staff attrition will become a bigger problem as time passes.

"They're getting worn out," he said of the employees.

An executive order signed by Gov. Doug Ducey will allow 62 hours of on-the-job training for assisted-living caregivers. That should help those facilities, but such caregivers can't work in nursing homes, Koester said.

The staffing stresses come as COVID-19 has increased dramatically in long-term care facilities in Maricopa County.

As of Monday, 75 of the county's approximately 500 long-term care facilities had reported at least one case of COVID-19. The county reported 356 cases among residents, of which 47 had died. And deaths at the facilities make up over half of the county's total 84 deaths.

The Arizona Department of Health Services has not released statistics on cases of COVID-19 among staffers at long-term care facilities. An executive order signed two weeks ago by the governor requires facilities to report weekly on cases involving residents, but not staff.

The Arizona Republic has recently reported infections and deaths at two Arizona nursing homes.

A Tucson nursing home has multiple cases of COVID-19 among residents and staffers, and a source told The Republic that more than 20 of its residents are presumed to have died from the illness.

On Tuesday, Pennington Gardens, an assisted living facility in Chandler, confirmed to The Republic that 13 residents have died of COVID-19 complications. Nine employees of Pennington Gardens have also tested positive and five have recovered, a facility spokeswoman said.

Amira Fahoum, a spokeswoman for Pennington Gardens, said in an email that several employees are staying at a hotel to protect their families and prevent further spread of the virus.

"We continue to be proud of the efforts made by those team members that have dedicated, at risk to their own health, to caring for the residents," she said.

Neither the county nor the state has released a list of facility names that have experienced outbreaks of COVID-19, despite a request from AARP Arizona, the state's largest advocacy group for retirees, and despite a national push for such information that has resulted in a growing number of states making the names public. States releasing names of nursing-home facilities with COVID-19 cases include North Dakota, New Jersey, California, Ohio, Minnesota, Oklahoma and Florida.

Patrick Ptak, a spokesman for Ducey, on Tuesday pointed to statements made last week by Arizona Department of Health Services Director Dr. Cara Christ, who said the addresses of such facilities are "protected health information."

Pressed by a reporter about why that information isn't being released, Christ said the state is working with facilities to make sure they let the loved ones of residents know what is going on. But as for releasing the names of facilities, "it's not information the department can give out," she said.

Arizona AARP has maintained that while privacy concerns are understandable, federal law that protects patient medical records applies to individuals, not facilities.

Reach the reporter at anne.ryman@arizonarepublic.com or 602-444-8072. Follow her on Twitter @anneryman.

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