Andy Eby’s senior living centers are doing something that Iowa's health department won’t: Publish notice of every single COVID-19 case at its facilities.

“This hide-and-hope mentality, I just don’t feel that’s the way to go,” Eby said. “Our customers want transparency.”

Eby is an owner of Bickford Senior Living, which operates in 13 Iowa locations as well as dozens of additional sites in 10 other states.

Residents and staff of nursing facilities are particularly vulnerable to spread of the highly contagious coronavirus and the illness it causes, COVID-19, because of the nature of congregate living and because the people living there fit the profile of those most at risk for serious illness and death from the disease — over 60 and with underlying medical conditions.

Iowa has more than 400 regulated long-term-care facilities. As of Friday, 55% of the state's coronavirus deaths — 17 out of 31 — had been long-term-care residents.

Bickford Senior Living began during the past two weeks posting online notices of positive coronavirus tests at its facilities.

Bickford owners believe the unconventional move is necessary as a matter of public health. The response, they said, has been overwhelmingly positive.

The company thinks it's the first senior care network in the nation to publicly self-report each coronavirus incident on its websites.

"There's kind of a fear from a lot of health care organizations about being transparent with the information because of the backlash," said Alan Fairbanks, another Bickford owner. "We asked ourselves, 'Are we really prepared to do this?' We determined that if we are truly following our values, we would" publish our coronavirus positive tests.

The Iowa Department of Public Health does not make public the names of senior living centers where staff or residents have tested positive until three or more cases have been identified. Iowa also does not make public how many people have died at facilities with outbreaks or whether the positive tests involve residents or workers.

Some state health departments are far more transparent. Minnesota, for example, publishes on a state website the names of each facility with at least 10 residents where at least one coronavirus case has been identified.

Iowa law allows the health department to release more information if Caitlin Pedati, Iowa's medical director and state epidemiologist, determines it necessary to protect public health. So far Pedati has deemed it necessary to release the location and total related cases for sites only after three or more positive coronavirus tests.

Using three cases at a single facility as a measure to alert the public allows state health officials to be confident that they have confirmed that the outbreak is associated with a facility, rather than detecting cases associated with another potential risk factor or source, Sarah Reisetter, deputy director of the Iowa Department of Public Health said Friday during a press conference.

The Iowa Health Care Association, a group that advocates for senior living facilities, issued a statement to the Register in support of the policy shortly after Reisetter's comment.

Because of limited supplies, Iowa is currently not testing all the residents and staff where a coronavirus outbreak is identified. That may change as more widespread testing becomes available, Reynolds said in a press conference Thursday.

"You know eventually hopefully we'll get there; we're just not there," Reynolds said.

As of Friday — the last time the health department responded to a request for updated facility outbreak information — the three Iowa senior care facility coronavirus outbreaks and the total number of infected residents and staff are:

Heritage Specialty Care in Cedar Rapids: 95

Premier Estates of Toledo: 33

McCreedy Home in Washington: 17

Bickford has announced that staff or residents from at least four of its sites — two at a single site in Iowa City — have tested positive for coronavirus.

Eby, in a video last week announcing its policy of online disclosure, said he believes one of the critical questions people want to know is whether there are any coronavirus cases at a facility, particularly for people looking for a senior facility.

“So let’s talk about this. It is the elephant in the room,” Eby said in the video.

Jeanne Bancroft's husband resides at Bickford's facility in Iowa City. Her husband has no symptoms of the virus and is not believed to have had contact with either of the cases at the Iowa City facility where he lives.

Bancroft believes Iowa could become a leader in ending the pandemic if state health officials enact transparency the way Bickford's facilities are and also begin testing all residents and staff of any senior living facility with a single coronavirus case.

"I don't think we as a county, state or country can know what we're dealing with unless we define it," Bancroft said, "and how can we define it if people keep information protected?"

Jason Clayworth is an investigative reporter at the Des Moines Register. He can be reached at 515-699-7058 or jclayworth@dmreg.com.