Federal coronavirus numbers on nursing homes show devastating impact; full scope remains unclear | Coronavirus

FAIMON A. ROBERTS III | Staff writer

For the first time, federal authorities on Thursday released nationwide data showing the coronavirus's impact on U.S. nursing homes, though they cautioned that the data is incomplete and inconsistent.

The data dump gives the public the first detailed look at the devastating toll the virus has exacted on nursing homes across the country, some of which have seen scores of vulnerable residents die and hundreds infected. The release was hailed by transparency champions and senior advocates, though the data comes with some major caveats. 

This much seems clear: there have been at least 95,000 cases and more than 31,000 deaths in nursing homes from the virus since the pandemic began earlier this year. Those numbers are likely undercounts, as not every one of America's 15,000-plus nursing homes reported data to the federal Centers for Disease Control and Prevention, and some of the data doesn't stretch back to the beginning of the pandemic.

The 31,782 deaths in nursing homes would represent about 28% of all U.S. deaths from COVID-10 as of this week -- though that percentage may rise as the federal data improves. Still, in Louisiana, the share of coronavirus deaths that have occurred in nursing homes is far higher: 43% as of this week, according to the most recent data released by the Louisiana Department of Health. 

The reasons for that disparity aren't immediately clear. But compared to other states, Louisiana steers an abnormally large share of its health-care money into nursing care rather than home- or community-based care, and many elderly people who need care find themselves with no choice but a nursing home. The quality of Louisiana's nursing homes is also generally low, experts say.

But it's also important to note that the federal data appears to be incomplete, and it may be dated. The CDC in May directed all federally certified nursing homes in the country to report to it any impacts from the coronavirus impacts. The CDC turned the data over the Centers for Medicare and Medicaid Services, or CMS, which oversees nursing homes around the country. But the totals were self-reported by nursing homes, and were inconsistent, CMS said. 

The data was due May 17, but homes got a two-week grace period.

In Louisiana, the CMS data does not appear to be nearly as current as what the state reported June 1, when the Department of Health last released nursing home information. According to the state figures, there had been 1,152 deaths in nursing homes, of the state's 2,690 total coronavirus deaths. That same day, the state reported 4,739 confirmed coronavirus cases in nursing homes.

CMS, by comparison, reported 920 Louisiana nursing home deaths as of Sunday, and 3,300 total cases in Louisiana.

CMS warned users to tread carefully with the information.

"Due to how some facilities submitted data, and since this is a new program, some data limitations exist and we caution users to consider these limitations when analyzing the data," a disclaimer on their website reads.

Brian Lee with Families for Better Care, a senior care resident and family advocacy group, praised CMS for finally releasing the data. 

"On the one hand, it's great," Lee said. "We know more today than we did yesterday."

But CMS is still working out the bugs in its reporting and data collection, he said, and there are some glaring errors.

"It's fraught with discrepancies," Lee said. "A lot what has been published is wildly erratic."

For instance, the CMS data show 753 deaths at a home in New Jersey where there are only 96 beds, Lee noted. And a Washington state nursing home where more than 30 residents died reported zero deaths to the CDC.

"Take it with a grain of salt," Lee said. CMS plans to update the data in two weeks and then weekly thereafter.

"We will hopefully see this fuzzy picture come into focus," he said.

Industry groups are issuing similar caveats. Louisiana Nursing Home Association Executive Director Mark Berger said in a statement that it's too soon to compare Louisiana to other states.

"There are variances in how states report and attribute deaths," he said.

But generally the federal information hammers home what has been known for some time: coronavirus has decimated the country's nursing homes, despite restrictions on visitors and resident interactions that began in mid-March and were extremely strict in some cases.

According to the numbers released Thursday, there have been 95,515 coronavirus cases in nursing homes around the country. There have been another 58,288 suspected cases, according to CMS. 

Those totals will doubtless grow. More than 1,700 of the 15,413 U.S. nursing homes did not report data to CMS. Those homes could face penalties of $1,000 for the first week they do not report, and $1,500 for the second, CMS officials said. In addition, some homes reported data going back to the beginning of the coronavirus crisis in March, while others just reported a single week's data, making the counts inconsistent, officials said.

The release from CMS was the culmination of weeks of pressure from activists and family members, as COVID wreaked havoc in nursing homes around the country, causing outbreaks that led to dozens of deaths in some cases. CMS announced in April it would begin requiring the homes to report and it gave them until May 17 before extending a two-week grace period.

In Louisiana, similar pressure, along with CMS' decision to disclose the numbers at the federal level, spurred the state to begin releasing nursing home data on May 18.

The deadliest outbreaks in Louisiana have been at Forest Manor in Covington, where 37 residents have died, and at J. Michael Morrow in Arnaudville, where 34 have passed away. Several other homes, many in the New Orleans area, have seen more than 20 deaths.

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FAIMON A. ROBERTS III | Staff writer


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