{"id":120187,"date":"2020-06-17T13:24:56","date_gmt":"2020-06-17T20:24:56","guid":{"rendered":"https:\/\/calmatters.org\/?p=120187"},"modified":"2021-09-29T10:57:58","modified_gmt":"2021-09-29T17:57:58","slug":"nursing-homes-assisted-living-covid-coronavirus-data-statistics-deaths","status":"publish","type":"post","link":"https:\/\/calmatters.org\/_zh\/health\/coronavirus\/2020\/06\/nursing-homes-assisted-living-covid-coronavirus-data-statistics-deaths\/","title":{"rendered":"Counting the dead: Nursing home COVID data a ‘tangled mess’"},"content":{"rendered":"
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\u603b\u4e4b<\/strong><\/p>\n\t\t\t\t\n\n\t\t\t\t\n\t\t\t\t

Throughout the pandemic, government officials have struggled to accurately track the thousands of vulnerable seniors and disabled people who contracted COVID-19 in nursing homes.<\/p>\n\t\t\t\t\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\n\t\t\n

Even a top epidemiologist, let alone a family member, might find it hard to tell just how many of the New Vista Nursing and Rehabilitation Center\u2019s elderly and frail residents fell ill or died of COVID-19 in recent weeks.<\/p>\n\n\n\n

County officials reported that 45 patients at the 121-bed nursing home in Los Angeles were infected. Eleven had died as of June 1.<\/p>\n\n\n\n

But a look at state and national data revealed something different: the California Department of Public Health showed that New Vista had 45 cases but no deaths, and federal data released June 4 showed no cases or deaths at all.<\/p>\n\n\n\n

Throughout the pandemic, government officials from the smallest of California counties to Washington, D.C., have struggled with the critical task of tracking the tens of thousands of vulnerable seniors and disabled people who contracted COVID-19 in nursing homes. They have partly relied on these homes to self-report. They also have changed methodologies and set up electronic reporting systems that didn\u2019t always work as planned.<\/p>\n\n\n\n

It\u2019s an especially daunting task in California, requiring the good-faith efforts of 1,224 skilled nursing facilities that serve a frail population of about 120,000<\/a>. A CalMatters data analysis finds that the state has both over-reported and under-reported COVID-19 cases and fatalities for individual homes. One Pacific Grove nursing home in late May was reported as having a death<\/a> when it did not.<\/p>\n\n\n\n

Preliminary federal data<\/a> released in early June for every nursing home in the country has complicated the picture even more.<\/p>\n\n\n\n

As a result, it\u2019s nearly impossible for the public to tell for sure how many COVID-19 positive residents and workers any one nursing home or assisted living facility has on any given day, or has had earlier in the pandemic.<\/p>\n\n\n\n

\u201cIt\u2019s such a tangled mess of differing facts,\u201d said Brian Lee, executive director of Families for Better Care, an Austin-based long-term care advocacy group. \u201cIt just leaves people confused.\u201d<\/p>\n\n\n\n

Public health experts say it\u2019s not surprising that gathering COVID-19 case data is a messy undertaking during a fast-moving pandemic when testing still remains limited and people can infect others without ever showing symptoms. <\/p>\n\n\n\n

\u201cWe\u2019re almost at 2 million cases nationally \u2013 this is unprecedented in terms of case counting,\u201d said Dr.<\/strong> Jeffrey Engel, who recently stepped down as executive director of the Council of State And Territorial Epidemiologists<\/a>, and is now the group\u2019s senior adviser. Engel said public health officials must gather data as accurately as possible, but what\u2019s more important is how quickly and competently they respond to individual outbreaks in skilled nursing facilities.<\/p>\n\n\n\n

Many state health departments, including the California Department of Public Health, call skilled nursing homes directly rather than waiting for self-reported data during outbreaks. The health departments also collect test data directly from public and commercial laboratories.<\/p>\n\n\n\n

\u201cWe\u2019re not waiting for perfect data before making policy decisions, but we need good data to tell us how what we\u2019re doing is helping.\u201d<\/p>Democratic Sen. Richard Pan, Sacramento<\/cite><\/blockquote><\/figure>\n\n\n\n

Still, the rapidly changing data makes it hard for families who need to move a loved one into a nursing home or assisted living facility \u2013 or monitor relatives already there \u2013 to get information they need to make decisions. Outside professionals, such as occupational therapists or physicians, who regularly visit skilled nursing facilities, also want to know what they\u2019ll face when they arrive.<\/p>\n\n\n\n

And, inconsistent data makes it hard for lawmakers to see if their policies are working, said state Sen. Richard Pan, a Sacramento Democrat.<\/p>\n\n\n\n

\u201cWe\u2019re not waiting for perfect data before making policy decisions,\u201d said Pan, a physician, \u201cbut we need good data to tell us how what we\u2019re doing is helping.\u201d<\/p>\n\n\n\n

The stakes couldn\u2019t be higher. On June 16, California\u2019s public health agency reported that 11,432 nursing home residents had tested positive for COVID-19 since the pandemic began and 2,154 had died.<\/p>\n\n\n\n

Starting in April, California made data about the state\u2019s 1,224 individual skilled nursing facilities public, joining at least 31 other states<\/a> that have released lists of facilities with COVID-19 cases. Lee praised the state for its transparency, even if flawed, noting that Arizona state officials successfully went to court<\/a> to prevent the public release of information from specific homes. <\/p>\n\n\n\n

But California\u2019s facility-level information at first wasn\u2019t easy to find, requiring a number of clicks on the Department of Public Health\u2019s website and the ability to download a spreadsheet. Now, you can search the agency\u2019s online database<\/a>, updated daily, for the name of a specific skilled nursing facility. You have to dig deeper into the agency\u2019s website to find a list of assisted living facilities<\/a> with COVID-19 cases, however, and that information isn\u2019t searchable.<\/p>\n\n\n\n

That poses a challenge for families who may have to urgently find a skilled nursing facility or assisted living placement for a relative who is recovering from a fall or illness and needs significant care, Lee said.<\/p>\n\n\n\n

\u201cThey\u2019re like deer in the headlights and they don\u2019t know where to turn,\u201dLee said. \u201cFamilies want honesty.\u201d<\/p>\n\n\n\n

The California Department of Public Health notes many caveats on its data, including that facilities self-report data, and that deaths of skilled nursing residents that occur in hospitals after 14 days may not be reported as nursing home deaths. In some cases, deaths may be double-counted and not coincide with county-level data because of different reporting standards.<\/p>\n\n\n\n

The agency maintains \u201cregular contact with skilled nursing facilities across the state including daily check-in calls. We monitor daily for non-reporters and follow up with facilities by phone to ensure data is tracked for all facilities,\u201d said spokesman Mark Smith in an email.<\/p>\n\n\n\n

California also has required all skilled nursing facilities to test all of their residents and healthcare workers for COVID-19 by June 30 and is reporting that \u201cbaseline\u201d data<\/a> online.<\/p>\n\n\n\n

The federal government chose to allow nursing homes not to report<\/a> COVID-19 cases before early May, although they could voluntarily do so. It appears that New Vista did not report its early cases, because it didn\u2019t have to; they occurred before early May. The home\u2019s COVID-19 deaths may never show up in federal data. <\/p>\n\n\n\n

Jean Perez, an administrator for New Vista Nursing and Rehabilitation Center, said \u201ceverything is being done per guidelines\u201d in the nursing home\u2019s data reporting. She declined to comment further. <\/p>\n\n\n\n

\u201cNursing homes are mandated to self-report, but enforcement is almost impossible, if there are no inspections on the ground,\u201d said Mike Dark of the San Francisco-based California Advocates for Nursing Home Reform. \u201cWhat you have is many facilities who see COVID reporting as a business problem that could hurt future profits, so they don\u2019t have an incentive to report. And they\u2019re not being caught.\u201d<\/p>\n\n\n\n

The Centers for Medicare & Medicaid Services, which released the federal data, \u8bf4\u8fc7<\/a> that, starting June 8, it may fine skilled nursing facilities hundreds or even thousands of dollars for each week they fail to report.<\/p>\n\n\n\n

\u201cWhat you have is many facilities who see COVID reporting as a business problem that could hurt future profits, so they don\u2019t have an incentive to report.”<\/p>MIKE DARK, CALIFORNIA ADVOCATES FOR NURSING HOME REFORM<\/cite><\/blockquote><\/figure>\n\n\n\n

Dr. Dawn Terashita, associate director of Los Angeles County\u2019s Acute Communicable Disease Control Program, said the data disparities among local, state and federal agencies are an unfortunate consequence of trying to provide as much real-time information as possible to the public.<\/p>\n\n\n\n

\u201cThis is one of the hazards of giving everyone transparency,\u201d Terashita said. \u201cSometimes there\u2019s an error because you got the name of a home wrong or a false positive on a test.\u201d<\/p>\n\n\n\n

Deborah Pacyna, spokeswoman for the California Association of Health Facilities, an industry group, said nursing home administrators had been calling her group saying the data they reported was incorrectly logged by state public health officials.<\/p>\n\n\n\n

But in other cases, nursing homes did not appear to report their data for days, although that has greatly improved in recent months, CalMatters\u2019 data analysis shows. Between 56% and 95% of nursing homes have reported their data to the state on any given day, although compliance rose as the pandemic progressed. It\u2019s difficult to tell whether the homes were failing to report or if the state public health agency wasn\u2019t logging their data.<\/p>\n\n\n\n

Engel, the senior advisor to the Council of State and Territorial Epidemiologists, suggests that family members take the current publicly available case data on nursing homes with some skepticism and ask tough questions of nursing home or assisted living administrators before placing a loved one in a home. Families should ask administrators how many COVID-positive residents and staff are currently at the facility, how they are being isolated from uninfected residents, and what specific measures are in place to prevent infection.<\/p>\n\n\n\n

Families also can search skilled nursing facility inspections and ratings by name or city at Nursing Home Compare<\/a>, a federal government consumer website. The California Department of Public Health also provides detailed nursing home information, including ownership records and disciplinary history, in its searchable database.<\/a><\/p>\n\n\n\n

\u201cI feel badly for anyone who has to put someone in a nursing home now; that\u2019s a really tough place to be in now during COVID,\u201d Engel said. But, as the pandemic moves into a second wave in the fall and winter, he added, \u201cwe think we can get into a place where the data are meaningful, timely, and complete.\u201d\u00a0<\/p>\n\n\n\n

CalMatters COVID-19 coverage, translation and distribution is supported by generous grants from the Penner Family Foundation, Blue Shield of California Foundation and the California Health Care Foundation.<\/em><\/p>","protected":false},"excerpt":{"rendered":"

Throughout the pandemic, government officials have struggled to accurately track the thousands of vulnerable seniors and disabled people who contracted COVID-19 in nursing homes.<\/p>","protected":false},"author":166,"featured_media":120150,"comment_status":"open","ping_status":"closed","sticky":false,"template":"single-feature.php","format":"standard","meta":{"_acf_changed":false,"_stopmodifiedupdate":false,"_modified_date":"","newspack_ads_suppress_ads":false,"newspack_popups_has_disabled_popups":false,"newspack_sponsor_sponsorship_scope":"","newspack_sponsor_native_byline_display":"inherit","newspack_sponsor_native_category_display":"inherit","newspack_sponsor_underwriter_style":"inherit","newspack_sponsor_underwriter_placement":"inherit","apple_news_api_created_at":"2020-06-17T20:25:01Z","apple_news_api_id":"6a702943-3812-48e6-b25c-646f383168ca","apple_news_api_modified_at":"2021-09-29T17:58:02Z","apple_news_api_revision":"AAAAAAAAAAAAAAAAAAAABA==","apple_news_api_share_url":"https:\/\/apple.news\/AanApQzgSSOayXGRvODFoyg","apple_news_cover_media_provider":"image","apple_news_coverimage":0,"apple_news_coverimage_caption":"","apple_news_cover_video_id":0,"apple_news_cover_video_url":"","apple_news_cover_embedwebvideo_url":"","apple_news_is_hidden":"","apple_news_is_paid":"","apple_news_is_preview":"","apple_news_is_sponsored":"","apple_news_maturity_rating":"","apple_news_metadata":"\"\"","apple_news_pullquote":"","apple_news_pullquote_position":"","apple_news_slug":"","apple_news_sections":[],"apple_news_suppress_video_url":false,"apple_news_use_image_component":false,"_spanish_translation_id":0,"_is_translation":false,"_newspack_byline_active":false,"_newspack_byline":"","newspack_content_restriction_is_exempt":false,"newspack_featured_image_position":"","newspack_post_subtitle":"","newspack_article_summary_title":"Overview:","newspack_article_summary":"","newspack_hide_updated_date":false,"newspack_show_updated_date":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[28393,9],"tags":[65003,26758,26759,2695],"legislator":[],"bill":[],"newspack_spnsrs_tax":[],"coauthors":[32162],"class_list":["post-120187","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-coronavirus","category-health","tag-aging","tag-coronavirus","tag-covid-19","tag-nursing-homes","entry"],"acf":[],"apple_news_notices":[],"yoast_head":"\nNursing home COVID-19 data is a 'tangled mess' - 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