INDIANAPOLIS — Hoosier families with loved ones in senior care facilities still don’t have a complete picture of the toll of the coronavirus.
The federal government released site-specific information on confirmed cases and reported deaths in nursing homes last week, but the data have been found to have significant discrepancies and inaccuracies.
“As with any new program, some facilities are going to struggle as they come online and there’s going to be honest errors in data entry,” Seema Verma, the administrator of the Centers for Medicare and Medicaid Services, told reporters last week.
While CMS attributed those errors to nursing homes entering incorrect information, it also said that it had conducted checks to determine whether nursing homes had entered information correctly. Those homes that did were designated as having passed quality assurance checks, and CMS said it withheld data for homes that didn’t pass the checks.
In Indiana, 429 of the state’s 534 nursing homes were marked as having passed the CMS Quality Assurance Check.
But even some facilities marked as having quality assurance reported that some of the information reported by CMS was wrong.
Of the seven nursing homes identified last week in a CNHI News Indiana story based on the data, four homes reached out to the newspaper group to report errors. Three said the reported deaths in their homes were overstated. Another nursing home said it had turned in its May 31 report, though the federal government data shows it had not.
“Wedgewood Healthcare Center had nowhere near the 42 deaths reported. Our data indicates the center had 10 deaths since March. Of those, nine were COVID positive,” Fred Stratmann, who identified himself as a spokesperson, said. “There are many instances of incorrect data being posted on the website and I have been working with media to correct bad numbers.”
Stratmann later clarified that the center, located in Clarksville, had 17 COVID-19 deaths but that seven had occurred at a hospital, away from the facility. Stratmann shared a list of deaths by date.
CMS requires nursing homes to include deaths of their patients that occur at hospitals, rather than just deaths in the homes.
The Indiana Health Care Association, a trade association for skilled nursing facilities and assisted living communities, said it had heard from homes that had difficulty getting registered for the “complex” CMS reporting system and found it “cumbersome” to use.
“We are not sure at this time as to why there are data errors and we understand CMS is looking into these issues,” IHCA said in a statement. “We do not believe errors are due to a lack of effort of nursing facilities, instead it appears there may be interpretations of reporting instructions that are either leading to the wrong data being reported or duplicate data being reported.”
STATE RESISTS RELEASE of data
AARP Indiana, a senior care advocacy group, has pushed the state to release site-specific data, sending Gov. Eric Holcomb a letter May 19. The state AARP didn’t receive a response until June 4.
Indiana and several other states have resisted releasing data. On its coronavirus website, the state reports only aggregate data for all long-term care facilities, which includes nursing homes and assisted living facilities.
”The lack of public information from the state is not only adding more confusion, it’s making our communities less safe,” Sarah Waddle, the AARP Indiana state director, said. “The discrepancies in the CMS numbers ... raises more questions than it answers.
”Hoosiers are now navigating a dizzying patchwork of information that could easily be cleared by a daily release of facility data on the state’s COVID-19 dashboard.”
The CMS’s data showed 1,141 COVID-19 deaths in Indiana nursing homes last week, 200 more than the state’s reported total COVID-19 deaths from the same week.
The state’s aggregate data include more than nursing homes, unlike the federal data, and officials said the 200-death difference could come from methods of reporting.
“We are currently looking into these differences and trying to figure out how we get closer to the real number,” Dan Rusyniak, chief medical officer of the Family and Social Services Administration, said last week. “We do not believe that there are 200 missing deaths from the total count; it’s much more likely an underreporting problem.”
One nursing home claims that 75 of those deaths in the CMS report are a data entry error.
At first glance, Transcendent Healthcare of Boonville had the most COVID-19 deaths in the state with 75 reported. But Tom O’Niones, the president and owner of the facility, shared emails showing the deaths data were an error and that the facility has 75 residents — not 75 COVID-19 deaths.
“In fact, Transcendent ... has NO confirmed cases,” O’Niones said in an email.
DATA PROBLEMS NATIONWID
News organizations in other states reported similar problems and glaring issues with the CMS data.
The Wall Street Journal found one New Jersey nursing home where reported deaths were eight times greater than the number of beds at the facility. The Daily Progress of Charlottesville, Virginia, reported that some homes had difficulty uploading data to the CMS system.
The Detroit Free Press found 33 nursing homes where resident deaths outnumbered reported COVID-19 cases. Kansas City radio station KCUR reported major differences in the dataset for Kansas and Missouri.
One Indiana facility, whose reports were not certified by the CMS quality assurance check, had 522 reported resident deaths (not limited to COVID-19) despite having only 75 occupied beds.
When asked about problems with numbers reported for a specific nursing home, CMS said, “As with any new reporting program, there can be data submission errors in the beginning.
“In an effort to be transparent, CMS made the data ... public as quickly as possible balancing transparency and speed against the potential of initial data errors.”
CMS said it anticipated that its future releases would have fewer errors as nursing home staff adjust to the reporting requirements.
This story was produced with the support of the Investigative Editing Corps.