True toll of COVID-19 in nursing homes still unknown

Published: Jul. 9, 2020 at 7:52 PM CDT
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(InvestigateTV) - Delia Satterwhite is almost certain that her brother’s death in a Texas nursing home in April doesn’t count.

The latest data released by the federal government on the impact of the coronavirus on nursing home residents shows that Riverside Nursing and Rehabilitation Center in Austin has had only three cases among residents and a single casualty.

But Satterwhite said she knows of more than a dozen residents who have been sickened with COVID-19, the virus that claimed her brother Stephan Morales on April 16.

“They’ve been lying this whole time,” Satterwhite said of the nursing home staff. “I know for a fact there were 15 cases because the nursing home administrator told me.”

Satterwhite suspects that the nursing home has opted to report to the federal government only cases that happened after May 7, which is allowable under government guidelines. That would make her brother’s death uncounted.

Stephan Morales was 71 when he died on April 16 after contracting COVID-19 while living in a...
Stephan Morales was 71 when he died on April 16 after contracting COVID-19 while living in a nursing home. His sister Delia Satterwhite suspects that his passing isn't included in the official death toll in nursing homes because of government guidelines that allow nursing homes to only tally cases that happen after May 7.(Family-provided)

The coronavirus nursing home data, self-reported by the facilities and compiled by the Centers for Medicare and Medicaid Services, remains flawed, InvestigateTV has found.

Since the data was first released last month, each bi-weekly report has been riddled with errors, inaccuracies and missing data.

CMS officials have ignored repeated requests from of members of Congress to explain the issues, said Rep. Lloyd Doggett, a Democrat from Austin. The agency also has ignored requests from InvestigateTV.

On June 25, the U.S. House Committee on Ways and Means Subcommittee on Health held a hearing on the impact of COVID-19 on nursing homes and the data inaccuracies. Satterwhite also testified at that hearing.

Doggett criticized CMS for waiting more than three months after the virus began its deadly spread across the country’s nursing homes to publicly release the names of facilities with COVID-19 cases and the number of residents and staff infected.

“When they did publish, it was incomplete, riddled with errors,” Doggett said during the hearing.

He also took aim at CMS for writing a rule that allowed nursing homes to report only those cases that happened after May 7.

“It’s become clear this was not responsive in disclosing the true scope of the crisis,” Doggett said.

In April, CMS announced that it was requiring nursing homes to report COVID-19 cases and deaths among residents and staff weekly. The first batch of data was released by CMS June 4.

But CMS cautioned in a disclaimer on the CMS website, where the data is publicly available, that it could be inaccurate. Some of the inaccuracies can be attributed to the CMS rule allowing nursing homes the option of either counting all cases since the beginning of the pandemic or just those who became sick after May 7.

Life Care Centers of Kirkland in Washington is a prime example. It reports zero deaths even though more than three dozen of its residents died of COVID-19. But they all died before May 8.

“We are doing what CMS is asking of us,” spokesman Tim Killian said when asked why the nursing home was reporting no cases.

CMS, he said, is asking for a snapshot of right now, rather than a cumulative total, adding that "numbers are not always facts."

Yet the data collection and public release was touted as an effort to show the true toll the pandemic has taken on the nation’s 15,700 nursing homes.

“This is part of the Trump Administration’s historic transparency efforts to ensure residents, families and the general public have information about COVID-19 in nursing homes,” CMS said on June 5 announcing the release of the data.

Doggett called the data “inaccurate and inadequate.”

Though reporting is mandatory, 527 nursing homes did not report any data to CMS in the most recent release, InvestigateTV’s analysis shows. Facilities are required to report even if they have had zero cases.

One of the nursing homes with missing data is Dellridge Health & Rehabilitation in Paramus, New Jersey. A month ago, when the case counts were first released, the data inaccurately showed that the 96-bed facility had 753 COVID-19 deaths. It had had 16 at that point.

InvestigateTV found numerous examples discrepancies between CMS data and what states reported on that same day, June 21.

In Michigan, for example, the state reported there had been 1,979 deaths in nursing homes. CMS reported 253 fewer.

In Louisiana, more than 400 deaths aren’t reflected in the CMS data.

New Jersey reported 6,404 deaths. CMS reported nearly 3,000 fewer casualties.

There are inconsistencies involving individual nursing homes, too.

The CMS data shows, for example, that Samaritas Senior Living Grand Rapids Lodge in Michigan leads the country in the number of nursing home deaths, with 171 residents falling victim to the virus.

State data on June 21, however, shows that there have been 24 deaths at that facility with 125 beds.

“While we cannot speak to the questions regarding discrepanies in the agencies’ data, we can state unequivocally that Samiratas has followed reporting guidelines for both the state of Michigan and CMS,” said nursing home spokesman Jeremy Witt.

At Carrington Place of Baton Rouge in Louisiana, CMS data shows that no residents have died.

The state has reported 16 deaths at the facility. The nursing home did not return phone calls seeking comment.

Texas does not release data on individual nursing homes. It only releases aggregate data.

This Google image shows the nursing home that Morales called home for four years.

That makes it impossible for Satterwhite to know for certain that her brother’s death is not among the counted nursing home COVID-19 victims.

A spokeswoman for Riverside’s parent company said she could explain the discrepancies.

“Regency cannot speculate on the cause of inaccuracies found in the data on the CMS website,” Michelle Buckalew said. “However, I can confirm that any new positive COVID case in any of our facilities is reported immediately to the appropriate officials.”

Morales, who suffered from dementia, moved into Riverside in 2016. Satterwhite said she never had any problems with the nursing home or her brother’s care until the pandemic hit and facilities across the country stopped allowing visitors.

On April 3, the nursing home called to tell her that Morales had a fever and a cough. Four days later, she learned he had tested positive. She said she asked the nursing home to send him to the hospital. They did not.

On April 9, she visited him through the window of his room. They exchanged “I love yous.” It was their last conversation.

During the 13 days before his death, Satterwhite said she called repeatedly to get updates and the phone would either ring unanswered or she would be put on hold. She wanted answers.

“I felt like the nursing home was trying to hide the fact the virus was in the nursing home,” she said.

However, its nursing home administrator finally called back Satterwhite – on July 2.

“He said, ‘I understand that you have questions about your brother’s death,’” Satterwhite said.

She wants to know if her brother’s death counted.

If it wasn’t, she said, it is as though “he never even existed. [That] is pretty much what you are telling me . . . My brother’s life. It mattered to me.”

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