It’s not fair to say the state is underreporting long-term care deaths from COVID
It’s not fair to say Michigan health officials underreported the number of COVID-19 deaths for residents of long-term care facilities, the state’s auditor general said Wednesday. to legislators.
Instead, auditor Doug Ringler told lawmakers his office reviewed data sources the state did not find reliable and said his team knowingly included data from unheld facilities. report deaths to the state.
“For long-term care facility-related deaths or related deaths, we knew the department wasn’t tracking all of those we were reflecting in our letter, so we didn’t think the word under-reporting was right. We did. ‘cited as a difference,’ Ringler told lawmakers, referring to the letter with his office’s findings that he recently sent to the Legislative Assembly.
At no time during the three-hour legislative hearing did Ringler say the Michigan Health Department violated the law, intentionally misled the public, or attempted to cover up deaths.
That hasn’t stopped some Republican lawmakers and politicians from using the results to say again — without any specific evidence — that Governor Gretchen Whitmer and her administration killed thousands of Michigan seniors early in the pandemic.
Following:Auditor: Nearly 2,400 more COVID-19 deaths than reported at Michigan long-term care sites
Following:What we know about the impact of Whitmer’s nursing home policies
Ringler defended his team’s work against accusations by Health Department Director Elizabeth Hertel that they politicized their findings. Hertel and his team attempted to preempt the publication of Ringler’s findings, attempting to discredit his work before it was published or widely distributed.
“We did a black-and-white analysis. We identified what we did, we identified the benefits of our work, we identified some of the warts that existed in trying to do data analysis. That’s where in black on white,” says Ringler.
“We said what we meant and we mean what we said.”
Hertel, who also testified, again accused the listener of intentionally providing misleading information. She also deflected or avoided several politically charged questions from lawmakers while generally championing department policies on preventing the spread of COVID-19 in nursing homes or similar facilities.
The auditor’s office found that the health department failed to attribute nearly 2,400 deaths from COVID-19 to long-term care facilities across the state. They looked at deaths from January 2020 to July 2021, finding 8,061 compared to the 5,675 reported by the state.
The auditor and his staff did not accuse the department of hiding these deaths – in fact, they found nearly the same number of overall COVID-19 deaths as the department.
The gap comes down to which deaths should be attributed to long-term care facilities and what everyone considers to be one of those facilities.
The auditor cited various sources, noting that the health department could have done more to find deaths than relying on facilities to report information to the state. He countered Hertel’s renewed assertions about the veracity of certain data by noting that it was cross-checked with additional data sources, including information about Medicare and other systems used by the state. Auditors easily corroborated 85% of a subset of deaths disproved by the health department and likely could have verified more, a staff member said.
Hertel stuck to her earlier critique of the report, noting again that the auditors intentionally used a broader definition of long-term care facilities and therefore obviously arrived at a higher death toll.
“What the Auditor General has released is in no way comparable to the data we share publicly,” Hertel said.
“One of the major flaws in the Auditor General’s report, and something that is clearly misleading, is the application of definitions that do not comply with federal and state legal and regulatory requirements and which appear to have no basis in these standards or any other standard.”
Following:Officials refute report that should allege undercount of deaths in COVID-19 long-term care
Following:Hertel: Michigan not underestimating deaths in nursing homes, but possible in other facilities
The entire hearing and review stems from an executive order Whitmer issued in April 2020 that long-term care facilities must accept residents, even if those residents have tested positive for COVID-19.
House Oversight Committee Chairman Steven Johnson, R-Wayland, argued the order applied to all facilities, not just those required to report death data to the Department of Health. state health.
“Michigan was one of the few states that decided to place COVID-positive patients in these facilities. For us to not count them would be foolish,” Johnson said.
“If you don’t count those (deaths), what you’re saying is fine, that person’s life in that facility was somehow worth less than the life in the facility that had to declare itself. In what world would that make sense?”
Hertel acknowledged that the facility definitions used in the executive order are broad, arguing that was one of the reasons the state revised the order before rescinding it months later.
The administration faced backlash at the time of the order, including from some players in the long-term care industry. However, even industry members agree that the order has never been widely executed in practice.
Melissa Samuel, president of the Michigan Healthcare Association, was one of those experts who criticized the original order. Yet she later told the Free Press that the requirement that facilities not established as regional centers for infected patients accept COVID-19 residents was never fully implemented.
Instead, Samuel and researchers from the University of Michigan pointed to a variety of factors that may have contributed to the rise in deaths in long-term care facilities. This includes a correlation between high community spread and spread within a facility and the high rates of worker exposure early in the pandemic before vaccinations were widely available.
Hertel repeated this Thursday, saying no facility was obligated to take a COVID-positive patient, even after the executive order was issued.
Experts noted that the state did a poor job of collecting data early in the pandemic. They also note that reporting requirements changed during the first chaotic months.
That doesn’t mean there hasn’t been transmission, Marianne Udow-Phillips, founding executive director of the Center for Health Transformation and Research at the University of Michigan, previously told the Free Press. Udow-Phillips said the team was unable to make a definitive analysis of transmissions in central or non-central care homes because they did not have good enough information.
However, Republican lawmakers and activists continue to run with the idea that the governor and his team are responsible for thousands of deaths.
“We are talking about a group of people who lost their lives because of bad public policy,” Senator Lana Theis, R-Brighton, said during the hearing.
After the hearing, Michigan Republican Party communications director Gustavo Portela said Whitmer’s executive order “essentially became a state-ordered death order” and that Whitmer had “blood on his hands.” .
Asked to cite data for the accusation that the governor killed people, a separate Michigan GOP spokeswoman pointed to the auditor general’s report, previous criticisms of the governor’s executive order and Whitmer’s decision to oppose his vetoed a bill that would have mandated sending residents who tested positive for COVID -19 to different buildings or parts of a facility.
None of this information, however, shows that the Governor killed anyone.
Theis did not immediately respond to a request for specific data indicating deaths directly linked to a policy. But she released a statement reiterating her remarks.
Oversight committees are expected to continue to review the executive order and its impact on nursing home residents.
Contact Dave Boucher at [email protected] or 313-938-4591. Follow him on Twitter @Dave_Boucher1.