LANSING, Mich. – Gov. Gretchen Whitmer's administration disputed the methodology and conclusions in a pending report that is expected to say there were thousands more coronavirus-related deaths tied to nursing homes and other long-term care facilities in Michigan than reported by the state health department.
Auditors plan to release their review next week. But in a rare step, the Michigan Department of Health and Human Services director sought to publicly preempt it by questioning how the data was compiled.
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In a letter written Sunday and released Wednesday, Elizabeth Hertel referenced “serious concerns” to the state auditor general's office — including with its plan to combine COVID-19 deaths at facilities that are subject to state or federal reporting requirements and those that are not. That would add 1,036 deaths to the 5,675 that long-term care facilities had reported as of early July, more than 40% of the additional 2,386 deaths likely to be revealed.
Hertel also said auditors will define reportable deaths differently from a federal standard. They are counting residents who were discharged before their deaths, including those who recovered from COVID-19 and returned home or went to hospice. Also being added are residents who were hospitalized for a non-virus reason like a fall but were infected in the hospital, and residents who lived at independent or assisted living facilities that share a campus with a nursing home, she said.
“Stating that long-term care facilities that did not report deaths in the above categories ‘underreported’ deaths is simply not accurate," Hertel wrote.
She also questioned auditors’ use of a disease surveillance system to help tally deaths, citing limitations and contending it is not a reliable way to check if a death is one that should be counted as a long-term care facility death.
The state requires nursing homes, along with adult foster care facilities and homes for the aged licensed to serve at least 13 residents, to report COVID-19 deaths and cases. Thousands of smaller adult foster care and elderly facilities are exempt. So are independent and assisted living communities.
The review was conducted at the request of a Republican lawmaker who in part asked that it account for “all” deaths in long-term care facilities. Rep. Steve Johnson of Wayland said the “undercount” — which is 30% short of the 8,061 deaths estimated by auditors or 42% higher than the 5,675 reported — is “sizable and shocking.”
“This was important information to gather for those throughout our state who have loved ones and relatives in nursing homes and are scared, and sadly those who lost friends and family to COVID-19 while inside of a nursing home or other long-term care facilities,” Johnson said, saying the House Oversight Committee will continue to investigate.
GOP legislators have criticized the Democratic governor for allowing hospitalized virus patients no longer needing acute care, but still in quarantine, to return to designated units in nursing homes as some hospitals faced surging cases early in the pandemic.
Whitmer has said the policy complied with federal guidance, though critics have questioned if it contributed to the virus spreading to vulnerable people.
Nearly a year ago in New York, then-Gov. Andrew Cuomo’s administration was forced to acknowledge a major undercount of nursing home residents who died because it tallied just those who died on facility grounds, not later in the hospital. Michigan includes both.
Long-term care facilities have reported the deaths of 6,216 infected residents and 93 staff to the state during the pandemic. They account for 22% of Michigan's more than 28,200 confirmed deaths.
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