Nursing home residents account for 1 in 4 COVID deaths in Michigan

Melissa Nann Burke
The Detroit News

At least one in four coronavirus deaths in Michigan have been residents of nursing homes, according to preliminary state data. 

The head of the state Department of Health and Human Services told lawmakers this week that 1,216 deaths in Michigan — 23% of deaths in the state through Tuesday — have been attributed to nursing home residents. 

Nursing home facilities have had at least 4,920 confirmed cases of COVID-19, or 9% of the state's total caseload. The release of the data came as Republican lawmakers have criticized Whitmer administration policies about COVID-19 and nursing homes. 

A worker inside the building wears PPEs while pulling back a curtain to watch the protest.

State officials stressed that the preliminary totals undercount nursing home deaths and cases, since 13% of facilities have not reported this information to the state. 

"As we complete the analysis, these numbers will rise," Robert Gordon, director of the Michigan Department of Health and Human Services, said in testimony prepared for a state Senate panel. 

"We need to clear out duplicates and institutions that don’t belong, but we also need to go back to institutions that haven’t reported and get them to report. While we will begin by asking nicely, we will be prepared to take enforcement action if they do not respond."

Nursing homes and other facilities for the elderly have suffered greatly amid the novel coronavirus pandemic, as older people and those with serious illnesses are among the most at risk for complications and death related to COVID-19. 

Seniors aged 70 and older comprise 69% of COVID deaths in Michigan, with a median age of 77, according to state data. Michigan has roughly 500 nursing homes. 

"It's been incredibly disheartening to see the number of nursing home residents who have gotten sick," Dr. Joneigh Khaldun, Michigan's chief medical executive, said Thursday.

The bulk of nursing home deaths occurred in Southeast Michigan, which has been hit hardest by the virus.

The three-county area of Macomb, Oakland and Wayne counties (including Detroit) had at least 1,372 deaths among nursing home residents, representing a third of COVID deaths in Metro Detroit, Gordon said.

That includes 674 deaths in Wayne, 421 in Oakland and 227 in Macomb, according to preliminary county data. These are undercounts since not all facilities are reporting.

Gordon acknowledged a reporting gap between the number of deaths that Metro Detroit facilities have reported to the county health departments (1,372 nursing home deaths) and what they've reported to the state so far (945), he said. 

"These departments deserve our praise and thanks for gathering these data because they begin to draw a fuller picture of what we are missing," Gordon said.

He said the state is working to expand testing in nursing homes statewide, including using the help of the National Guard at the request of facilities. 

Detroit has tackled outbreaks in its nursing homes and worked to test and retest residents and employees in each facility. As of Friday, the city had reported 315 deaths of nursing home residents out of roughly 1,350 deaths citywide. 

The state had not regularly reported data on nursing home deaths since the start of the pandemic. State health officials were reporting outbreaks by facility online until recently, as it revamps its data collection process.

Critics have called on Gov. Gretchen Whitmer's administration and the facilities to be more transparent about how many nursing home residents have died and where the worst outbreaks have been.

Many nursing home issues that are getting noticed in the COVID era are long-standing problems in the industry, such as staffing shortages, lack of training for front-line workers and poor infection control, said Sarah Slocum, co-director of the Program to Improve Eldercare at Altarum, an Ann Arbor-based nonprofit group. 

"It’s particularly important for the state to get and publish data from nursing homes with coronavirus. This might be stating the obvious, but nursing homes are a concentrated group of highly vulnerable, high-risk people in a COVID environment," Slocum said.

"I’m not completely surprised that there are high number of infections or deaths in nursing homes, even compared to other congregate settings like a prison or college dorm. ... This population really needs a close look at what’s happening."

The federal government last month started requiring nursing homes nationwide to inform residents, their families or representatives when a staffer or resident contracts the illness at a facility.

The notification must come within 12 hours of a confirmed case and followed instances of nursing homes not disclosing outbreaks. 

Whitmer's administration has faced criticism by Republican lawmakers over the safety of nursing home residents in facilities that also care for people recovering from the virus.

GOP legislators have argued that mandates for the admission or readmission of people to nursing homes who test positive for COVID-19 were exposing and endangering a vulnerable population of uninfected people in the nursing facilities.

Last week, the state updated directives for nursing homes, saying residents affected by COVID-19 should only be discharged from a hospital to a facility capable of safely isolating the resident.

"Clearly, COVID patients being discharged from a hospital — we wanted to make sure that they had a place to go," Whitmer said Thursday.

"We have tried to address this so that we kept people safe but also give them a place to return to. We've had to strike a balance here, and I think as we continue to learn, we continue to improve."

Khaldun said Thursday that officials are making sure that nursing facilities only accept patients if they have the appropriate personal protective equipment for staff, or if they've been able to create a dedicated unit for COVID patients.

"We still have to do more work to get this right — to make sure that our nursing home residents have someplace safe to go, and we continue to work on that," Khaldun said.