Feds count more Michigan COVID-19 nursing home deaths than state's tally

Melissa Nann Burke
The Detroit News

New federal data shows that at least 1,654 nursing home residents died due to the novel coronavirus in Michigan, more than the state counted in preliminary data released last week.

The nursing home deaths counted by the federal government represent 30% of the 5,553 total deaths due to the disease COVID-19 in Michigan through Tuesday.

The new number, released by the Centers for Medicare and Medicaid Services, is likely too low because 17% of facilities failed to respond to the survey.

The nursing home deaths as counted by the federal agency exceeds the preliminary figure of 1,216 reported last week by Michigan officials, who acknowledged gaps in reporting by 9% facilities.

Federal health officials released the new data as they pledged greater fines for facilities with persistently poor infection control and required states to boost facility inspections in the COVID-19 era.

Sheffield Manor in Detroit has had 12 deaths due to COVID-19 and 55 cases of the disease, according to city data.

“While many nursing homes have performed well and demonstrated that it’s entirely possible to keep nursing homes patients safe, we are outlining new instructions for state survey agencies and enforcement actions for nursing homes that are not following federal safety requirements," CMS Administrator Seema Verma said in a statement.

Her agency's survey found 2,864 cases of the disease COVID-19 among nursing home residents in Michigan through May 24, as well as 1,159 cases and 12 deaths among facility staff. The figures are based on reporting by 83% of 442 Michigan nursing homes.

Facilities were not required to report COVID-19 deaths and cases that occurred prior to the first week of May, but they could have opted to report retrospectively back to Jan. 1.

Nursing homes and congregate facilities for seniors have been hot spots for COVID outbreaks, where staffing shortages, lack of training for front-line workers and poor infection control were problems before the pandemic, experts say. 

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. 

Nursing home residents accounted for a third of COVID deaths in the three-county area of Macomb, Oakland and Wayne counties (including Detroit) through May 26, with at least 1,372 deaths, according to county data.

"It's disheartening to see the deaths at our nursing facilities. It's not just Michigan but across the country where people are just grappling with this," Michigan Chief Medical Executive Dr. Joneigh Khaldun said Monday. 

The federal survey by CMS found that roughly 26,000 nursing home residents have died nationwide due to COVID-19, based on reporting by 80% of facilities. Nursing homes also confirmed nearly 95,000 cases of COVID-19 among residents and staff, and 449 staff deaths.  

Some Republican lawmakers have criticized the Whitmer administration over the safety of nursing home residents in facilities also caring for individuals recovering from the virus. 

GOP legislators have argued that state rules 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 facilities.

Last month, 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.

"With regard to our nursing home policies, we have learned a great deal in the last 10 weeks. I think that if we could go back in a time machine and do some things differently sure there are things that we would improve upon," Gov. Gretchen Whitmer said at a Monday press briefing.

"But every action we took was based on the best science and the best information available to protect people and to save lives."

Khaldun stressed that the state has followed guidance from the Centers Medicare and Medicaid Services for nursing homes "the entire time." 

"But clearly, there's no question we need to do more — not just with our nursing facilities, but also with our data and reporting, which we've been very open and honest about," Khaldun said.

The chief medical executive said last week the state is working to close the reporting gap and expedite testing in skilled nursing facilities statewide. Specialized infection prevention and assessment teams have worked with local health departments to do assessments of 278 nursing facilities throughout the state.

Another of the state's focuses is ensuring facilities have appropriate staffing, she said. 

"We've never forced any nursing facility to take patients that they did not feel like they could take good care of with the appropriate distancing and (personal protective equipment)," she said Monday. 

CMS said $80 million in federal funding will be available to states to boost their inspections of nursing home infection control in response to the pandemic.

CMS officials are requiring those surveys to be complete by July 31 or states risk losing 10% or more of their funding allocation under the federal CARES Act for 2021.

With the additional coronavirus funding, states will be required to perform on-site surveys of nursing homes with previous COVID outbreaks and will be required to perform on-site surveys of any facility with new suspected and confirmed cases of COVID within three to five days.