Senate, House Republicans want investigation in Michigan's nursing home data

Beth LeBlanc
The Detroit News

Eight Republican state senators sent a letter to the state and U.S. attorneys general Tuesday seeking for an investigation into Gov. Gretchen Whitmer's pandemic policies around long-term care facilities. 

They want investigators to look into whether there were discrepancies in the way nursing home cases and deaths were tallied. House Republican lawmakers are expected to send similar correspondence in the coming days.

Attorney General Dana Nessel's office said it had received the senators' letter and is reviewing the request.

Specifically, the Senate letter asks the attorneys general to investigate the state's long-term care facility policies, compliance with Centers for Disease Control and Prevention guidelines, compliance with public records laws and the accuracy of data provided on long-term care facilities. 

The last request comes after New York Gov. Andrew Cuomo has taken fire for allegedly withholding data on nursing home resident deaths at hospitals, keeping the actual number of nursing home deaths artificially low by only counting those deaths that occurred at nursing homes themselves. 

His top aide Melissa DeRosa told New York Democratic lawmakers the release of that data was delayed because officials were concerned the data would be "used against us" by former President Donald J. Trump's Department of Justice. 

In this April 17, 2020, file photo, emergency medical workers arrive at Cobble Hill Health Center in the Brooklyn borough of New York. Unlike every other state with major outbreaks, New York only counts residents who died on nursing home property and not those who died in hospitals.

New York and Michigan were among four states from which the U.S. Department of Justice in August sought data on nursing home deaths during the pandemic. 

As of Monday, the state had reported 23,978 cases of COVID-19 among residents of long-term care facilities and 5,549 deaths. 

In their Tuesday letter, senators asked Nessel and acting U.S. Attorney General Monty Wilkinson to request copies of the same data submitted to the Department of Justice "and work with members of Michigan's Legislature for the protection of our most vulnerable elderly Michigan residents."

The letter was signed by Republican Sens. Jim Runestad of White Lake, Tom Barrett of Charlotte, Ruth Johnson of Holly, Kim LaSata of Bainbridge Township, Roger Victory of Hudsonville, Lana Theis of Brighton, Dale Zorn of Ida and Curtis VanderWall of Ludington.

Rep. Steve Johnson, R-Wayland, said Thursday that some House members would send a similar request. 

"What you saw in New York — where Gov. Cuomo (was) hiding the death numbers — we've asked those questions here," Johnson said.

"Did we properly report the numbers? The department has said they are, but they won't provide a breakdown of the deaths in hospitals versus nursing homes, so it's hard to tell how they can actually show that.

"They told us they have really good data; we'd like to see that data," he said. 

On its end, the Health Care Association of Michigan, which represents nursing homes, said it reports cases and deaths based on "location of occurrence."

"Nursing facility residents who pass away at the hospital are reported by the hospital.  Conversely, people discharged to a nursing facility, i.e., on hospice, are reported by the facility," said Melissa Samuel, president and CEO of the Health Care Association of Michigan. The department then takes further steps with the data, the association said.

Since June 2020, the state has been requiring facilities to conduct weekly testing on staff and residents — in addition to more frequent testing of symptomatic staff or residents —  that is reported to the Department of Health and Human Services and posted publicly on a weekly basis, said Lynn Sutfin, a spokeswoman for the agency. 

"An individual who was transferred to the hospital and who then tests positive or dies would be counted in the nursing home case or death counts if the facility was holding their place. In other words, they were expecting them to return to the facility," Sutfin said. 

In a Wednesday letter to Johnson, Michigan Department of Health and Human Services Director Elizabeth Hertel declined an opportunity to testify before the House Oversight Committee about how death data is gathered, noting the department "spent significant time" testifying on the subject last session, and that the state's collection of COVID-19 data has been "exemplary."

"MDHHS has consistently implemented the most accurate reporting protocols with the goal of maintaining quality death data," Hertel wrote.

From April 15, long-term care facilities were required under executive order to report "all presumed positive cases in the facility." On April 20, the state health department issued additional guidance on reporting, three weeks ahead of the federal government issuing similar guidance, Hertel wrote.

In May, the department reissued its guidance to better align with federal requirements and launched a new reporting module allowing the state to collect current and cumulative case and death tallies by facility, she wrote.

The federal requirements mandate that nursing facilities report data on residents with suspected or confirmed cases of COVID-19 who died in the nursing home or elsewhere, Hertel wrote. The state has validated its data with the help of the Institute of Health Policy at Michigan State University, she said.

"This process captures all but the rarest instances of nursing home transmission," Hertel wrote. 

But senators said in their Tuesday letter some nursing homes in their districts had "discrepancies" in how they reported cases to the state, with some not counting cases from individuals who were suspected to have the virus at the facility, but tested positive after transfer to the hospital. 

"The executive orders have only required long-term care facilities to report when they have a resident who had a positive test at their facility, but not when a patient who was transferred tests positive," the letter said. "Additionally, there may be similar discrepancies in how these deaths are reported after transfer."

The senators pointed to Whitmer’s policy early in the pandemic requiring nursing homes with capacity to accept residents who tested positive for the virus. The state did not put in place reporting policies that would document cases by long-term care facilities after a transfer or readmission, senators said.

"It is essential that all COVID-19 cases originating in nursing homes are tracked and publicly documented to have data on when a patient from a facility tests positive or dies after transfer to the hospital," the letter said. "Without this tracking, we do not have data on cases or deaths attributed to outbreaks in nursing homes."

Staff writer Craig Mauger contributed.