Michigan nursing homes linked to 1 in 4 coronavirus deaths. Tally will grow.

There have been at least 4,920 COVID-19 cases linked to nursing homes, about 9 percent of the statewide total. (Shutterstock)

LANSING — Michigan Gov. Gretchen Whitmer’s coronavirus pandemic policies for nursing homes have been “an epic fail,” a Democratic lawmaker said Wednesday as state officials disclosed incomplete new data linking 1 in 4 COVID-19 deaths long-term care residents.

State Rep. Leslie Love, D-Detroit, said her mother contracted COVID-19 in a nursing home last week and questioned whether Whitmer’s policies jeopardized vulnerable residents by requiring facilities to create units  for patients discharged from hospitals or send them to other nursing homes designated as regional hubs.

“I’m so appreciative of what the governor has done to try to keep us all safe... but when it comes to the decisions around our nursing facilities, I think we have an epic fail,” Love said during emotional testimony before the Senate Oversight Committee.

“To have them integrate [COVID-19 patients] into those communities, I think puts our senior citizens at harm.”

 

Robert Gordon, director of the Michigan Department of Health and Human Services, defended the state’s response as he shared preliminary data showing at least 1,216 nursing home residents had died from coronavirus complications as of Friday, either in their facilities or after being transferred to a hospital. That accounts for 23 percent of the state’s total deaths. 

There have been at least 4,920 COVID-19 cases linked to nursing homes, about 9 percent of the statewide total.

But that data, reported under new state guidelines designed to mirror federal standards, is incomplete, Gordon told lawmakers on the oversight panel, which has spent weeks examining nursing home pandemic policies.

As of Friday, 434 of 499 nursing homes expected to provide COVID-19 data to the state had done so. 

In Wayne County — which includes Detroit, an early epicenter of the pandemic in Michigan — only 73 percent of facilities had reported COVID-19 data requested by the state. Because of that reporting gap, the state data only includes 374 deaths from Wayne County nursing homes even though local health officials have identified 674 deaths there.

Robert Gordon

About 30 percent of COVID-19 deaths in Michigan were nursing home residents, said Robert Gordon, director of the Michigan Department of Health and Human Services. (Courtesy photo)

“It’s a very large gap,” Gordon acknowledged. “And that tells us that we’re going to find out about more deaths.”

The virus has wreaked havoc in nursing homes across the country, spreading through facilities where elderly residents with pre-existing conditions are more likely to die. 

As of May 11, nursing home residents and workers accounted for one-third of all COVID-19 deaths in the United States, according to an analysis by the New York Times.

If additional data already reported to local officials in Wayne, Oakland and Macomb counties are confirmed to the state, nursing home residents will account for closer to 30 percent of all deaths in Michigan, Gordon said. 

“Candidly, it will be higher than that as well as we get the non-reporting facilities in the rest of the state,” he told lawmakers.

Policy switch

Whitmer first issued an executive order for nursing homes on April 15, more than a month after officials confirmed the state’s first case of the novel coronavirus.  The order required nursing homes at less than 80 percent capacity to create dedicated units for “COVID-19 affected residents” and mandated they take in new patients so long as they had “appropriate” personal protection equipment for employees.

Love and a small group of other Democratic lawmakers two weeks ago submitted proposed policy revisions to Whitmer, and on Tuesday she thanked the governor for adopting some of those ideas in a new executive order signed last week. 

Whitmer’s revised order requires nursing homes to “make all reasonable efforts to create a unit dedicated to the care and isolation of COVID-19-affected residents” but no longer makes that mandatory. The order also specifies that nursing homes should not accept the return of a hospitalized COVID-19 resident if they do not have a dedicated unit to care for them. 

“We’re doing everything in our power to protect people who don't have COVID from getting infected by people who do, given the facilities we have and given the need to treat people in facilities that are appropriate for them,” Gordon said. 

As Bridge Magazine has reported for weeks, Michigan has been under fire to release more information about the coronavirus in nursing homes. 

For the first six weeks of the pandemic, the state didn’t even list nursing homes with suspected COVID-19 cases. At one point, health officials said doing so would cause “undue stress” on homes. 

Even now, the data are limited, reflecting only current cases in homes rather than total cases and the number of residents who have recovered. 

On Friday, Michigan began collecting information about admissions, testing, staff cases, staffing shortages, and discharges in ways that comply with new federal requirements, said Lynn Sutfin, spokesperson for the Michigan Department of Health and Human Services.

Additionally, the state requires nursing homes to submit information about their personal protective equipment and numbers of residents each transfers to regional hubs.

Sutfin acknowledged Wednesday that it’s still not clear how deaths will be publicly released — by nursing homes, at a county level or even at a state level.

The department is weighing the demand from the public for detailed information against privacy concerns for residents in smaller facilities, Sutfin said.

“We are looking to CMS for guidance on this,” she said. “There are questions still on how deaths will be reported.”

Demands for greater transparency

As AARP and other advocates have demanded greater transparency in nursing homes nationally, estimates of COVID-19 deaths in nursing homes have varied, with one estimate claiming long-term care facilities account for 43 percent of all COVID-19 deaths.

Pennsylvania – where about 69 percent of that state’s deaths are reported to be in nursing homes and assisted living facilities – lists COVID-19 nursing home deaths both by county as well as by individual nursing home. It first disclosed that list on May 19.

New York began releasing the number of COVID-19 deaths by individual nursing home in early May, though its reported share of coronavirus deaths among nursing home residents – at about 14 percent of the overall total – is thought to be low because the state does not count residents who die in the hospital.

In Michigan, state Rep. Peter Lucido, R-Shelby Township, has argued the state can’t protect nursing home residents with limited information. He has asked both state Attorney General Dana Nessel and federal prosecutors to investigate the state’s nursing home policies. 

“Everybody’s asking me how many people died in the nursing facilities as a result of mixing COVID with non-COVID [residents,]” Lucido said Tuesday, questioning why the state still does not have complete data. 

Marianne Udow-Phillips, executive director of the Center for Health Research and Transformation at the University of Michigan, said the disclosure of death counts by nursing homes should be a trigger for further action.

She said the state could leverage that information to form nursing home “strike teams,” as states including Maryland have done. Since early April, Maryland has sent teams composed of hospital health care workers, National Guard members and state and local health care workers to nursing homes with COVID-19 outbreaks. The teams assist with testing and provide on-site medical support.

“The state could be deploying these teams to help with infection control. It’s something the state could be working with the nursing home, to have these traveling teams to be available,” she said.

Kate Massey, MDHHS senior deputy director for the Medical Services Administration, said the state expects “close to 100 percent” of nursing homes will be reporting COVID-19 data within two weeks. 

The Michigan Elder Justice Initiative, a Lansing-based nonprofit advocacy organization, continues to hear from distraught family members of nursing home residents, said Alison Hirschel, managing attorney.

They fear loved ones could be exposed to the virus, but remain the dark about what’s going on inside because they are not allowed to visit, she said.

“They are not feeling confident about whether COVID is in the facility. They looked in the window and they don’t think the staff is wearing masks and not using PPE,” Hirschel said.

Hirschel called full disclosure of nursing homes of deaths from COVID-19 “incredibly important.”

“I think we were a little slow in the beginning to figure out the mechanics for this to be reported. A lot of it was being reported to local health departments, but it wasn’t clear to me it was being reported to the state,” she said.

She questioned whether reported deaths by nursing homes can be trusted when that information is released: “I don’t know if there is going to be any auditing of that information. I’m not confident it will be accurate.”

Under federal guidance, the Michigan Department of Licensing and Regulatory Affairs suspended routine nursing home inspections during the pandemic but has continued sending teams into facilities for infection control surveys.

Inspectors have so far visited 327 Michigan nursing homes for infection control surveys, LARA Director Orlene Hawks told lawmakers Tuesday. 

Of those, 17 were inspected a second time to determine if residents were in “immediate jeopardy.” The state health department has designated 20 nursing homes as regional hubs to care for elderly COVID-19 patients. Of those, 13 have been inspected so far, Hawks said. 

To date, the state has received 2,216 complaints about Michigan nursing homes so far this year, up from 1,766 complaints at the same point in 2019. 

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Comments

Matt
Wed, 05/27/2020 - 9:09pm

25% would be surprisingly low and especially when compared to death rates experienced by other Democratic governors and their state's nursing homes where the actual number is more like 50% of all fatalities. There's a reason these numbers are being avoided. The stress trying to be avoided is not on the nursing homes but on the politicians responsible for these polices. Are we going to hold these governors (Cuomo !!!Whitmer!!! among others.) responsible for sticking infected people into these facilities? Where are all the Whitmer supporters singing her praises now? Can't blame this on Trump it was all her.

erin davis
Fri, 05/29/2020 - 3:42pm

How about dropping the tired old red vs blue routine and realize that it is both parties allowing the places to do this. If we don't come together as communities, this will continue. The people that own these places are larger hospital groups that have overall donated $35M this election cycle and, in turn, received complete immunity from any lawsuits or damages from their negligence. Executives that make the decisions on our vulnerable loved ones aren't even from our state and see them as numbers on a spreadsheet. I don't know if you noticed that this happened in Canada as well. No Whitmer there that I know of. These "leaders" are accepting bribes and turning a blind eye to the disasters that are our nursing homes, and the money is flowing to all of them.

Greg
Wed, 05/27/2020 - 11:52pm

Horrifying that family members have no means of overseeing assisted living care while the state is obfuscating nursing home data. What happened to follow the data and "science"?

Karen Beasley
Thu, 05/28/2020 - 9:14am

Marianne Udow Phillips was the State of Michigan DHS director in previous years. Robert Gordon now holds that position.

Whitmer's Fault
Thu, 05/28/2020 - 9:15am

All of these deaths are a direct result of Governor Whitmer's policies and she should be held accountable. Whitmer is in charge and these deaths are on her.

Remember all of the people who were calling for Snyder's head because of the Flint water crisis, saying that because he was in charge that it was his fault? This is the EXACT same thing.

Rick Raisen
Thu, 05/28/2020 - 10:02am

Did I read this correctly? "The state health department has designed 20 nursing homes as regional hubs to care for elderly COVID-19 patients.... Of those, 13 have been inspected so far." So the State of Michigan designated (I think that's what it meant) 20 locations as hubs in which to concentrate high-risk COVID patients, and yet has only inspected 13 of those locations so far.

What the flying f$#k is the state doing? Perhaps Whitmer should spend less time promoting herself and going on national shows and start inspecting these facilities? Perhaps instead of continually misdirecting state resources to pester legal protesters or to cover up for her unethical travel, she should be directing state resources towards protecting those people who are dying! Whitmer is continually out there saying that the state should take over and run more and more and more things- but what she is supposed to be running are turning into death traps. The things which Whitmer does have control over are killing people, and she wants more and more control. And she's going to next pretend she's the victim and that she really isn't in charge or something.

Michigan voters killed thousands by electing Democrats to executive positions in Michigan last election. No amount of virtue signaling is worth that.

Optics
Thu, 05/28/2020 - 11:31am

As soon as the nursing homes had to be listed with their numbers of cases and deaths, they stopped testing for coronavirus at all.

Diana
Thu, 05/28/2020 - 4:19pm

We are not getting he truth on nursing home deaths. Anyone with Coronavirus should not be placed in or stay in a nursing home. Government run health care is horrible.

Sally
Fri, 05/29/2020 - 10:34am

Diana, The nursing homes are not government run. They are corporate owned.

Patricia S Duffy
Sun, 05/31/2020 - 8:21am

True. Nursing home deaths across the country make up one-third of all Covid deaths. It's not just Michigan.

Arjay
Fri, 05/29/2020 - 7:14pm

We can thank our Michigan governor for the excessive deaths in nursing homes by her lack of action in not isolating them completely early enough. Her lack of action is personally responsible for half the nursing home deaths in Michigan. I spoke with two owners of multiple homes in Florida, where the first action Gov. Ron DeSantis did was to completely isolate the nursing homes, established a mobile test lab that went home to home and tested all the residents and the help. Of the two owners between them, they had 5500 residents in their homes with only 2 deaths total and 8 cases of the virus, and the 2 deaths were of people who caught it on the outside and then came into the homes as patients. With isolation they did not infect any other resident.

And remember that Florida has more than twice the population of Michigan, and in total has about 40% of the deaths and far fewer cases. I wouldn't hold Michigans governor up for any awards for fine handling of the situation.

LH
Sun, 05/31/2020 - 1:46am

I totally agree. We arrived in Florida just as the pandemic hit. Everything was open when we got there but just a few days later social distancing came on the scene. South Florida (Miami area) and the Keys were shut down pretty quickly, but elsewhere in Florida local authorities had the discretion regarding "stay home" orders for weeks until the governor finally gave in to political pressure and issued a statewide order. Meanwhile, family members were urging us to leave Florida and come back to Michigan. Just reading the news was enough to convince us that was not a wise move. Knowing the demographics in Florida, though, I expected the elderly population to take a tremendous hit. I was reading the news about nursing home deaths in Michigan, New York and elsewhere, and wondered what Florida was covering up. Turns out the governor did exactly the right thing, and not only refused to let Covid19 patients be discharged to nursing homes for rehabilitation, but required anyone who got Covid19 while in a nursing home to be isolated or moved. Yes, it meant more patients stayed in hospitals longer, but the end result is the hospitals had fewer patients to deal with because elderly people were not being put back into nursing homes to infect more residents. It is too late for the thousands of nursing home residents who died in Michigan, but if there is a resurgence of coronavirus, I hope and pray that Michigan and other states can take a page out of Florida's playbook and keep infected people out of nursing homes.

Anticipating those who say that hospitals in Michigan were full and had to move patients out, yes, in some areas of the state they were stretched to the limit and beyond. But what about the temporary hospital set up in the convention center in Detroit? My understanding is it was barely occupied. Couldn't patients have been transferred there for rehab, etc.? And again, discharging contagious people back into a vulnerable population exponentially increased the pressure on hospitals by infecting many more people. Maybe there would have been more hospital capacity if Covid19 patients were not put into nursing homes.

Anonymous
Sat, 05/30/2020 - 9:06pm

It's sad we send people to nursing homes that offer terrible care.