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Are Nursing Homes Under-Reporting COVID-19 Cases?

On Behalf of | May 15, 2020 | Recent Articles

SACRAMENTO (CBS13) — Are nursing homes under-reporting COVID-19 cases and deaths? Many believe they are.

As it stands, at least two out of five COVID-19 deaths in California are linked to nursing homes.

In a review of weeks of nursing home COVID-19 data, CBS13 found inconsistencies and inaccuracies. It’s a serious concern for many with loved ones in these facilities.

Yolanda Elston was shocked when her mom’s nursing home called to say she’d suddenly passed away.

“She was lively. She was fun,” Elston said.

When Elston asked if her mom had coronavirus, “I was told no, she did not. And in fact, they had no cases in the facility.”

That was before the feds officially ordered nursing homes to disclose COVID-19 cases to residents and families last week.

The home now reports as many as 85 cases and fewer than 11 deaths, but the facility won’t say if Elston’s mom Gail is included in that number. Her official cause of death is still Chronic Obstructive Pulmonary Disease (COPD).

Attorney Wendy York says she believes many nursing homes are under-reporting. She says the more coronavirus cases they report, the less likely it is that they’ll get new clients, and more likely it is that they’ll face scrutiny from public health officials.

“They have a financial incentive to under-report,” York said.

But the California Association of Health Care Facilities disagrees, telling CBS13: “Of all the different healthcare settings, skilled nursing homes in California are the most transparent.” They point to the data they are required to provide for the federal Nursing Home Compare website and the daily COVID-19 reports the homes are now required to give the state.

But York says she’s heard from many with first-hand knowledge of nursing home COVID-19 cases who say the numbers posted on the state’s website are wrong.

“They said, ‘Hey, we’ve got a loved one in this facility here and they have a lot more COVID-19 cases in what’s reported on the facility,’” York said.

CBS13 also found inaccuracies within those reported numbers, and confusing updates.

For instance, Yolanda’s mom’s nursing home reported 85 cases earlier this week, but on Thursday, those numbers were removed. The Department of Public Health tells CBS13, “The data is facility reported. If a skilled nursing facility does not report that day it is listed as N/A.”

Shortly after CBS13 questioned the California Department of Public Health about the inconsistencies, the webpage was updated to include the following note (here is a previous version of the web page):

“NOTE: Data collection is undergoing a transition during the weeks of May 10, 2020 and May 17, 2020 as CDPH enhances its data collection process to improve accuracy, timeliness, and to align with new guidance from the federal Center for Medicare & Medicaid Services (CMS). CDPH guidance for the new reporting process is in All Facilities Letter 20-43.2″

“You can’t fight when you can’t find and we need to make sure we have all the info available,” said Congressman Josh Harder, whose district has been hit hard by the coronavirus.

One Turlock nursing home now reports more than 150 cases and 16 deaths. Just nine days ago, state data showed no reported cases at all.

“We need to make sure that there are testing requirements,” Harder said.

He says the first step is new federal legislation that he voted for today. He says it will, among other things, require nursing homes to report accurate demographic data on residents with COVID-19 and require the feds to post those numbers on the national Nursing Home Compare site.

The legislation brings some comfort to Elston.

I think people should be aware of what’s going on,” she said.

California Association of Health Facilities told CBS13 they have been advocating for testing of all nursing home residents and staff for several months. Harder says he’s pushing for that on the federal level too.