Feds nationwide nursing home data expansive but incomplete

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AUSTIN (KXAN) – The Centers for Medicare & Medicaid Services (CMS) released data Thursday that was expected to offer the most detailed picture available of COVID-19 cases in nursing homes nationwide, but the data for Texas facilities appears incomplete and shows fewer cases and deaths than state-level data that has already been provided.

CMS has been gathering COVID-19 case information for weeks from facilities throughout the country. Many state health agencies already provide facility-level data of cases and deaths in nursing homes, but Texas does not.

The Centers for Medicare and Medicaid Administrator Seema Verma said, so far, every state has had their own methodology for tracking cases, but this “unprecedented” effort would standardize their response.

“It has already helped inform a number of new policies,” Verma said on a call Thursday afternoon.

The data released Thursday includes more than two dozen fields of information on COVID-19 cases and deaths in nursing homes, as well as information on protective equipment and supplies. The federal government made the effort to catalog cases in nursing homes after the facilities became hotspots for COVID-19.

But many nursing facilities have not provided federal health authorities with required information, and some of the federal data does not square with information already relayed by the Texas Health and Human Services Commission.

For example, as of Thursday, HHSC reports Texas nursing homes have had over 4,000 cases in residents and 706 deaths. The federal data shows just 1,927 total resident cases and 321 deaths in the state. Also, nearly 20 percent of more than 1,200 Texas facilities provided no information to federal authorities on May 31, the most current reporting date.

In another example, KXAN previously confirmed Trinity Care Center in Round Rock has had 50 cases of the virus, but Trinity reported no information to CMS on May 31, according to the data. KXAN has also confirmed at least two cases of the virus at Gracy Woods Nursing Center in North Austin, but that facility reported zero total cases to federal authorities.

‘If you look at what is required under the new federal reporting, they didn’t mandate that you go all the way back to January,” said Kevin Warren, President of the Texas Health Care Association. “They said, ‘Let’s start moving forward.’ Whereas the state data, we know that they’ve been required to report for many months. Will that data ever come together and synthesize like you are saying, where it is a true one-to-one? I honestly don’t know.” 

Verma acknowledged there would be discrepancies in state and federal data, as they collected data directly from the homes.

Also, officials on the call noted that the first round of reporting was due on May 17, and the agency couldn’t go back and “retroactively” implement reporting requirements.

Verma also explained several limitations with the data itself. For instance, only 88% of homes nationwide had reported.

KXAN Investigators noted more than 230 Texas homes with blanks — where information should have been entered. Five Austin-area homes had yet to submit the data, as of May 31.

“As with any new program, some facilities are going to struggle as we come online,” Verma said.
“There are going to be honest errors.”

She said they are working with homes on entering the correct data for each category — such as cumulative case counts as opposed to weekly changes.

On June 4, 2020 – months after the coronavirus pandemic began in the United States and medical experts expressed concerns over people living in nursing homes – the Centers for Medicare & Medicaid Services (CMS) began publicly releasing data and results from targeted inspections of such facilities conducted by the agency since early March. While initial reporting appears incomplete and the agency acknowledges the likelihood of occasional human error, it also offers a more complete look at the virus’ spread within this vulnerable population. Stricter accountability in the reporting is expected in the future with the goal of further enhancing and updating the data regularly. KXAN will continue to update this map, as more details become available. Read more about this data.

West Oaks Nursing and Rehabilitation Center in Austin is the worst hit Central Texas facility, according to the federal data, with 81 cases and 22 deaths.

KXAN has previously confirmed one staff member of West Oaks who died from COVID-19. The federal data seems to indicate two staff members have died, but a spokesperson for Regency Integrated Health Services, who operates the home, said the database has inaccurate information for their facility.

“We are working with CMS website administrators to ensure all information related to Regency Integrated Health Services’ facilities is correct.  I can confirm that we have not had a second staff member pass away since the onset of the Coronavirus pandemic,” the spokesperson said.

Lack of protective equipment

In addition to case and death numbers, the federal data notes whether facilities have certain protective equipment and hygiene supplies on hand. Many Texas nursing homes did not on May 31, according to the federal records.

Asked if they have “any current supply of N95 masks,” 56 nursing homes in the state said no. In response to a question asking if they have “any current eye protection,” 54 facilities said no, and 49 facilities said they have no current supply of hand sanitizer, records show.

The data also tracks shortages of clinical staff, nursing staff, aides and other employees.

Infection Prevention

CMS officials have noted that homes who received one-star ratings on federal inspections were more likely to see higher numbers of cases.

MORE: Prior to virus, many Central Texas nursing homes cited for infection control

They emphasized, still, the presence of COVID-19 at a facilities does not mean they did everything wrong or didn’t follow Infection Control guidance.

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