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Nursing home deaths actually closer to 60% of state total, new data shows

State announced changes in reporting on July 1
Indiana Nursing Home COVID19 pic.jpg
Posted at 4:29 PM, Jul 29, 2020
and last updated 2020-07-29 21:41:31-04

INDIANAPOLIS — New numbers released by the Indiana State Department of Health this week reveal a greater percentage of Indiana’s COVID-19 deaths occurred in long-term care facilities than the state has been reporting.

1,618 residents have died at long term care facilities, according to new numbers, making up 60% of the state’s total coronavirus deaths.

Previously, COVID-19 deaths at nursing homes made up about half of the state’s total deaths.

Here’s what changed.

On July 1, the state agreed to release nursing home deaths and cases, broken down by facility, after pressure from Call 6 Investigates, the AARP Indiana, and other advocates.

As a result, the state-required nursing homes to submit their data by July 14, dating back to March 1, showing the number of cases and deaths for both residents and employees.

As of July 14, 83% of facilities reported their historical data dating back to March 1 to the state.

As of Monday, July 27, an additional 95 facilities have reported historical data to the state, which accounts for the increase in numbers, according to Indiana State Department of Health spokeswoman Megan Wade-Taxter.

“These numbers will continue to change as we continue to work to get 100 percent of facilities to report their historical data,” said Wade-Taxter.

Another reason for the increase is because under the old system that went into effect April 8, long-term care facilities were required to report deaths within 24 hours.

So that means, until now, nursing homes were not sharing numbers from March 1 to April 8.

AARP Indiana’s state director Sarah Waddle said the state’s latest data shows we weren’t getting the full picture.

“Now that we’re stepping back and taking a comprehensive look at it, the situation is worse than what we thought it was,” said Waddle. “It wasn’t comprehensive data because it was only data from the middle of April when they started requesting that, We are pleased we are finally seeing these new numbers, but this is exactly the reason we were asking for them— because we weren’t getting a complete picture of what was going on.”

For months, ISDH and the Governor’s office refused to release the number of cases and deaths at specific nursing homes.

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AARP Indiana, Call 6 Investigates and other advocates for seniors pushed for a full breakdown of the data, including where outbreaks and deaths have occurred.

“This now just shows how important it is to make this information publicly available,” said Waddle. “Families need to know it. Communities need to know it. And we need to know it as a system to better deploy our resources for the residents and the staff.”

Waddle said the confusion surrounding deaths at nursing homes should serve as a reminder of the importance of accurate and timely data gathering and reporting.

“I definitely think there is something we can learn,” said Waddle. “It just shows how important transparency is through all of this. I am hoping we can get past this data conversation so we can work on improving the lives of Hoosiers.”

All deaths have been required to be reported to the state throughout the pandemic.

However, some of those deaths may not have been linked to a long-term care facility when initially reported, said ISDH spokeswoman Megan Wade-Taxter.

“That is why the new historical reporting mandate provides a more accurate picture of COVID deaths in long-term care facilities,” said Wade-Taxter.

Dr. Dan Rusyniak, Chief Medical Officer at Indiana Family and Social Services Administration, said people need to know the data may still change, as they are working to gather data from the remaining 5% of facilities.

“We have never under-reported or hid data,” said Dr. Rusyniak. “We have always reported the aggregate data that facilities submitted to us. However, the way we collected data from facilities has changed."

Dr. Rusyniak also explained that after a nursing home submits data, the state has to verify it is accurate.

“We do this by cross-checking the information,” said Dr. Rusyniak. “For example, if they send us a case that’s positive, we want to look in our corresponding test databases to find a corresponding lab result. If we have a death, we want to crosscheck with our death reporting systems.”

Dr. Rusyniak explained that the state’s previous data system for long term care facilities was never intended to be for public reporting like the current system is.

He also said facilities are more likely to report data because the state improved its submission portal.

The state removed the long-term care aggregate totals from its dashboard, calling the new numbers “more comprehensive” than what was currently posted.

“The reason these numbers are different is that facilities have gotten better at reporting,” Dr. Rusyniak. “We’ve gotten better at collecting the data. We’ve also made it easier for facilities by providing better instructions and giving them more time to go back and identify cases.”

Rusyniak said the state has also made improvements to its data submission portal and enhanced the state’s in-house data teams.

He said people should keep in mind that if a nursing home has cases doesn’t mean they’ve had an outbreak.

“Every resident case does not necessarily correlate with an outbreak in that facility,” Rusyniak said. “Many facilities admit patients from a hospital because they had COVID and now require a nursing home.”

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The state plans to publish the nursing home historical data every Monday until the new nursing home dashboard is publicly available, which is expected in the next two weeks.

It will allow you to search by a nursing home or on a map, and in the future may include features like demographics and recoveries.

AARP provided the following list of questions you can ask if you’re concerned about COVID-19 at your loved one’s facility.

1. Has anyone in the nursing home tested positive for COVID-19?

  • This includes residents as well as staff or other vendors who may have been in the nursing home.

2. What is the nursing home doing to prevent infections?

  • How are nursing home staff being screened for COVID-19, especially when they leave and re-enter the home?
  • What precautions are in place for residents who are not in private rooms?

3. Does nursing home staff have personal protective equipment (PPE)—like masks, face shields, gowns, gloves—that they need to stay safe, and keep their patients safe?

  • Have nursing home staff been given specific training on how to use this personal protective equipment?
  • If no, what is the plan to obtain personal protective equipment?

4. What is the nursing home doing to help residents stay connected with their families or other loved ones during this time?

  • Does the nursing home help residents call their loved ones by phone or video call?
  • Will the nursing home set up a regular schedule for you to speak with your loved one?

5. What is the plan for the nursing home to communicate important information to both residents and families on a regular basis?

  • Will the nursing home be contacting you by phone or email, and when?

6. Is the nursing home currently at full staffing levels for nurses, aides, and other workers?

  • What is the plan to make sure the needs of nursing home residents are met—like bathing, feeding, medication management, social engagement—if the nursing home has staffing shortages?