No State COVID Death Tracking At Nearly 3,500 Care Facilities

There are 4,596 long-term care facilities in Michigan. Most of them — 3,480 — do not have to report COVID-19 mortality data, according to a COVID tracking website of the state health department. The database also appears to indicate the department doesn’t plan to report numbers from those facilities.

“That is the problem,” said Steve Delie, director of labor policy at the Mackinac Center for Public Policy. “The people of the state of Michigan deserve to know who died and where.”

Delie's comments were made at a state House Oversight Committee hearing on findings that Michigan may have undercounted COVID nursing home deaths by a substantial amount. Investigations of the matter have turned into disputes over what qualifies as a nursing home. They also led to an acknowledgment that the state of Michigan is not tracking COVID-19 deaths to many facilities.

In his testimony to the committee, Delie said, “Based on what we’ve investigated, it appears that we do not have an accurate count of the total number of deaths in nursing homes in Michigan.” The common usage of the term “nursing home,” he said, includes skilled nursing homes, homes for the aged, and long-term care facilities.

The technical definition of “nursing home” became a matter of debate throughout the hearing, however. The director of the Michigan Department of Health and Human Services, Elizabeth Hertel, led her response by saying “long-term care” is an overarching term, while “nursing homes” are licensed separately from “homes for the aged” and “adult foster care” facilities. She acknowledged that the state was not requiring smaller facilities to report their COVID-19 deaths.

State Rep. Jack O’Malley, R-Lake Ann, called the stricter definition “governmentese.” He added, “When decisions are being made ... you need good data.” He questioned whether the department had a good grasp of the situation.

“The problem we have here, is there is plausible doubt that the department knew what was going on” when making its decisions, O’Malley said.

Hertel said the most accurate way to track nursing home deaths is to use “self-reported data from the nursing homes.” She noted that 100% of the state’s nursing homes report to the state. As for adult foster care facilities and homes for the aged, just under 88% of facilities with 13 or more residents are reporting. Facilities with 12 or fewer residents are not reporting.

Committee Chairman Steve Johnson, R-Wayland, said that for long-term care facilities, “the number [of reported deaths] is low.” He continued, “We don’t know how low, but it is low.”

Hertel gave a qualified agreement. “Yes, if we don’t have all of them reporting, there could be a contention that they’re not reporting deaths or maybe they haven’t experienced any deaths.”

Johnson later said that for long-term care facilities, “The director has said the number is low.”

Hertel replied, “I want to be clear that if we’re quoting the things that I’m saying, I’d like them to be accurate. I said they could be low. We do not know, because we don’t know what’s occurring in those facilities.”

Delie says that if the state is going to make policies based on data, it needs to be accurate. State officials had previously said they would not release some mortality data, citing privacy concerns. Delie suggested the state withhold names, but release data on COVID-19 deaths, where they occurred and where the deceased were living.

Delie says that doing this would let the state track deaths in all long-term care facilities and have better data. Hertel said that this information, found in death certificates, would be incomplete and it would be difficult to do the task Delie asked for.

According to Johnson, policymakers need better records on deaths at long-term care facility deaths if they are to assess previous decisions and make better ones in the future. He added that the committee would request an audit from the Office of the Auditor General.