Nursing homes call for more accountability from the state over COVID-19 data

PITTSBURGH — Several nursing homes are stepping up their efforts to find out why their COVID data is still not showing up in the state’s public database.  The action comes after 11 investigates exposed that COVID case and death numbers for hundreds of nursing homes were not being included in weekly reports by the Pennsylvania Department of Health.

The problem has been happening for more than a year, throughout the entire pandemic. At its peak in January, about 450 of the state’s 692 nursing homes were listed as reporting “no data.”

Since our initial report, the state has made changes to try and improve the numbers, but progress is slow going. The latest numbers show about 170 still on the “no data” list.

Nursing Homes Frustrated

One month after our investigation the administrator at one of Quality Life Service’s ten nursing homes— was frustrated to see his facility still listed as reporting “no data” to the state.

“Very discouraging,” Henry Clay QLS Administrator Paul Nicholas told 11 Investigates with a deep sigh, shaking his head.

When we first talked with Nicholas this May, he insisted he was reporting his facility’s COVID numbers every day. Dozens of other nursing homes on the “no data” list also told 11 Investigates the same thing.

Nicholas even showed us the green checkmark notice he gets every time he submits data.

“Once you hit submit, you get a confirmation. So, it looks like it went through.” he said.

Who’s to blame?

The state has blamed nursing homes for the missing data problem— saying they reported either “no data or inaccurate or incomplete data.”

But the Pennsylvania Healthcare Association, which advocates for nursing homes, says that’s not fair.

“To blame providers and to blame those on the frontlines for inaccurate data is really not the tact we should be taking,” said PHCA President Zach Shamberg.

Shamberg suspects at least part of the problem is on the state’s end.

“We’ve heard throughout the year that there have been technical glitches, technical problems,” he said.

Shamberg told 11 Investigates 81 of their nearly 200 members were still showing up as reporting “no data” in June and many don’t know why.

Even though the state says it works with nursing homes to fix the problem PHCA says many of their nursing homes have not heard from the state.

QLS told us they didn’t know about the problem until 11 Investigates contacted them.

“They still have never reached out to me to say – ‘Hey, your data is not coming through,’” Nicholas told us.

Nicholas says he reached out to the state after our report, but only got an email telling him to try clearing his browser or trying a different one—which didn’t work.  So, he contacted PHCA, which stepped in to help.

Changes made

Five days after our initial report, the state changed reporting requirements for nursing homes from daily to weekly.  At the time telling us they hoped easing the burden would increase compliance.

But confusion over questions in the online questionnaire nursing homes must fill out to send in their data has also been a key problem.

The Department of Health acknowledged the confusion and told us in an email that “in addition to changing the requirement for nursing homes to report their numbers from daily to weekly” it also just recently “revised language on the survey to be as clear as possible.”

We wanted to ask DOH why the change in language was not done sooner, given that the missing data problem has been ongoing throughout the entire pandemic, but they have repeatedly declined to do a follow up interview with 11 Investigates and ignored those questions in emails we’ve sent.

Revised Questions More Clear

The revised questions appeared in the survey for the first time in mid-June.  They do make it more clear to nursing homes that the state wants them to report the total number of COVID cases and deaths since the start of the pandemic, by adding the words “as of March 6, 2020” to several questions.

Previously, many nursing homes misunderstood the questions created by the state, because they seemed to ask how many cases and deaths a facility had currently. That created a lot of confusion. So even if they had an outbreak earlier, they put “zero” if they had no cases “currently.”

Then, when numbers didn’t match previously submitted numbers, the state would consider that an error and list a facility as “no data.”

Pennsylvania Healthcare Association is calling on the state to be more proactive and reach out to facilities when that happens.

“There needs to be a way to look at that data and then to report back to providers if the data doesn’t appear to be right. You can’t just say no data anymore,” Shamberg told 11 Investigates.

Moment of Truth

Nicholas sat down with 11 Investigates and walked us through the revised questions that he answered for the first time in mid-June.

“This is a brand-new question. It was never on the survey before.” he told us, showing us the added “March 6, 2020” language—indicating more clearly the state is looking for the cumulative number of cases and deaths since the start of the pandemic.

Nicholas told us he had been answering those questions with “zero,” because his QLS Henry Clay facility didn’t currently have any cases or deaths—even though they did have an outbreak in December and January with 67 cases and 8 deaths.

“I put zero, because that (March 6, 2020) wasn’t there before,” he said.

With the updated language he is now answering the questions with cumulative numbers for his facility.

The moment of truth came when we checked the state’s latest COVID data report filed on Tuesday.

“You’re not in there,” 11 Investigates told Nicholas. With a sign of relief, he said he was “very happy.”

Whack a Mole

But just as the QLS Henry Clay facility came off the “no data” list, another one of their facilities that wasn’t on the list last week, appeared.

QLS co-owner Mary Susan Tack-Yurek was at a loss.

“It’s like a game of whack a mole,” she said. “As soon as you successfully think you’ve got one home off list, it seems like another one pops up.”

Tack-Yurek says it’s frustrating, because they’ve worked very hard to be transparent with the public and their families, but she worries the state is making them look bad.

“As providers and as consumers, we all want there to be reliable consistent data on there. So, when it isn’t, it’s just mind boggling.”