State nursing home data questioned

Jul. 1--LANSING -- The only U.S. industry with a more complex list of regulations than nursing homes is nuclear power, the administrator of a top-rated downstate county facility said Tuesday.

Even before the COVID-19 pandemic ravaged the country's elderly, Brenda Kretzschmer added.

"What we must do now, and I do understand why, is just added to that 8-inch binder of regs," she said.

Administrators like Kretzschmer of Tuscola County Medical Care in Caro, one of state's highest rated county-owned nursing homes, are now mandated to test staff and residents for COVID-19, and must report the results and other facility data to a state web portal.

The testing, administrators interviewed said, is useful in devising medical treatments and in stopping the spread of the disease.

The results of the state's data collection, however, is still flawed, administrators said -- even after the state took the data offline at the end of May, changed the reporting requirements, distributed a 15-page instruction guide, conducted telephone interviews with individual facilities, put the data back online and reported 99 percent compliance.

"As of today, the only facilities that have not reported are new to the process, having been added into EMResource in the last week or two," Department of Health and Human Services spokesperson Lynn Sutfin said in an email Tuesday.

"We are working with directly with these facilities to provide technical assistance and assure they have the system access and knowledge to report and do so accurately," she added.

Kretzschmer isn't convinced.

"I don't love any of that reporting for a couple of reasons," Kretzschmer said. "One, it's only good in any particular moment. And two, it's still not 100 percent accurate."

Rose Coleman, director of clinical services for Grand Traverse Pavilions, also experienced problems with data accuracy.

She told the facility's oversight board Friday that it took more than two weeks for two positive COVID-19 tests of Pavilions staff, to make it onto the state's public dashboard.

"We report weekly to the CDC but the state wants to do things a little differently," Coleman told the three-member Grand Traverse County Department of Health and Human Services board Friday.

Coleman explained that under new reporting guidelines, the state of Michigan now reports on a facility's behalf to the Centers for Disease Control via EMResource, an online portal.

"We are experiencing some difficulty with that," Coleman said. "Our data didn't show for a couple of weeks. So we're working on trying to correct that and it has taken a lot of our time."

On Monday and Tuesday Pavilions tested staff and residents and Coleman estimated 800 tests would be sent to the lab by Wednesday. Results were expected by Monday, said spokesperson Deb Allen.

Sutfin said any positive cases would be added to a facility's cumulative cases and posted to the state's public data dashboard. There is discussion at the state level about adding a date to the tests.

"We are currently exploring collecting the date of the most recent facility-wide testing to better support monitoring of the new testing requirements," Sutfin said.

An June 15 executive order signed by DHHS Director Robert Gordon mandates baseline tests of all nursing home staff and residents who do not opt out.

Marna Robertson, administrator of Meadow Brook Care Facility in Bellaire said two recent positive cases reported in Antrim County highlight another problem, this one related to county of residence.

On June 26 the Health Department of Northwest Michigan, which covers Antrim, Charlevoix, Emmet and Otsego counties, reported six new cases of COVID-19 in Antrim and Charlevoix counties associated with a long term care facility.

And yet according to the state's dashboard and to Meadow Brook's records, the facility had zero cases of the virus.

"When word went out, who do you think the public immediately thought of? Us, of course," Robertson said. "We have no cases but my phone started ringing because family members were calling. The public thought we had COVID here."

All six cases were among staff at Grandvue Medical Care Facility in Charlevoix, but because two of the people who tested positive live in Antrim County, those two cases were listed as Antrim County cases, Robertson said.

The same is true for patients who test positive for COVID-19 and are transferred to a Regional Hub in another county, Grand Traverse County Health Officer Wendy Hirschenberger previously said.

A Hub is a nursing home which has agreed to accept recovering COVID-19-positive patients into their facility and is paid extra from the state and Medicare and Medicaid.

The only Regional Hub in northern Michigan is MediLodge GTC, which states on the facility's website staff there are currently treating one COVID-19-positive patient and previously treated 21 COVID-19-positive patients and/or staff and discharged 19.

The state's dashboard, however, shows no cases among residents or staff.

Medilodge GTC spokesperson Bill Gray could not be reached for comment Tuesday but Sutfin said the transferring facility is the one who counts the cases in their data.

The wide-range of timeframes when people who have the virus can continue to test positive is another way data can be skewed, Kretzschmer said.

"We had one gentleman who was our second positive COVID positive resident back in March," Kretzschmer said. "On June 15 when when the state says we want to test all staff and all resident as a baseline, this gentleman had been symptom-free for 2.5 months. He tests positive and we have to count him as a new case."

Kretzschmer also said there are problems with data collected on supplies of personal protection equipment.

A recent shipment of 20 cases of N95 masks were useless, she said.

"I popped a box open and they looked like sanitary napkins," she said. "They were not going to cover anything but if I kept them because they were better than nothing at all, I'd have to report I had a good supply."

Instead, Kretzschmer told her staff to get the boxes out of the building. She didn't want to have to count them among her supplies.

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