At least 126 nursing home residents infected with the respiratory disease have died in Nevada, the Centers for Medicare & Medicaid Services reported June 1. State officials had reported only 89 deaths as of June 5.
A new dataset released by the CMS later in the week also indicates that about one-fourth of Nevada nursing homes are not regularly submitting COVID-19 data to federal officials, a finding which some of those nursing homes disputed.
The federal report comes less than two weeks after Nevada Department of Health and Human Services director Richard Whitley announced that nursing home residents accounted for only about 20 percent of the state’s COVID-19 deaths. The federal numbers would put that figure closer to 30 percent.
Neither state or federal officials could immediately point to what was causing the large discrepancy between their figures, and both said they were receiving information directly from nursing homes.
CMS administrator Seema Verma on Thursday said some states may not be including the deaths of nursing home residents who died at local hospitals.
“Right now this is the data that has been reported to us by the nursing homes,” she said.
But Nevada DHHS spokeswoman Shannon Litz said the state isn’t excluding deaths occurring at hospitals from its data.
“We count all deaths with COVID-19 where the patient has not recovered from COVID-19 before dying; it is not necessary for COVID-19 to be listed as the cause of death,” she wrote in an email.
Other numbers in the federal report also differ largely from state-published data.
CMS reported 147 total cases, including deaths, among nursing home residents in Nevada, almost four times less than the 577 reported by the state as of June 5.
Similarly, the federal report stated only 125 nursing home staff had contracted the disease in Nevada. The state has reported 403 cases among staff.
One reason the numbers of cases may be lower in the federal data is that CMS did not require nursing homes to report infections discovered before May 8. However, that would not explain why the number of reported resident deaths is higher in the federal data than the state’s.
Litz said the state’s numbers come from both laboratory data and information that nursing homes are required to submit daily. Cases and deaths are added to the state’s publicly published data once a DHHS worker confirms them with the nursing home.
“We will be looking into this further,” Litz wrote in an email Friday.
The federal report also shows that Nevada is one of four states where state health officials have completed on-site inspections of all nursing homes since early March.
CMS has so far only published inspection findings for four of the state’s 66 facilities. None were cited for failing to meet federal standards for infection prevention and control.
More inspection results will be published on June 24 and then on a monthly basis, according to CMS.
Nursing homes question data
CMS, which regulates and oversees the nation’s nursing homes, last month began requiring the facilities to submit COVID-19 data on a weekly basis to the Centers for Disease Control and Prevention’s National Healthcare Safety Network.
The new initiative is being used to identify problem areas and help CMS better plan infection control actions.
The federal dataset was released publicly for the first time this week. It indicates that 17 of Nevada’s 66 nursing homes are not regularly submitting data.
The state’s two deadliest outbreak sites — The Heights of Summerlin in Las Vegas and Lakeside Health & Wellness Suites in Reno — were among the facilities that did not submit weekly data to the CDC in time for either of its first two deadlines, May 24 and 31. Facilities that don’t participate can face recurring fines, starting at $1,000.
But administrators from both nursing homes said the federal data is flawed and that they submitted the information.
“We have followed all reporting protocols in a timely manner and have the documentation as a record of our submission,” The Heights of Summerlin administrator Andrew Reese wrote in an email Thursday evening. “It appears their data needs to be updated and we will contact them first thing tomorrow to discuss.”
“We believe it is a mistake and will resolve it directly with CMS,” Lakeside Health & Wellness Suites administrator Ellen Kelly wrote in an email.
The federal dataset also shows that only 30 nursing home residents in Nevada have died from COVID-19, a direct contradiction of the report CMS released earlier in the week.
A CMS official did not directly answer a Review-Journal reporter’s questions about the conflicting death tolls the agency published, but wrote in an email that the agency was performing quality checks to find any ”data submission errors” from nursing homes.
In addition to tracking COVID-19 infections and deaths, CMS is also collecting information about nursing home staffing levels and their inventories of personal protective equipment.
The federal data shows Life Care Center of Las Vegas reported having a shortage of nursing and clinical staff, as well as a shortage of aides and other workers. Executive director Clarissa Dewese did not return a request for comment.
Lake Mead Health and Rehabilitation Center in Henderson reported having no supply of N-95 masks, surgical masks, eye protection, gowns, gloves or hand sanitizer, according to the federal data. But facility spokesperson Annaliese Impink wrote in an email Friday the facility “has ample PPE.”
Verma said the CMS expects to see fluctuations in the data throughout June as nursing homes get used to reporting information to federal officials.
The dataset will be updated in two weeks, and on a weekly basis after that.
“There’s going to be honest errors in data entry,” she said. “We’re going to be continuing to work on scrubbing the data.”
Contact Michael Scott Davidson at email@example.com or 702-477-3861. Davidson is a member of the Review-Journal’s investigative team, focusing on reporting that holds leaders and agencies accountable and exposes wrongdoing. Follow @davidsonlvrj on Twitter.