Chairman Neal Calls on Administrator Verma to Make COVID-19 Nursing Home Data More Reliable and Comprehensive
Aug 5, 2020
Unreliable data are being collected in long-term care facilities, despite their populations accounting for more than 40 percent of all COVID-19 deaths nationwide
SPRINGFIELD, MA – Amidst surging cases of coronavirus across the country, House Ways and Means Chairman Richard E. Neal (D-MA) called on Centers for Medicare & Medicaid Services Administrator Seema Verma to improve the reliability of data collected from long-term care (LTC) facilities to protect residents and staff. LTC facilities have been the perfect storm for COVID-19, with vulnerable residents living in tight quarters that are hotspots for infection and disease. Insufficient data collection makes it hard to understand the full picture of the crisis and appropriately allocate resources. Analysis by the Ways and Means Committee staff found incomplete and unreliable data in the Nursing Home COVID-19 Public File, a product of CMS.
“Access to timely, robust, and reliable data is critical in understanding the magnitude of the COVID-19 crisis in nursing homes and appropriately allocating resources to the hardest hit facilities as well as those at greatest risk for outbreaks,” wrote Chairman Neal. “The Centers for Medicare & Medicaid Services (CMS) started requiring LTC facilities to report limited COVID-19 data through its May 8, 2020, Interim Final Rule (85 FR 27550). Despite this requirement, reports of insufficient and unreliable nursing home data persist, most notably nursing home COVID-19 staff fatality data. Furthermore, issues of unreliable and insufficient data go beyond lapses in staff data, as the Nursing Home COVID-19 Public File contains large amounts of insufficient, unreliable, and missing data.”
In regard to the insufficient nursing home COVID-19 staffing data, Chairman Neal explained, “to date, no reliable national data on the number of Long-Term Care facility workers that have died as a result of COVID-19 exist…Ways and Means staff analysis of the Nursing Home COVID-19 Public File found that over three percent (about 3,900 data fields) of the data related to COVID-19 cases and deaths of LTC facility workers was completely missing. Even more alarming, Occupational Safety and Health Administration (OSHA) claims to have received reports of only 99 LTC facility worker fatalities related to COVID-19, suggesting there are data and reporting issues for this population across the federal government.”
There are similar data shortages in the nursing home resident COVID-19 data sets. Neal highlighted, “approximately three percent (about 3,900 data fields) of the data related to COVID19 cases and deaths among facility residents were missing or incomplete.” He also noted that, “approximately 16 percent of the data were missing on the ‘three or more confirmed and suspected COVID-19 cases’ metric and 66 percent of the data were missing for the ‘total COVID-19 deaths as percentage of confirmed COVID-19 cases among LTC facility residents’ metric. Most alarmingly, 96 percent of the data related to the supply of ventilators in facilities are blank within the datafile.”
The Administration announced in July it would allocated another $4.9 billion from the Provider Relief Fund to Medicare-certified LTC facilities and state veterans’ homes; however, the Department of Health and Human Services (HHS) has yet to announce the underlying methodology for disbursing and using these funds. Chairman Neal emphasized, “given the lack of reliability of both staff and patient COVID-19 nursing home data CMS has publicly reported, I am deeply concerned that the decisions related to the allocation of these funds may be informed by incomprehensive and unreliable data.”
The full letter and data tables are accessible HERE.