Michigan Undercounted COVID-19 Nursing Home Deaths by 30 Percent, Auditor Finds
Michigan Undercounted COVID-19 Nursing Home Deaths by 30 Percent, Auditor Finds

By Steven Kovac

The administration of Michigan Gov. Gretchen Whitmer underreported the number of nursing home residents who died from COVID-19 by 30 percent, according to a report by the state’s auditor general.

Auditor General Doug Ringler has been haggling with the Michigan Department of Health and Human Services for months over the numbers and how to count them. His final report was made public on Jan. 17.

At the start of the pandemic, Whitmer, a Democrat, issued an emergency executive order to place infected senior citizens in extended care facilities that had the ability to isolate them in a designated wing. As the infection spread, many residents and care workers died.

The audit found that 8,061 elderly Michiganders died of the disease in the state’s nursing homes between March 2020 and July 2, 2021. The officially posted death toll is 5,675, as self-reported by the state’s extended care facilities, which is required by law.

On the face of it, that appears to be an undercount of 42 percent. The audit provides 13 pages of explanation of why the real undercount is only 30 percent.

The auditor’s finding prompted Republican state Rep. Steven Johnson, chairman of the House Oversight Committee, to call for hearings.

“The state’s Department of Health acknowledged in a letter that a previous total of COVID-19 long-term care facility deaths is 30 percent lower than what the Auditor General found,” Johnson, who asked for the audit, said in a Jan. 13 statement. “This is a large discrepancy. … There is frankly a lot to answer for, and our legislative panel will be working to get those answers.”

A week before the auditor’s findings were made public, the Whitmer administration was already putting out its side of the story.

In a Jan. 9, 2021, letter to Ringler, Elizabeth Hertel, director of the state’s Department of Health and Human Services and a Whitmer appointee, explained that the additional deaths found by the investigation were due to differences in counting procedures and not an intentional undercount.

Hertel wrote that the audit’s numbers combine “COVID-19 deaths in facilities that were required to report to the state and those that were not required to report, creating the impression of a larger undercount by long-term care facilities than is warranted.”

Hertel said she had “serious concerns” that the audit’s methodology could lead to the official state count being “misinterpreted,” and could call into question “the work and integrity of long-term care facilities, local health departments, coroners, and other frontline workers who we rely on to report data.”

“The audit’s data table is misleading and appears to suggest that there was a 30 percent underreporting when almost half of this difference can be attributed to facilities not subject to reporting requirements,” she wrote. “An additional 1,036 deaths were identified when your team looked across all long-term care facilities, rather than limiting the scope to facilities subject to state and/or federal reporting requirements.”

Hertel also cited problems with “different definitions.” She said, “long-term care facilities were only required to report COVID-19 deaths within the definition provided by the CDC [Centers for Disease Control and Prevention].”

Hertel also criticized the auditor’s reliance on data from the Michigan Disease Surveillance System, which she said was “not an appropriate source for determining if a COVID-19 case resulting in death should be counted as a death in a long-term care facility.”

She called the system “an outdated, clunky platform that we’ve continued to utilize … because we have been unable to upgrade or replace it.”

Whitmer’s office didn’t respond to a request for comment by press time.

State health officials in New York are also under fire for allegedly undercounting the number of COVID-19 deaths among the state’s nursing home population.

On March 25, 2020, then-Gov. Andrew Cuomo, a Democrat, issued an emergency directive barring nursing homes from turning away admissions or readmissions of COVID-positive individuals.

After investigating a sample of 62 of the state’s nursing homes in the late spring of 2020, New York Attorney General Letitia James, a Democrat, concluded, “COVID-19 deaths associated with nursing homes in New York state appear to be undercounted by the Department of Health by approximately 50 percent.”

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