Editorial Staff

Study Calls for Better Reporting on Impact of COVID-19 in Eldercare Facilities

/in , , , , , , , /by Editorial Staff
Share on Facebook
Share on Twitter
Share on
LinkedIn
+

State has made improvements, but more needed

BOSTON – Over time, the Massachusetts Executive Office of Health and Human Services and Department of Public Health (DPH) have improved reporting about cases and deaths from COVID-19 in state-regulated eldercare facilities, but flaws and omissions remain and should be corrected, according to a new study published by Pioneer Institute.

“High mortality rates in Massachusetts eldercare facilities during the pandemic make the availability of clear and complete information on cases and deaths in each of these facilities vitally important,” said Barbara Anthony, co-author of A Brighter COVID Dashboard: State Should Cut Confusion And Clarify All Eldercare Cases and Deaths.

Failure to include all eldercare facilities

The “interactive data dashboard” published by DPH is the most prominent feature on the COVID-19 Response Reporting page of Mass.gov.  Its “Higher Ed and LTCF” section used to report total cases and deaths for long-term care facilities, which include nursing homes, rest homes and skilled nursing facilities.

Beginning in December 2020, Pioneer pointed out that the section excluded cases and deaths in assisted living facilities (ALFs), and that the dashboard should include those numbers in order to encompass the full range of state-regulated eldercare.  According to an April 2020 WBUR report, the more than 250 ALFs in Massachusetts had 16,500 residents, or around 40 percent of the 38,000 who live in nursing homes and 3,000 in rest homes.

In its April 15 dashboard, DPH continued to exclude ALFs, and in addition stopped including the number of COVID-19 deaths in nursing homes, rest homes and skilled nursing facilities, collectively long-term care facilities (LTCFs).  Instead, it included a reference to a sub-section of the COVID-19 “Response Reporting” page, which in turn contains links to complex spreadsheets with hundreds of rows of data.

Conflicting standards produce differing totals

Immediately before the April 15 change, the dashboard reported more than 9,000 total deaths in LTCFs alone, not including ALFs.  (There have been over 17,000 COVID-19 deaths statewide.)

However, the state recently eliminated that 9,000-plus figure, and a separate state report cites a total of 6,224 eldercare deaths including those in ALFs – a huge reduction.  The state explains that this far lower number is based upon a long-term care-specific Centers for Disease Control and Prevention (CDC) standard that excludes those who recovered from COVID prior to their death (presumably from another cause).

The state should clarify precisely how those many deaths have been excluded from the relevant total, to assure public confidence in the reduction at issue.

Also, the thousands of deaths that have been removed from the calculation of total eldercare deaths appear to remain in the state’s calculation of overall COVID-19 deaths, which – though information is scarce – appears to be based on a more expansive counting methodology.  The state’s presentation of different totals using different methodologies obscures an important metric:  the proportion of eldercare deaths to overall deaths.

“The report identifies information the state should provide to clarify how it is calculating eldercare deaths, and deaths overall, due to COVID-19,” said David Clancy, who co-authored the Pioneer report.  “The public has a right to clear answers about the number of COVID-19 deaths associated with state-regulated eldercare facilities, and how that total relates to the number of overall COVID-19 deaths in the state.”

The COVID-19 Weekly Public Health Report

A section of this DPH report shows the total number of cases and deaths at each LTCF.  Until April 15, the section only reported total cases in opaque ranges.  The highest was “>30,” even though some facilities have had more than 200 cases.

In accordance with Pioneer recommendations, the section now reports the actual number of total cases, and also provides the number of cases and deaths over the last 14 days.

“This change provides information that is helpful to those trying to decide among long-term care facilities for themselves or a family member,” said Pioneer Executive Director Jim Stergios.

The Weekly Public Health Report also has a companion section for ALFs. Unfortunately, DPH did not change that section to include recent case counts and exact total case counts.

In addition, the ALF section reports no information on deaths, even though hundreds have died at these facilities.

The reporting flaws identified in the report can be readily remedied by administrative or legislative action.

About the Authors

Barbara Anthony, lawyer, economist, and public policy expert, is a Senior Fellow in Healthcare Policy at the Pioneer Institute. She was also a former Senior Fellow and Associate at the Harvard Kennedy School’s Center for Business and Government where she researched and wrote about Massachusetts market reform and healthcare cost containment efforts. She served as Massachusetts Undersecretary of the Office of Consumer Affairs and Business Regulation from 2009 to 2015.  Among other positions, Anthony served as the Director of the Northeast Regional Office of the Federal Trade Commission in Manhattan, and was a top deputy to the Massachusetts Attorney General. She began her career as an Antitrust Trial Attorney at the U.S. Justice Department in Washington, D.C. Anthony is a well-known consumer advocate and regularly appears as a media commentator on consumer protection and business regulation issues.

David S. Clancy, a resident of Concord, Massachusetts, is a partner in the law firm Clancy & Shine LLC, which focuses on civil disputes. Mr. Clancy was previously a partner at an international law firm, from which he retired after a 20-year career, also practicing civil litigation. Among other professional activities, Mr. Clancy served three terms on the Board of Editors of the Boston Bar Journal, and has published multiple articles in that and other legal publications.

About Pioneer

Pioneer’s mission is to develop and communicate dynamic ideas that advance prosperity and a vibrant civic life in Massachusetts and beyond.

Pioneer’s vision of success is a state and nation where our people can prosper and our society thrive because we enjoy world-class options in education, healthcare, transportation and economic opportunity, and where our government is limited, accountable and transparent.

Pioneer values an America where our citizenry is well-educated and willing to test our beliefs based on facts and the free exchange of ideas, and committed to liberty, personal responsibility, and free enterprise.

Get Our COVID-19 News, Tips & Resources!

  • This field is for validation purposes and should be left unchanged.

Related Content:

Johns Hopkins’ Dr. David Steiner on Teaching Wisdom in Schools

This week on The Learning Curve, guest cohosts Charlie Chieppo and Alisha Searcy join Dr. David Steiner for a wide-ranging discussion about the importance of education as a means of transmitting enduring wisdom to young people.

Adam Ozimek: Immigration Policy Is Innovation Policy

The United States is built on all kinds of immigrants with all kinds of skills and experiences. While politicians might have us believe immigration is a divisive issue, the fact is Americans across the political spectrum agree at least on this: High-skilled immigrants are good for the country, and we need more of them.

Court Compels Colorblindness: Harvard Told No Exceptions for Equality Under Law

Joe Selvaggi speaks with Thomas A. Berry of Cato Institute about the Supreme Court’s ruling in Students for Fair Admissions Inc. v. President & Fellows of Harvard College, its impact on affirmative action, and what comes next for colleges seeking to ensure diverse enrollments.

Pulitzer Winner Stacy Schiff on Samuel Adams & American Independence

This week for the Fourth of July, the Learning Curve interviews Pulitzer Prize-winning biographer Stacy Schiff, who explores the American revolutionary Samuel Adams. She discusses Adams’ background, religion, and formative intellectual development, including the influences that Greco-Roman history, the Bible, and Enlightenment thinkers had upon his life and political thought.

Pioneer Study: Every Student Succeeds Act Not Meeting Needs of All Students

The most recent reauthorization of the Elementary and Secondary Education Act makes some progress toward fulfilling the mandate that public school districts provide wide-ranging academic and educational supports to students who attend nonpublic schools, but there is more to be done.

Cara and Gerard on Their Time with The Learning Curve

This week on The Learning Curve, Cara Candal and Gerard Robinson close out their time as long-time cohosts of the podcast by sharing highlights and memories from over the last several years. They reflect upon the state of education reform, the growth of school choice, parental empowerment, the impact of the Great Books, and the wisdom of many well-known and influential guests.

Baking Young Minds: Scientific Concerns for Cannabis on Kids

Joe Selvaggi talks with professor of psychiatry Dr. Ryan Sultan about the findings of his recently released study on the effects of cannabis on the mental health of American adolescents. Dr. Sultan’s work shows a substantial correlation between cannabis use and negative mental health outcomes.

Sebastian Corbat Brings Us Healthy Foods ‘From the South’

Immigrants move for many reasons, and sometimes it can be a matter of life or death if they don’t uproot. Sebastian Corbat came to the U.S. for life-saving treatment, and post-op therapy gave him both a new lease on life and a business idea: We should all have access to healthy, organic and tasty foods.

Study: Update Finds Boston Public Schools Making Slow, Uneven Progress

The Boston Public Schools (BPS) are experiencing some positive change but have a long way to go to streamline critical processes, improve school accountability, and create a realistic, school-centered budget, according to a new study from Pioneer Institute.

Becket Fund’s Eric Rassbach on Religious Liberty & American Schooling

Eric Rassbach of the Becket Fund for Religious Liberty discusses school choice and religious freedom, competing legal philosophies and views of the U.S. Constitution, and why issues pertaining to religion and schools remain so divisive at the K-12 level.

Curing Medicaid’s Cold: Unwinding Pandemic Expansion Before Federal Funds End

Joe Selvaggi talks with healthcare policy expert Dr. Brian Blase about Medicaid expansion during the COVID-19 healthcare emergency and how states can efficiently reexamine eligibility criteria so as to protect the vulnerable before federal support expires.

PRI’s Lance Izumi on Charter Schools & School Choice

Lance Izumi of the Pacific Research Institute discusses K-12 education reform, declining test scores, COVID-related learning loss, and the growth of education bureaucracy. He reflects on charter schools, school choice, and how U.S. history and civics should be taught.