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:

Improving the Bay State’s Public Pension Fund Investment Policies

0 Comments
/
While current policies provide a solid basis for preserving assets in Massachusetts’ 105 public pension funds, improvements and updates would boost flexibility and investment returns, while promoting accountability and limiting unnecessary risks, according to a new study published by Pioneer Institute.

Exploring Jewish Day Schools in Massachusetts

0 Comments
/
A new Pioneer Institute study of Jewish day schools in Massachusetts calls for the creation of an education tax credit program to ensure that children have the widest possible access to the schools their parents choose for them.

Enter the Better Government Competition for Your Chance to Win $10,000

Enter Pioneer Institute's 2013 Better Government Competition for your chance to win $10,000. Read the contest guidelines and details about the topic.

Rejection of Anti-Common Core Model Legislation a Sad End to a Bizarre Process

1 Comment
/
Pioneer Institute's statement on the decision of the American Legislative Exchange Council Board to reject anti-Common Core model legislation that had been approved twice by ALEC’s education task force.

Continuing State Public School Enrollment Decline Will Increase Fiscal Pressure on Districts

0 Comments
/
Enrollment in Massachusetts public schools is continuing to fall, and the decreases could result in under-utilized facilities, higher per-pupil costs and more political pressure to limit the growth of charter schools according to a new Pioneer Institute white paper, Enrollment Trends in Massachusetts: An Update.

Unrealistic Investment Return Assumptions Mask True Cost Of Retiring Unfunded Pension Liabilities

0 Comments
/
Pension boards across Massachusetts must use more rigorous actuarial assumptions about pension fund investment returns and accelerate the rate at which they pay down unfunded liabilities to meet the 2040 statutory deadline for fully funding public pensions in the Commonwealth according to a new study published by Pioneer Institute, The Fiscal Implications of Massachusetts Retirement Boards’ Investment Returns.

The Great Experiment

0 Comments
/
The Great Experiment: The States, the Feds, and Your Healthcare…

STUDY: Obamacare tax to hit middle class in Massachusetts

0 Comments
/
While the Affordable Care Act might have taken its inspiration and ideas from the groundbreaking 2006 health care reform law in Massachusetts, the Bay State will not be exempt from some of the costs associated with the federal law.

2013 Ruth & Lovett Peters Fellowship Opportunity

0 Comments
/
Pioneer Institute is thrilled to announce the second annual Ruth and Lovett Peters Fellowship, an opportunity for a current or recent graduate student with a passionate interest in education policy and strong entrepreneurial and analytic abilities.

Pioneer Forum to Focus on SABIS® and the Role of For-Profit Charter School Management Companies

0 Comments
/
Pioneer forum on SABIS® and the Role of For-Profit Charter School Management Companies.

Big “Cadillac Tax” Ahead for Massachusetts’ Middle Class

A new brief from Pioneer Institute, The Impact of the Federal Health Law’s “Cadillac Insurance Tax” in Massachusetts, estimates additional costs associated with the ACA's so-called "Cadillac tax," will affect well over 50% of workers in Massachusetts.

Big ACA Middle-Class Tax Increase in Mass, $87K for Small Biz Employee

2 Comments
/
Pioneer is releasing a new brief estimating the impact of…