Since May 8, all Skilled Nursing Facilities have been required to report various COVID-19 related data to the CDC and CMS via the CDC’s website. The data points include:

  • Resident beds and census
  • Suspected and confirmed COVID-19 infections among residents and staff
  • Total deaths and COVID-19 deaths among residents and staff
  • Access to COVID-19 testing
  • Staffing shortages
  • Personal protective equipment
  • Ventilator capacity and supplies in the facility

This is in addition to any reporting requirements that may be required at the state level.  Facilities that fail to report data are subject to both F-Tag violations and increasing weekly fines.  Critically, facilities are not required to report COVID-19 data prior to May 8. CMS gives facilities the option to report cases and deaths retroactively, but only some have chosen to do so. 

On June 4, CMS released the first COVID-19 dataset, which only covers the two weeks ending May 24 and May 31.  Because homes were not required to report past figures, data from the week ending May 24 could include all cases and deaths fully retroactive to Jan 1, retroactive to the beginning of the required reporting on May 8, or just the week of May 24.  CMS does not differentiate.  Because facilities may correct previously reported data in future weeks, the numbers reported for these two weeks may change.

Additionally, there are issues with data integrity and completeness.  17% of all facilities nationwide reported no data, and a further 700 or so records failed CMS’s Quality Assurance check.  Both media analysis and our own investigation of the data have turned up other inconsistencies, including incomplete records and case-to-death ratios that cast doubt on the accuracy of the reporting.  Anecdotal evidence from operators and administrators we’ve talked to also indicates that some facilities had issues submitting data and getting confirmations, with one being told by the CDC that they were overwhelmed and that they were unable to find the data that the facility had submitted.

For these reasons and perhaps others, CMS explicitly advises against using this data for analysis:

Due to these factors, CMS cautions users to consider these factors when performing any analysis. For example, data reported over the first few weeks should not be used to perform trend analysis and longitudinal analyses. We expect the data to stabilize as nursing homes become more familiar with how to submit data via the NHSN Long Term Care Facility Module.

Even with all these issues, the summary statistics from the homes that have reported data reveal dramatic totals.  According to the figures, there have been over 95,000 COVID-19 cases across the nation’s Nursing Homes, and close to 32,000 deaths.

Since so much data is missing, the real totals are very likely much higher.

CMS expects to publish updated COVID-19 data on June 18, with ongoing weekly updates.  We will continue to analyze and report on how these numbers change, and how they’re impacting residents, staff, operators, lenders, and the industry at large.  For now, operators should continue to focus on delivering care, but also on ensuring they’re meeting the reporting requirements and avoiding fines.  Likewise, lenders should be looking at the data to ensure that the facilities in their portfolio aren’t experiencing any issues.  StarPRO’s StarAnalyzer tool has been upgraded to include a COVID-19 widget with all the relevant data for each home.  Watch this space as we adjust to changes in and additions to the data.

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