Pa. health officials quietly alter erroneous nursing home case, death counts as providers cry foul

Spotlight PA is an independent, nonpartisan newsroom powered by The Philadelphia Inquirer in partnership with the Pittsburgh Post-Gazette and PennLive/Patriot-News. Sign up for our free weekly newsletter.

Updated, May 22

HARRISBURG — Two days after the state released a long sought-after list of nursing homes where the coronavirus has infected or killed residents or staff, Pennsylvania’s top health official admitted there are errors in the data.

“I have heard that there were a small number of errors,” Secretary of Health Rachel Levine said Thursday, after being confronted by lawmakers who said facilities in their districts were reporting different numbers of cases than the state had posted on its website. “We’re correcting those.”

The secretary’s comments sought to minimize the extent of the problem, as nursing home owners and the associations that represent them say the health department’s data is riddled with inaccuracies and, despite knowing about it for days, officials took little action in response.

Provider associations said publishing erroneous data has sown panic and anger among family members, distrust among nursing home staff, and frustration for providers.

“Minutes after the data was published, it became clear it contained inconsistent and inaccurate information,” Zach Shamberg, president and CEO of the Pennsylvania Health Care Association, which represents more than 400 long-term care facilities, said in a statement. “The Department of Health has not provided a plausible explanation for why it will not remove faulty data or alert the public that the posted data is inaccurate.”

A review by Spotlight PA found the department has been quietly making changes to the data since its release. In perhaps the most egregious examples, the state until Wednesday reported 20 deaths at the Jewish Home of Eastern Pennsylvania and 32 at Saunders House in Montgomery County.

But by Thursday, without any notation or acknowledgment, the state’s data showed no deaths at either facility. On Friday, the department released another version of the list that showed the death count at the Jewish Home as “not available," while Saunders House was listed as between 1 and 4.

The Pennsylvania Health Care Association first notified the department of inaccuracies Tuesday evening, just hours after the list was posted. On a call with the health department Wednesday, the association asked for the data to be taken down, but health officials refused, Shamberg said. The association is now threatening legal action to force the department to remove the information until it can be corrected.

Health department spokesperson Nate Wardle said the nursing home data shared with the public was meant to come directly from the facilities, but not enough providers reported the information in time. Instead, the health department used its electronic disease surveillance system, which matches case information and facility address, to compile its own list.

“We are constantly working to make sure the data we provide is accurate,” Wardle said.

Nursing home administrators said the health department only requested the data last Friday afternoon with a deadline less than 48 hours later. As they juggle multiple state and federal reporting requirements and caring for residents, that’s simply not enough time, many said.

Adam Marles, president and CEO of Leading Age PA, which represents more than 300 nonprofit facilities, said several providers were unable to log into the survey the health department sent out to collect data.

At the hearing Thursday, Levine didn’t provide any specific explanation as to why the information compiled by the department was wrong. Nor had the department put any disclaimer on the public data posted to its website to alert viewers to the inaccuracies, or to acknowledge what has been changed since the original version.

Friday, a day after this article was published, the state added a disclaimer to the data detailing its limitations. “Many facilities offer different levels of care at the same location,” the text reads. “From the data received by [the state’s electronic disease surveillance system], it is usually not possible to determine which part of the facility the case is associated with. Thus, the case counts in the table may not correctly capture the number of cases within that specific licensed facility.”

Family members, senior-care advocates, and legislators have long been pleading for the release of data on coronavirus cases and deaths by facility. As long-term care facilities have become the epicenter of the state’s pandemic — with nearly 70% of coronavirus deaths occurring among residents — many say there is a need for greater transparency.

In its absence, advocates say, some facilities have been hiding known cases of the virus from residents, families, staff, and the larger community, and obscuring the state’s sense of which homes are most in need of resources.

State officials initially resisted releasing the data, saying it was too messy and that it was protected by a decades-old disease privacy law. But they eventually reversed course following a regulatory change that mandated long-term care facilities report cases to federal officials. The list was first published on the health department’s website Tuesday.

Now, as reports of inaccuracies in the public data pile up, some worry its release is doing more harm than good.

“Putting out data that is inconsistent with the realities that providers have been reporting has the potential to undermine trust,” Marles said.

Numbers at some facilities are being overreported, while others underreported, Marles said. “Some of our members aren’t even listed,” he said, “And some of the facilities that were reported to have cases actually have none.”

In a few instances, the health department reported a higher number of cases than there were residents at the facilities, The Philadelphia Inquirer found.

Douglas Motter, president of Homestead Village in Lancaster, said his facility is listed twice, as Homestead Village and Homestead Village Inc. And neither set of data is correct.

The facility has received calls from confused family members who wondered why the case counts reported on the health department’s site were lower than what the facility had told them.

“Our response was to always go to our website,” Motter said. The facility has been posting detailed numbers of positive cases, recovered cases, and resident deaths since mid-April.

Presbyterian SeniorCare, which owns more than a dozen long-term care facilities across western Pennsylvania, said it will begin posting data on its website this week to ensure families get accurate information.

The company has only had one resident test positive, said Bobbie Gray, vice president of care communities. But while the health department had the resident listed at Southmont, they were actually at the company’s Southminster Place facility.

As nursing homes find and report the inaccuracies, their representative associations are passing them along to the health department, which has agreed to correct them.

LeadingAge PA and PHCA both agreed that the data should be public. But, they emphasized, only if it’s accurate.

“We want to get true numbers out there as soon as possible,” Marles said.

Sarah Anne Hughes and Sara Simon of Spotlight PA contributed reporting.

Spotlight PA receives funding from nonprofit institutions and readers like you who are committed to investigative journalism that gets results. Give a gift today at spotlightpa.org/donate.