At least 512 residents of nursing homes who died of COVID-19 are missing in state reports.
Also outside the state’s reports are 25 employees in nursing homes who died of COVID-19.
March 1, State Department of Health reported 1,863 long-term residents of Oklahoma have died of coronavirus since the pandemic began.
The latest federal data reports 2,375 such deaths per March 6, increasing the state’s victims by 27%.
Federal reports only include residents of nursing homes funded by Medicare and Medicaid, meaning they capture less than half of Oklahoma’s long-term care facilities.
The State Department of Health was the only agency that tracked COVID-19 deaths among nursing home residents, non-federally funded retirement communities, and veterans’ homes, which had some of the state’s highest number of deaths and cases. Officials say the department now relies on facility staff and families to voluntarily report these cases. Because reporting is not mandatory, the state will no longer release case or death information for these facilities to the public.
Without these counts, Oklahomans are left with a fragmented picture of the virus’ burden on the state’s 660 nursing homes and their residents.
The state’s reporting of resident infections is also deficient.
The Department of Health reported 11,031 COVID-19 cases on March 1, compared to 17,346 reported by the Federal Agency for Fewer Facilities. That is 57% more than the state reported.
“We recognize that this information was in no way accurate and did not provide an accurate picture of what was going on in these facilities,” said Jolianne Stone, state epidemiologist. “We do our best with validation, and we do our best to try to paint the most accurate picture we have, but surveillance has limitations, and unfortunately, this is one of the limitations of surveillance.”
State is now dependent on federal data
The federal agency overseeing nursing homes, Centers for Medicare and Medicaid Services continues to track the deaths, cases and vaccinations of 297 Oklahoma facilities. This data is available online but it can be difficult to navigate.
The state now uses federal data to produce its weekly reports, which include only active cases among residents and staff.
As more mask restrictions are lifted and some Oklahomans try to regain a sense of pre-pandemic normality, vulnerable long-term care residents continue to die from the virus. And the state no longer reports these deaths to the public.
An 85-year-old farmer who lived at Beadles Nursing Home in Alva died Feb. 27 after contracting COVID-19 for the second time. He was vaccinated and boosted and had been out of quarantine for about two weeks when the charge became too high.
“He was the father of my classmates, so I knew him since high school,” said Adam Jordan, whose family has owned nursing home for almost a century. “He lined up as a bus driver for my kids when they were little.”
Jordan fills out the federal reports every week. But the farmer is not being held accountable because they did not know for sure that COVID-19 was the cause of death before the death certificate was completed this week. Jordan said he plans to go back to the previous report and add the resident as a COVID death, bringing the home’s total to six lives lost.
Unknown or delayed causes of death are one of many factors that make accurate reporting a challenge.
The federal agency that regulates nursing homes requires facilities to provide weekly COVID-19 updates. Non-compliant facilities face fines that could affect their funding.
Facilities reported some of the same information to the state. However, officials said these reports were unreliable and delayed, so they chose another method to track the impact of COVID-19 on long-term care.
When a positive COVID-19 test was reported to the health department of a laboratory, hospital, or long-term care facility, it was assigned to an investigator or contact tracker. The investigator called the patient or family member using the information on the form completed at the test site and asked if they lived in a high-risk environment, such as a nursing home, and which.
“We rely on individuals to report information to us,” Stone said. “It’s their choice whether they choose to do it or not.”
If a patient or family member did not pick up the phone or refuse to talk to the investigator, they were left out of long-term care.
This strategy was used by all 50 states, Stone said. It’s not unique to Oklahoma, and neither are the gaps in cases and deaths, she said.
In January, the state stopped calling anyone who tested positive. Instead, they send text messages asking them to write “yes” if they would like more information.
The Ministry of Health’s weekly epidemiological report was updated this month. It does not include vaccination rates or deaths, which are part of the federal database.
During the first week of March, nine residents of nursing homes died of COVID-19 at six facilities, federal data show.
Health authorities said the reports are intended to inform family members and the public about the outbreak status of a facility before deciding whether it is safe to visit.
Almost 42% of the facilities lacked information on active cases in the first iteration of the new report.
For nursing homes with five or fewer cases, the exact number was omitted.
The following questions from Oklahoma Watch on the value of this information to the public, the Ministry of Health again amended its report.
The state mentions concerns about privacy
The latest report, released Thursday, includes resident totals and the number of active infections among residents and staff. Of almost 300 facilities, 20 are missing information. The specific infection rate is now included for plants with five or fewer cases.
Kendra Dougherty, director of the State Acute Disease Investigation, said the reporting changes reflect the agency’s transition from a pandemic response to an endemic response while still serving the public.
When asked why deaths were no longer reported, Dougherty cited concerns about privacy.
The state has been releasing specific counts of infections and deaths by facility for nearly two years. The initiative also goes against advice from former Attorney General Mike Hunter that COVID-19 information can be released as long as no person can be identified.
LaTrina Frazier, a deputy health ministry commissioner working with state facilities, said early reporting was needed to help the public understand the challenges staff and residents faced when they were closed to the public.
Frazier said it’s time for these facilities to go beyond fighting COVID-19 and shift some of their focus to other aspects of care such as residents’ mental health, which dropped dramatically during shutdowns.
Whitney Bryen is an investigative reporter and visual storyteller at Oklahoma Watch with an emphasis on domestic violence, mental health, and nursing homes affected by COVID-19. Contact her at (405) 201-6057 or [email protected] Follow her on Twitter @SoonerReporter.