Report: More than 8,000 COVID deaths in Michigan were in long-term care

The Michigan Office of the Auditor General identified 8,061 deaths connected to long-term care through July last year — 42 percent more than the state’s official count of 5,675, according to a long-awaited report.

The findings are sure to reignite partisan disagreement over Gov. Gretchen Whitmer's handling of the pandemic — but both her administration and Auditor General Doug Ringler agree that much of the difference in the numbers comes down to the way deaths are counted.

Among the discrepancies were 923 deaths in facilities not required to report long-term care deaths to the state at all, Ringler found.

Related:

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• COVID rates plunge in Michigan nursing homes following vaccinations
• Michigan continues to stumble in tracking coronavirus in nursing homes
• In tense hearing, Whitmer official defends MI COVID nursing home strategy
• A third of Michigan’s COVID deaths are in nursing homes. Who is to blame?

The report is expected to be released Monday. Bridge Michigan obtained it Friday, one day after Whitmer’s health department preemptively launched an attack on the report, calling it politically motivated.

State Rep. Steve Johnson, R-Wayland, chairs the House Oversight Committee and sought the review in July, after the Republican-led chamber criticized the Whitmer administration for its handling of safety measures in nursing homes and other facilities, saying it may have led to more deaths. 

The state’s former health director, Robert Gordon, was questioned for designating nursing homes as “regional hubs” where patients diagnosed with COVID-19 could be housed and treated in wings segregated from other patients in the facility. The policy has long been rescinded.

Additionally, family members in Michigan have criticized the suspension of visitation — a move meant to curb COVID’s spread, but which also isolated residents, sometimes leaving them to die with no loved ones by their side.

“I think Gov. Whitmer's decision to place COVID positive patients in nursing homes was a deadly decision,” Johnson said. 

But the 13-page document obtained by Bridge, which includes a one-page letter and a dozen pages of numbers and explanations, does not address the regional hub issue or other policy questions.

Johnson told Bridge on Friday that lawmakers had suspected for months that the death tally from Whitmer’s administration was “not an accurate count,”and the report shows “how far off” it was.

In a statement to Bridge Michigan, Whitmer’s spokesperson Bobby Leddy said the state followed appropriate protocols.

“The Office of the Auditor General confirmed Michigan counted 100 percent of COVID-19 deaths that were reported to the state per CDC guidelines and accurately reported the numbers provided by nursing homes and long-term care facilities,” Leddy wrote in a text message. 

The report makes clear the difficulty in tracking COVID-19 deaths as the pandemic unfolded.

One problem was that the state relied on self-reports from long-term care facilities, first ordering facilities to report deaths in April 2020. It made the reporting requirement retroactive to Jan. 1, 2020.

The auditor general analyzed records from electronic death records, Medicaid records, the Michigan Disease Surveillance System and others, and its review includes both “confirmed” and “probable” deaths.

Ringler noted several issues that may have contributed to discrepancies in numbers.

• The auditor general’s report includes deaths in facilities not required to report to the state, such as adult foster care homes with 12 or fewer residents.
• In addition to confirmed deaths linked to COVID-19, the auditor general’s review includes “probable” deaths as well.
• At times, a death certificate identified COVID as a death, even when the decedent “had only negative COVID-19 test result(s).”
• In some cases, people may have died at a facility type different than the one where they were listed. (A single address might house, for example, both a skilled nursing facility and an assisted living.)

State officials have defended the health department numbers, drawing from those discrepancies. 

Whitmer’s health director, Elizabeth Hertel, defended the state’s decision to rely on self-reporting of deaths from nursing homes and other facilities, noting they would face federal funding cuts if they were caught supplying incorrect reports.

“I absolutely trust them,” she said of licensed facilities, in reporting death data.

The auditor general report agreed that the state accurately posted the number of self-reported COVID-19 deaths at long-term facilities.

But the state disputes  the auditor general’s characterization that another 1,511 deaths were connected to long-term care facilities, questioning the reliability of the data sources, according to the report.

Ringler’s office also examined overall COVID deaths throughout the state from Jan. 1, 2020 to July 2, 2021. 

It found 21,577 deaths overall, just over 3 percent more than the state.  Among the discrepancies were 788 deaths from reviews of death certificates that the state had not included in its count.