Michigan auditor general releases review of COVID-19 deaths in long-term care facility

A report from Michigan's Office of the Auditor General that concluded a higher number of patients at long-term care facilities had died from COVID-19 than what the state health department was reporting dropped on Monday.

The report, which received media coverage and criticism ahead of its publishing on Jan. 17, announced it identified 7,010 COVID-19 deaths linked to LTC facilities between Jan. 1, 2020 and July 2, 2021. That's 1,511 more deaths than what the state had reported.

The figure is disputed by the Michigan Department of Health and Human Services, which argued last week and doubled-down Monday that differences between the report and its own totals were because the departments used different definitions when defining long-term care facility deaths. 

In a letter addressed to Oversight Committee Chair Rep. Steve Johnson (R-Wayland), the OAG said the health department had accurately posted death figures to the state's COVID-19 dashboard. However, using figures from the MDHHS Electronic Death Registration System and four other databases, it concluded the number of patients at long-term care facilities that died of COVID-19 was about 30% higher than what MDHHS reported.

Part of the reason for the difference was that the OAG also included figures from the Michigan Disease Surveillance System (MDSS) when tallying deaths. The MDHHS has argued that database was unreliable. 

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A statement from the health department said it had "serious concerns" about the methodology that was used and worried it misinterpreted the integrity of the department. 

"We were upfront and clear about what deaths were and were not included in our count. The OAG has chosen to use a different definition of a long-term care death than MDHHS is using based on federal requirements. The analysis combines COVID-19 deaths in facilities that were required to report and those that were not required to report, creating the impression of a larger undercount by long-term care facilities than is warranted."

The OAG said it believed using the MDSS field for totaling figures was reliable. 

Johnson previously argued the report, which explicitly stated was not an audit of the nursing home figures, revealed a "shocking undercount."

"Make no mistake – this is a large discrepancy, and the report makes that clear," Johnson said last week.


But the figures don't reveal an undercount or underreport of the data, Gov. Gretchen Whitmer's press secretary said. Instead, the "differences" that were identified came about because the definitions the OAG used fell outside the scope of the CDC's definition for reportable long-term care facility deaths.

"Throughout the pandemic, the State of Michigan closely followed the data and science within the CDC’s guidelines to slow the spread of the virus and save lives," said Bobby Leddy. "The Office of the Auditor General confirmed Michigan counted 100% 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."

The report was also able to reconcile 97% of the total COVID-19 deaths that the state had reported through July. 2, 2021.