ICYMI: Probe into Missing Nursing Home COVID Death Data Focuses on NY, PA, Other States

Mar 30, 2021 Issues: Health Care

WASHINGTON—New York and Pennsylvania are under increased congressional scrutiny for their handling of nursing home death data following a Health and Human Services (HHS) briefing to congressional staff on the collection of nursing home data and COVID-19, and whether certain states may have misled the public and the federal government. In new letters to both HHS Secretary Xavier Becerra and to Pennsylvania Attorney General Josh Shapiro, Ways and Means Republicans have stepped up efforts to retrieve data to resolve unanswered questions about what happened in states that required nursing homes to admit or re-admit COVID-19 infected residents—regardless of whether the nursing homes were capable of complying with CDC guidelines.

The letters call on HHS to provide the federal government’s summary reports given to states with mandatory admit or re-admit policies, beginning in May 2020. The letter to AG Shapiro asks for an explanation for why some state data appears to be missing in Pennsylvania, and to provide an update on what his office is doing to get answers to these questions.

The lawmakers write HHS explicitly seeking all summary reports provided to New York, Pennsylvania, Michigan, New Jersey, and California:

“During the March 11 briefing, we learned that the Centers for Disease Control and Prevention (CDC) used the National Health Safety Network (NHSN) to gather COVID-19 related nursing home data directly from nursing homes across the country. As part of that data collection effort, which began in May 2020, the CDC provided monthly reports to state governments summarizing the data reported directly by nursing homes.” They add: “We have intentionally kept our request narrowly focused so as not to create any unnecessary burden on the agency.”

The letter was signed by Ways and Means Republican Leader Kevin Brady (R-TX), Ways and Means Subcommittee on Health Republican Leader Devin Nunes (R-CA), Ways and Means Subcommittee on Oversight Republican Leader Mike Kelly (R-PA), Ways and Means member Tom Reed (R-NY), and Ways and Means member Rep. Lloyd Smucker (R-PA).

To Pennsylvania’s Attorney General, the lawmakers noted that the former Pennsylvania Secretary of Health, Dr. Rachel Levine (newly confirmed as Assistant Secretary for Health), never responded to congressional inquiries about why Pennsylvania nursing home death data remains missing. They write: 

“Given that context and the missing Pennsylvania data, we are concerned that there may be a concerted effort in the state to conceal the true scope of COVID-19 related nursing home deaths. Perhaps something else explains the missing data, but we have yet to receive satisfactory answers for why the data remains missing.”

These inquiries have been made not only by members of the House Ways and Means Subcommittee on Oversight, but also by members of the Pennsylvania delegation in the House. The letter was signed by Ways and Means Republican Leader Kevin Brady (R-TX), Ways and Means Subcommittee on Health Republican Leader Devin Nunes (R-CA), Ways and Means Subcommittee on Oversight Republican Leader Mike Kelly (R-PA), and Ways and Means member Rep. Lloyd Smucker (R-PA).

The letter to HHS Secretary Becerra is available in PDF form here. The letter to Pennsylvania Attorney General Shapiro is in PDF form here. The text of the letters appear below.

Letter to HHS Secretary Becerra

March 24, 2021

Secretary Xavier Becerra
U.S. Department of Health and Human Services

Dear Secretary Becerra:

We write to follow up on the briefing you provided to Ways and Means Committee staff on March 11, 2021. The briefing was very helpful and informative, and we are grateful that the Department made staff available. As you likely know, we continue to be concerned about policy decisions in the early days of the COVID-19 pandemic regarding nursing homes and about whether certain states, including New York and Pennsylvania among others, may have intentionally misled the public and perhaps the federal government regarding COVID-19-related deaths in those facilities.

During the March 11 briefing, we learned that the Centers for Disease Control and Prevention (CDC) used the National Health Safety Network (NHSN) to gather COVID-19 related nursing home data directly from nursing homes across the country. As part of that data collection effort, which began in May 2020, the CDC provided monthly reports to state governments summarizing the data reported directly by nursing homes. Our inquiry into this matter is largely a state-focused issue, but we have one modest request that would assist us in better understanding these issues.

We ask that your Department provide us with all NHSN summary reports that were provided to the following states:

  • New York
  • Pennsylvania
  • Michigan
  • New Jersey
  • California

We have intentionally kept our request narrowly focused so as not to create any unnecessary burden on the agency. During the last Congress and during the Trump Administration, the Department of Health and Human Services consistently produced documents responsive to the requests of the Ways and Means Committee. We hope that this practice will continue at the Department under your leadership.

If possible, we would appreciate receiving these documents by April 6, 2021. 

Sincerely,

Kevin Brady
Republican Leader
Committee on Ways and Means 

Devin Nunes
Republican Leader
Subcommittee on Health
Committee on Ways and Means

Mike Kelly
Republican Leader
Subcommittee on Oversight
Committee on Ways and Means

Tom Reed
Committee on Ways and Means

Lloyd Smucker
Committee on Ways and Means 

Letter to Pennsylvania Attorney General Shapiro

March 24, 2021

The Honorable Josh Shapiro
Pennsylvania Office of Attorney General

Dear Attorney General Shapiro:

We write regarding your state’s COVID-19 related nursing home death data. Significant questions remain unanswered as to why data from dozens of nursing homes in Pennsylvania continues to be missing from the state’s publicly reported database. You are likely aware of recent public reports about the state of New York’s effort to intentionally hide accurate data from the public and potentially from the federal government. Given that context and the missing Pennsylvania data, we are concerned that there may be a concerted effort in the state to conceal the true scope of COVID-19 related nursing home deaths. Perhaps something else explains the missing data, but we have yet to receive satisfactory answers for why the data remains missing.

We sent a letter to President Biden’s nominee for Assistant Secretary of Health and former Pennsylvania Secretary of Health, Dr. Rachel Levine, asking for answers as to why nursing home death data remains missing. Dr. Levine has not responded to our letter, which we have enclosed for your reference. We ask that your office pursue answers to those same questions.

Additionally, the Republican members of the Pennsylvania delegation in the U.S. House of Representatives sent you a letter dated February 16, 2021. That letter asked whether your office plans to develop and publish a similar report to the report issued by New York Attorney General in January 2021. Our understanding is that your office has not yet replied to that letter.

Given this context and the U.S. House Ways and Means Committee’s jurisdiction over Medicare reimbursement to skilled nursing facilities and Congress’s continued role in providing COVID-19 financial aid to states, it is imperative that we get answers to these questions. Therefore, we ask your office to provide the following:

Answers to the questions regarding Pennsylvania’s missing nursing home data contained in our enclosed letter to Dr. Levine dated March 15, 2021.

Answers to the questions asked in the Pennsylvania Republican delegation’s letter dated February 16, 2021, regarding whether you will publish a report on COVID-19 related nursing home death data in Pennsylvania.

An update on any and all efforts your office is undertaking to investigate the missing nursing home death data and Pennsylvania’s policy of requiring nursing homes to admit or readmit COVID-19 infected patients.

If you have any questions, please contact Ways and Means Committee Republican Oversight staff.

Sincerely,

Kevin Brady
Republican Leader
Committee on Ways and Means 

Devin Nunes
Republican Leader
Subcommittee on Health
Committee on Ways and Means 

Mike Kelly
Republican Leader
Subcommittee on Oversight
Committee on Ways and Means 

Lloyd Smucker
Committee on Ways and Means

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