Over the course of the last three months our nation has experienced a shift in the way we live, interact and care for one another. Nursing homes have been in the spotlight since the virus began spreading and, unfortunately, the information being uncovered is not positive. What started in a facility in Kirkland, Washington, has spread to at least one nursing home in every state, in some states the majority of COVID-19 cases are housed in nursing homes.
Not only has this virus exposed the staggering number of nursing homes that were unprepared for this pandemic, despite clear guidance for years advising that emergency plans be put into place, but it has struck a call to action for the nursing home industry to begin patching up long-existing gaps in its system.
In response to the alarming situation within United States’ nursing homes, Centers for Medicare and Medicaid Services (“CMS”) issued new reporting requirements for facilities “[i]n an effort to support surveillance of COVID-19 cases and increase transparency for residents, their representatives, and families.” As part of these new reporting requirements CMS and CDC require nursing homes to report data to the CDC’s National Healthcare Safety Network (“NHSN”) system and a COVID-19 Nursing Home Data Set (“Data Set”) has since been released to the public as of May 26, with an update as recent as June 9. Using resources such as this Data Set as well as previously-reported numbers by several states, we continue to see a dire situation brewing in nursing homes as they now account for more than one-third of all COVID-19 deaths in America. The situation in Texas is not any better.
Consistently ranked in the bottom 10 for quality of care, Texas continues to have its fair share of COVID-19 cases in its nursing homes. The unfortunate part is that it is not surprising.
In an interview with The Dallas Morning News, Kay Van Wey noted how
Texas has over 1,200 nursing homes yet 568 of those nursing homes have had confirmed resident or staff cases of COVID-19 with 47% of COVID-19 deaths being tied to skilled nursing and assisted living facilities; almost half of the nursing homes in the Lone Star state are struggling to fight against the virus. As mentioned, these devastating losses stem from years, if not decades, of complacency and a broken industry focused on profit over life. To explore an example of this, we look to the Brentwood Nursing Center (“Brentwood”), also known as Brentwood Place (inclusive of buildings One, Two, Three and Four), located here in Dallas.
Similar to other nursing homes, Brentwood has a page dedicated to their COVID-19 response and within it they attempt to reassure and give peace of mind to the community. The question we have is how much peace of mind can there really be when Brentwood, as of June 17, has had a total of 163 resident and 42 staff COVID-19 cases? The short answer – probably none at all. These numbers are nothing short of concerning but sadly are not too surprising considering Brentwood received a 1-star rating, out of a Five-Star Quality Rating System, by CMS this past year. A 1-star rating categorizes Brentwood as a “Much Below Average” facility, this is exemplified in CMS’s inspections of Brentwood where in the last three years Brentwood has had a minimum of four complaints each year. In the most recent inspection of July 2019 there were 7 health citations found in Brentwood Place One, slightly higher than the Texas average of 6.9.
Brentwood has demonstrated their ability to track data, as shown through COVID-19 updates on their website, yet a closer look into CMS’s Data Set shows that Brentwood was flagged with a “N” in the “Quality Assurance Check” column, meaning they likely had inconsistencies in the data they provided to the CDC. Although we cannot say whether the data Brentwood provided to the CDC was intentionally presented in that manner, but it is striking that the data Brentwood provides on their website is significantly inconsistent with the data they gave to the CDC. In our interpretation, the data Brentwood provided to the CDC does not accurately represent the current situation or quality of the facility. For example, nursing homes were asked to provide the “[n]umber of residents with laboratory positive COVID-19 (CONFIRMED) since 01/01/2020” to which Brentwood answered “13” for Brentwood Place One while, in actuality, the number was closer to 83 for the same entry date of May 31st. What do these discrepancies in data reporting tell us? On one end, maybe it further demonstrates a characteristic of carelessness in the facility which is reflected in the quality of the facility itself; or on the other end it could be representative of poor management and the trickle-down effects of such lackluster leadership. These are all possibilities but who is to say for sure except those deeply involved?
We dive into a facility such as Brentwood to show how badly the virus has torn through neighborhood nursing homes but also how an investigation into past to current practices at these facilities can inform us of the danger that surrounds a profit-driven industry. Facilities should be held accountable for the harm they contributed to and as the virus continues to rage on, we must continue to fight for our nation’s elderly population as well as staff on the front lines.
If you or someone you know has experienced unacceptable care in a facility such as Brentwood, don’t hesitate to contact us for a free evaluation of your case. Our team is looking forward to discussing this issue with you.
 Centers for Medicare & Medicaid Services, Interim Final Rule Updating Requirements for Notification of Confirmed and Suspected COVID-19 Cases Among Residents and Staff in Nursing Homes (May 6, 2020), https://www.cms.gov/files/document/qso-20-29-nh.pdf.
 John Burnett, Texas Calls in A Strike Force To Try To Slow Coronavirus Spread in Nursing Home, NPR (June 15, 2020, 5:06 AM), https://www.npr.org/2020/06/15/875392871/texas-calls-in-a-strike-force-to-try-to-slow-coronavirus-spread-in-nursing-home.
 Holly Hacker et al., ‘She’s So Afraid.’ Dallas Nursing Home Residents At Center Of COVID-19 Crisis, The Dallas Morning News (Apr. 25, 2020, 2:26 PM), https://www.dallasnews.com/news/investigations/2020/04/25/shes-so-afraid-dallas-nursing-home-residents-at-center-of-covid-19-crisis/.
 Burnett, supra. Texas Health and Human Services, COVID-19 Outbreaks in Long-Term Care Facilities, https://www.dshs.texas.gov/coronavirus/COVID-19OutbreaksinLong-termCareFacilities.aspx.
 If a facility is flagged with a “N” in the “Passed Quality Assurance Check” column of the Data Set this means that the CDC has identified an unusual pattern of data entry or instance where a facility may have entered incorrect data as well as other data entry errors.
 In Brentwood Place One’s submission to the CDC, the facility responded “13” for the total number of residents that have had a confirmed, positive COVID-19 case since 01/01/2020. However, on Brentwood’s website, https://www.brentwoodnursingcenter.com/covid-19/, the facility entered “83” for the total number of residents that have tested positive for COVID-19. Both data entries were on May 31st.