The Mackinac Center worked with Pulitzer Prize winning journalist Charlie LeDuff last year to investigate how well the state tracked COVID-19 deaths in nursing homes. Our initial findings suggested that as many as 40% of all Michigan COVID-19 deaths could be tied to a long-term care facility. Seeing our investigation, the House Oversight Committee called on the Office of the Auditor General to review the state’s data. The resulting report shows that the Whitmer administration miscounted deaths among Michigan’s vulnerable and elderly population.
The office concluded that deaths associated with COVID-19 in long-term care facilities were 42% higher than officially reported. As of July 2, 2021, the Michigan Department of Health and Human Services reported a total of 5,675 deaths in long-term care facilities. The auditor found that the actual death toll was 8,061, meaning that 37% of all COVID-19 deaths in Michigan can be traced to these facilities.
The Whitmer administration knew this report was forthcoming and tried to rebut it before it was even published. After it was released, the health department’s director, Elizabeth Hertel, doubled down by arguing with the report’s methodology. She claimed that the Auditor General’s office tracked deaths at facilities that were never required to report them, adding that the office used a health department database not meant for tracking deaths.
Neither claim holds water. This is easy to see from the Auditor General’s review, which identifies the additional deaths that should have been included in the tally. In just the long-term facilities required to report, the Auditor General found a total of 7,010 deaths, significantly higher than the state’s official count of 5,675. Put another way, the state missed almost one in every four deaths it claimed to be tracking. Another 1,051 deaths could be traced to smaller facilities not required to report deaths to the state.
Director Hertel’s claims that the Auditor General used an unreliable database is odd: It’s the same one her department uses for contact and outbreak tracing. The state uses the Michigan Disease Surveillance System, as this database is called, to report new cases. The Auditor General drew on this database to construct its report. If there’s a problem with using it, then a host of the state’s official COVID-19 statistics suffer from the same shortcomings as well.
Regardless of director Hertel’s objections to the report, Michigan residents now have a more accurate understanding of how COVID-19 affected people in long-term care facilities. But this episode raises an important question: If the state did not properly categorize or fully account for all COVID-19 deaths, was its data reliable enough to guide the governor’s life-altering policy decisions?
The state knew its data was incomplete. In June 2020, the health department performed a miniaudit of its numbers, using a method similar to that of the Auditor General’s. That miniaudit found 44% of deaths identified by death certificates could be traced to long-term care facilities. This should have triggered changes in how the state tracked deaths that could be tied to long-term care facilities. But it appears that nothing happened.
Michigan Attorney General Dana Nessel decided last March not to investigate Gov. Gretchen Whitmer’s nursing homes policies, citing a lack of evidence. The U.S. Department of Justice announced last year that it was dropping a similar investigation. Both should reconsider their decision in light of these most recent findings. And even if no legal action is called for, the health department should revise its policies to ensure it has better and more accurate data when making policy decisions.
The Auditor General’s report documents the state’s failure to accurately track data. But it also calls into question the Whitmer administration’s pandemic response. Thanks to undercounting deaths related to nursing homes, COVID-19 was made to appear more benign to residents of these facilities — and deadlier to the general population. Policy decisions, like locking down the state and shuttering businesses, may have been based in part on inaccurate data like this. The Michigan Department of Health and Human Services failed the people of Michigan on this front, and it should be held accountable.
