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How we did it: Read about the data-driven work behind USA TODAY’s nursing home project
Half the nation’s 140,000 COVID-19 deaths in nursing properties got here within the winter surge that lasted from October 2020 by means of February 2021, months after greatest practices had been established and federal support issued for dealing with the coronavirus.
USA TODAY took a more in-depth take a look at efficiency throughout that interval utilizing COVID-19 surveillance knowledge. Beginning in Could 2020, each nursing residence was required to report a big selection of numbers weekly to the U.S. Facilities for Illness Management and Prevention and to the Facilities for Medicare and Medicaid Providers, the federal company that regulates these services.
Reporters additionally decided which services had been operated by one of many Prime 10 nationwide chains, consulting possession lists from annual stories filed with Medicare and Medicaid, in addition to company web sites, property information and filings with Wall Road regulators.
For the 22 weeks from Sept. 28, 2020 by means of Feb. 28, 2021, reporters calculated COVID loss of life and an infection charges at every facility primarily based on knowledge submitted by practically all 15,340 nursing properties within the nation as of March 28, 2021. USA TODAY ranked main chains on these and different metrics.
To account for components that would drive a series’s loss of life price greater, USA TODAY tailored an method utilized by the federal Well being Assets and Providers Administration to award billions of {dollars} in efficiency funds to nursing properties. The company’s calculations begin by evaluating every nursing residence’s an infection price to that of its area people. The company then examined whether or not a house’s rely of resident deaths from COVID-19 was decrease or greater than what could be anticipated, given the variety of infections and the well being standing of residents.
Investigation: This nursing residence chain stood out for nationally excessive loss of life charges as pandemic peaked
To duplicate the primary aspect of the federal government’s formulation, USA TODAY turned to county-level data from the Johns Hopkins Coronavirus Useful resource Middle after the federal government declined a request to supply the native an infection knowledge utilized in its calculations.
For the second a part of the federal company’s method, reporters utilized regression, a statistical method. Federal officers used the tactic to manage for affected person age, gender, sort of nursing residence keep (long-term or short-term), variety of residents contaminated with COVID-19, and the share admitted with COVID-19 versus those that grew to become contaminated on the facility.
As a result of federal officers declined to supply the weekly facility and affected person traits behind their calculations, USA TODAY turned to latest historic knowledge on the facility degree. The info, from Medicare and Medicaid, is standardized for public use by Brown College below a grant from the Nationwide Institutes of Well being.
USA TODAY in contrast its estimate of predicted deaths at every facility to the variety of deaths the ability reported to the federal government, then computed a median for every chain. Reporters additionally examined various formulation to account for components that would affect loss of life charges.
Analysis has persistently correlated the standard of care in nursing properties with the degrees of nurse and aide staffing. Preliminary analysis targeted on the pandemic additionally suggests staffing performs a task in COVID-19 outcomes. To measure staffing, USA TODAY used two sources of knowledge nursing properties file with the Facilities for Medicare and Medicaid Providers, which regulates the trade: annual price stories and each day statistics from the Payroll-Primarily based Journal, which distinguishes hours spent on “direct care” versus administrative work.
USA TODAY analyzed nursing residence staffing on the facility and chain degree for all weeks when reporting was required from 2017 to 2020. Reporters additionally reviewed annual price stories about spending on wages and advantages. Reporters then in contrast every nursing residence’s reported staffing degree to a 2001 research for the Facilities for Medicare and Medicaid Providers, which calculated the minimal degree of care wanted to restrict hurt and stays the company’s commonplace advice.
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