Someren Glen, a nursing home facility in the Denver metro area has said that the Colorado Department of Public Health and Environment (CDPHE) has stepped in to change the attending physicians’ determination of cause of death to COVID-19 in at least 3 cases.
Last week the Pennsylvania health department was forced to revise downward the state’s tally of COVID-19-caused deaths by 200, or about 10 percent, after coroners in the state produced a different number of COVID-19 deaths than the state’s numbers.
Someren Glen previously had four COVID-19-related deaths. The revision now puts them at seven deaths.
In one revised case by the CDPHE, the physician had previously consulted with the county coroner to determine that it was not a case of COVID-19-induced death. In one or more cases, the patient was actually in hospice care.
“This would be a cause of concern for a coroner,” said Douglas County Commissioner, Lora Thomas, who previously served as coroner for this metro county just south of Denver. “Short of a car accident, or something similar, a change in a hospice doctor’s determination of death is extraordinary intervention.”
The facility put out both a letter to families and a slightly different blog post expressing some concern about the changes.
“We do not want a state health department ruling to override the dignity and honor we bestow upon all residents, no matter their stage of life,” said Tim Rogers, executive director at Someren Glen. “We also don’t want to diminish the tireless hard work being put in by a dedicated team of professionals to care for everyone at Someren Glen.”
The CDPHE has taken pains to remind citizens that the “number of epidemiologically-linked cases represents a very small portion of the reported cases.”
While technically true, the epidemiologically-linked cases, like the revisions made by the CDPHE, are a very significant portion of the number of deaths. Total reported COVID-19 deaths are a little under 750.
The state of Colorado list 232 nursing homes as of the 3rd quarter of 2019 and the state has said that 60 percent of COVID deaths in Colorado are happening in these facilities. The state’s latest census calculates residency at nearly 17,000 people.
That would indicate a mortality rate from COVID-19 of 2.64 percent for population in a nursing facility and a mortality rate of 0.00517 percent for the rest of the population of the state of 5.8 million.
Someren Glen indicated that there is no medical reason that would induce the reclassification of cases to COVID-19, overriding the attending physicians cause of death.
“We have never seen a situation where the health department overrules a physician’s findings,” Rogers said in the letter. “However, these are unprecedented times and the health department official did not share [with us] the motivation for changing physicians’ orders.”
Assertions have been made recently that the hospitals may be using “presumed” cases of COVID-19 to bulk up their reimbursement from the federal government. Recent, widely disseminated “fact checks” have determined that hospitals do get 20 percent higher reimbursement for COVID-related cases.
But Medicaid and Medicare reimbursements come through the state, not directly through the hospitals. And state departments of health might have more legal authority to change the causes of death without causing messy problems like fraud charges.
The state of Colorado’s Department of Public Health and Environment did not answer repeated inquiries into this story at the time of publication.