With COVID-19 on the rise again and many nursing home staffers unvaccinated, families still lack easy access to crucial Medicare immunization data that will help them pick the right facility for their loved one.
Medicare has a "Care Compare" website for consumers it has spent years refining. But that's not where the agency is posting vaccination numbers for residents and staff at individual nursing homes. Instead Medicare is relying on a COVID-19 data page geared to researchers. One way to navigate it involves scouring a map for little red dots that represent nursing homes. There's also a huge spreadsheet. It's not seen as particularly user-friendly.
"Getting this on 'Nursing Home Compare' is super important," said David Grabowski, a Harvard health care policy professor who has researched the impact of the pandemic on nursing homes. "Having it buried in a spreadsheet is really frustrating."
Access to the numbers is critical because there are wide differences among nursing homes, and within nursing homes, when it comes to vaccination.
Grabowski's analysis of Medicare data indicates that nationwide, about 78% of residents and 56% of staff completed their vaccinations as of the week ending June 20.
Statistics posted by Medicare reveal big disparities between states. In Alaska, 91% of residents are vaccinated, but in Florida it's 69%. In Hawaii, 82% of staffers are vaccinated, but in New York it's 62% and in Louisiana, 42%. Staff vaccination rates are important because infected staffers can unwittingly bring the virus into a nursing home before they develop symptoms.
Within states, there can be big differences among counties, and even among nursing homes in the same community, said Terry Fulmer, president of the John A. Hartford Foundation, which works to improve care for older adults.
"We now have a Delta variant and we could have a surge," said Fulmer. "My concern is that residents will die and that staff will die, and it could have been prevented."
Medicare's parent agency, the Centers for Medicare and Medicaid Services, acknowledged in a statement that it has work to do. "We are focused on making this data more consumer-friendly and easy to navigate," the agency said.
But the agency stopped short of making a commitment to post nursing home vaccination rates on its Care Compare site. Instead it pledged improvements to the data site, and a spokesperson said CMS will listen to recommendations.
Medicare said its planned improvements include highlighting nursing home vaccination rates on "a number" of its websites and adding a snapshot of vaccination rates at all facilities on the nursing home COVID-19 data page. It also plans to "enhance functionality so consumers can more easily identify an individual facility's resident and staff vaccination rates, and compare rates among facilities."
The agency gave no time frame, noting the vaccination data has only been available for little over a month.
Nursing homes bore the brunt of the pandemic throughout last year, but cases and deaths have plunged since vaccines became available. That has fostered a false sense of security, said Charlene Harrington, a professor at the University of California School of Nursing in San Francisco.
"Once the vaccines started being given out and the rates went down, then I think the administration kind of forgot about nursing homes," said Harrington. "So they really need to get on top of the situation."
Consumer advocates say they're concerned that bureaucratic inertia will make it harder for Medicare to change course.
"This data needs to be readily accessible to folks, not just dropped in a big file on their website," said Sam Brooks of Consumer Voice, a national advocacy group for quality long-term care. "It's just ridiculous that people should have to work this hard."
Medicare already provides information on flu and pneumonia vaccination rates for individual nursing homes on its Care Compare site. The two main nursing home industry groups say they have no objection to handling COVID-19 vaccination rates the same way.
"Care Compare is the website for the public, and the information has to be there," said Toby Edelman, who monitors nursing homes for the nonprofit Center for Medicare Advocacy. "If they want it to be somewhere else, they have to let people know. It makes no sense to me."
Although some states require nursing homes to post vaccination rates, there's no such national requirement. Some individual nursing homes require staff to get vaccinated, but most rely on persuasion.
Nursing school professor Harrington said she would want to see vaccination rates in the 90% range for both nursing home residents and staff.
"I would not recommend that any consumer to go to a facility that has a low vaccination rate," she said.