Monday, August 3, 2020

Testing Numbers in Texas May Be Off - Here's Why...

Testing numbers in Texas, especially for long-term care facilities such as ICF/IID programs, may be off and up to double what they should be due to reporting issues.  As of last week, we learned of one ICF working with the county where the lab reported the same numbers as the facility did.  That meant the facility showed double numbers. 

The realizations of the potential for double counts came during a conversation between county health officials and the administrator for the facility.  The administrator was asking questions in regard to PPE and other issues related to staff when the county official expressed appreciation for the list received.  Surprised, the administrator said, "I am working on the list now.  I have not sent it in yet."  The county official then pulled the list for the facility and found that the lab had reported the test results and completed the county forms.  With a large number of facilities reporting, it is possible that without this type of conversation, the county could have counted the facility residents twice. 

If we are looking at drastic numbers in nursing facilities, we need to be aware that the lab and the facility both reporting can double the numbers on record.  The average ICF is six beds in Texas so this could increase a count up to twelve if everyone in the home was infected.  This may not sound like a great number, but if we consider a little over 800 ICFs in Texas, then those numbers become scary.  If all 800 (rounded) ICF programs were six beds and all had COVID-19, the numbers should be at 4,800 cases - again assuming everyone in each six-bed facility had COVID-19.  Now, if the county is getting numbers from the facility and the lab, those numbers double.  Instead of 4,800 on the books, you would have 9,600 positive cases of COVID-19. 

It is doubtful that you can coordinate with your lab and keep them from reporting.   Most facilities, when speaking with the county officials, should discuss the possibilities that the lab and the facility may both be putting out the same numbers.  If you make your county coordinator aware of the problem, it may help ensure the number count is more accurate.