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When the Trump administration required nursing homes to report their COVID-19 cases, it also promised to make the data available to residents, families and the public in a user-friendly way.But some facilities that have had coronavirus cases and deaths turn up as having none on Medicare’s COVID-19 nursing home website. Those data may be incomplete because the reporting requirements don’t reach back to the start of the pandemic. Numbers don’t necessarily portray the full picture.“The biggest thing that needs to be taken away ... is in its current form, it is really leaving consumers in the dark,” Sam Brooks, project manager for Consumer Voice, said of Medicare’s data website. Consumer Voice is a national advocacy group for improved quality in long-term care.Nursing homes are only required to provide the government with data on coronavirus cases and deaths among residents and staff as of May 8, or more than two months after the first outbreak in a U.S. facility was reported. Nursing homes have the option of full disclosure, but not all have taken it, and there is no penalty for withholding older data that may reflect poorly.The missing information from early in the pandemic leads to some puzzling results on the website.For example, a nursing home that had one of the first major reported outbreaks in the country — Life Care Center of Kirkland, Washington — shows no confirmed COVID cases and no deaths on the CMS data page.A spokesman for Life Care Centers of America, a major chain, said the company is providing the information the government requested.“We are reporting what CMS is asking us to report to them,” said Tim Killian. “We are not evading them in any way.“The Kirkland facility is now COVID-free and it has been for some time,” Killian added. The data showing no cases “is a snapshot of what is currently in the facility.”The company said its cumulative count shows 100 residents tested positive, and 34 died. “You can ask us directly and we’ll give you the exact numbers,” said Killian.But consumer advocate Brooks said that information should be on the CMS site.As it stands, the site “doesn’t tell the whole picture,” he said. “You are not going to be able to look at a home and make an informed decision.”The federal Centers for Medicare and Medicaid Services, which sets standards for nursing homes, said protecting nursing home residents is a top priority, and “transparency and information sharing has proven to be one of the keys to the battle against this pandemic.”But CMS said it lacked the legal authority to require nursing homes to disclose COVID information from before the effective date of its reporting rule in May.On Capitol Hill, there is pressure for more information.Sen. Chuck Grassley, R-Iowa, recently introduced legislation that would require nursing homes to report coronavirus cases and deaths going back to Jan. 1, a push that has bipartisan support.The estimated 1.4 million people living in some 15,500 nursing homes represent a tiny share of the U.S. population, but they have borne a disproportionate share of coronavirus deaths. Nursing homes are only now starting to emerge from a national lockdown that took effect in mid-March.According to the latest CMS figures, more than 33,000 nursing home residents have died in the pandemic. A running tally by The Associated Press, which also includes other long-term care facilities and staff as well as residents, shows more than 55,000 deaths.Depending on the total count, that translates from about one-fourth of the deaths to more than 40%, strikingly high proportions in either case.Coronavirus data for nursing homes do not appear directly on Medicare’s NursingHomeCompare website, the main portal for consumers trying to research a facility on behalf of a family member or friend. Instead, a link takes users to a different COVID-19 site that features statistics and a national nursing home locator map.Finding information on individual nursing homes via the data website can be confusing.If users type in a ZIP code or the name of a nursing home, the website’s locator map will display some small red dots near a larger marker icon, which also has a big dot in the middle.Instructions say click on one of the dots. But which one?The data is under the small red dots, not the larger locator, which instinctively draws the user’s eye.“I would click on the big dot,” said policy attorney Toby Edelman of the Center for Medicare Advocacy, which represents enrollees. “Why would I look for this thing that I can barely see?”CMS said it has received no reports related to search problems although more than 100,000 individuals accessed the site in June.The agency says it will continue to evaluate the usability of the website to ensure it meets consumer needs. 4782

When Dr. Harold Bornstein described in hyperbolic prose then-candidate Donald Trump's health in 2015, the language he used was eerily similar to the style preferred by his patient.It turns out the patient himself wrote it, according to Bornstein."He dictated that whole letter. I didn't write that letter," Bornstein told CNN on Tuesday. "I just made it up as I went along."The admission is an about face from his answer more than two years when the letter was released and answers one of the lingering questions about the last presidential election. The letter thrust the eccentric Bornstein, with his shoulder-length hair and round eyeglasses, into public view."His physical strength and stamina are extraordinary," he crowed in the letter, which was released by Trump's campaign in December 2015. "If elected, Mr. Trump, I can state unequivocally, will be the healthiest individual ever elected to the presidency."The missive didn't offer much medical evidence for those claims beyond citing a blood pressure of 110/65, described by Bornstein as "astonishingly excellent." It claimed Trump had lost 15 pounds over the preceding year. And it described his cardiovascular health as "excellent."The White House didn't respond to a request for comment about Bornstein's claim.Later, as questions mounted over the health both of Trump and his rival Hillary Clinton, Bornstein offered a more businesslike assessment, listing things such as Trump's height, weight and prescription medications.He later told CNN's Drew Griffin he'd dashed off the first letter as he was seeing patients."I was just rushed for time," he said in September 2016. "I had people to see."He insisted then that the words were his own."Did I really write that letter? Yeah," he said.Now, as Bornstein re-enters the spotlight claiming Trump's ex-bodyguard Keith Schiller robbed his office when Schiller retrieved Trump's medical records, the story behind the letter is becoming clearer."That's black humor, that letter. That's my sense of humor," he said. "It's like the movie 'Fargo': It takes the truth and moves it in a different direction."He said Trump read out the language as Bornstein and his wife were driving across Central Park."(Trump) dictated the letter and I would tell him what he couldn't put in there," he said. "They came to pick up their letter at 4 o'clock or something." 2369

What goes well with a hot pepperoni pizza? Pizza Hut is banking on its customers to say, "Cold beer."Pizza Hut announced on Wednesday that beer delivery will be available at 100 of its Arizona and California locations. The company said beer delivery is part of a nationwide pilot program. The beer will be stored in special coolers to keep it cold during delivery. Coors Light, Blue Moon and Miller High Life will be among the offerings. Customers who order a six-pack in some Arizona markets will have their delivery fee waived. "Nothing complements an oven-hot pizza like an ice-cold beer," said Zipporah Allen, CMO, Pizza Hut. "In addition to our extensive delivery network, many Pizza Hut restaurants are already licensed to serve and distribute beer, without third party services, additional fees, or extended wait times. Expanding the pilot program is a natural way for Pizza Hut to get our customers the perfect pizza and beer combo they're craving, delivered right to their doors."  Pizza Hut said it currently offers beer delivery at participating restaurants in Phoenix, Tucson, Glendale, Prescott, and Winslow in Arizona, along with participating restaurants in Los Angeles, Bakersfield, Riverside, Sacramento, Santa Barbara and Santa Clara in California. Pizza Hut will roll out beer delivery soon to additional locations, including Anaheim, Fresno, Huntington Beach and Redding later this month. 1456

With emotions still raw days after a deadly school shooting in Florida, one Ohio family is fighting back against what they think is an unfair punishment.Beth Mertel says one of her son's peers brought a toy gun to Greenbriar Middle School in Parma on Feb. 8, and pointed it at her son, Joey."He says he doesn't want to be the snitch," Mertel said. "They're 11 years old. They're kids. They're trying to find their place with their friends too."Mertel says the Parma City School District suspended the student who brought the toy gun, along with three other students, including Joey, for knowing about it but not telling an adult about it.The district stands behind the discipline, saying the three additional students were punished under a part of the Student Handbook labeled "Withholding Information."Mertel's concern is with the severity of the punishment, not the rule she admits her son should have followed."No matter how much I disagree with the suspension, you still should have said something," said Beth.Mertel says Wednesday's tragedy in Florida is an important teaching moment."I said [to Joey] you need to go home and turn on the news," said Beth. "You need to watch this, you need to understand this."The district tells us that suspension will stay on Joey's internal school record through middle school and into high school. Beth says it's a hefty punishment that falls short of teaching the lesson she says is worth learning."Whenever you see something, you have to tell somebody," said Mertel. "That's the only way this is going to be taken care of." 1605

We've all heard exercise helps you live longer. But a new study goes one step further, finding that a sedentary lifestyle is worse for your health than smoking, diabetes and heart disease.Dr. Wael Jaber, a cardiologist at the Cleveland Clinic and senior author of the study, called the results "extremely surprising.""Being unfit on a treadmill or in an exercise stress test has a worse prognosis, as far as death, than being hypertensive, being diabetic or being a current smoker," Jaber told CNN. "We've never seen something as pronounced as this and as objective as this."Jaber said researchers must now convey the risks to the general population that "being unfit should be considered as strong of a risk factor as hypertension, diabetes and smoking -- if not stronger than all of them." 799