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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 the Rockefeller Center Christmas Tree arrived in New York City, some thought the tree was a perfect metaphor for 2020. But just like your 7-foot spruce in your living room, the Rockefeller Center tree just needs a little fluffing. "Wow, you all must look great right after a two-day drive, huh? Just wait until I get my lights on! See you on December 2!" Rockefeller Center tweeted. The 75-foot Norway spruce arrived at New York City’s Rockefeller Center on Monday to serve as one of the world’s most famous Christmas trees. The tree was trucked in Saturday morning and lifted into place by a crane. The tree will be decorated over the coming weeks. It was donated by Al Dick of Daddy Al’s General Store in Oneonta in central New York. NBC says it's broadcasting the tree-lighting at 7 p.m. Dec. 2. No in-person spectators will be allowed this year because of the coronavirus pandemic. The pandemic has spurred the cancellation of other New York holiday customs including the Radio City Christmas Spectacular. 1022

With health experts warning about the possibility of a "twindemic" — a bad flu season combined with COVID-19 — officials are urging everyone to help by getting a flu vaccine this fall.Lisa Rasmussen is not living the retired life that she once dreamed."I became a flu widow at age 55," she said.Four days before their 29th wedding anniversary, Rasmussen's husband Paul died at the age of 57."I had to spend the day of my anniversary in a funeral home making arrangements," she said.That was in April of 2016. Four years later, it's still painful for Lisa. She's still grieving — and she's angry."I think I'm always going to be a bit mad at him because his death was preventable and because he didn't listen to me when I tried to talk him in to getting flu vaccines," Rasmussen said.Today, Rasmussen spends her time traveling and advocating for Families Fighting Flu. The national non-profit is dedicated to increasing vaccination rates and advocating on behalf of families who have lost loved ones to influenza."Maybe it's my revenge — I shouldn't call it revenge — but it's my way of dealing with it: With the anger, frustration and grief that I have," she said. "I just don't want to see what other people to have to go through what I did."Every year on Oct. 4 — her late husband's birthday — Rasmussen gets her flu shot, in his honor.Dr. L.J Tan, the Chief strategy officer for the Immunization Action Coalition, says that most people don't get vaccinated for the flu not because they're against vaccines, but because it's not convenient."The people who adamantly refuse to get the flu vaccine is actually a small percentage for the other people who end up not getting the flu vaccine," Tan said. "A lot of time it's because flu is a vaccine of convenience."The Immunization Action Coalition is the largest private sector non-profit that helps educate and support health care providers about all immunizations, including the flu. Tan joins other experts who are worried about this year's seasonal flu."We don't want flu and we don't want COVID together and there are reasons for that," Tan said. "We have chronic diseases, chronic illness — COVID-19 will have a serious impact on you. We also know that's true of flu. If you're over 60 or 65, COVID has a serious impact on you. We know that's true of flu as well."The flu vaccine covers four strains and will either protect a person entirely or reduce their chances of contracting severe or serious influenza.Some experts believe that the 2020 flu season won't be as severe due to social distancing measures already in place. But that's not a risk Tan is willing to take."Here's the problem: If I pray for that and that outcome happens, everyone is going to tell me, 'Why are you crying chicken little? Why were we all getting vaccinated against the flu?'" Tan said. "I don't know if that's the outcome. Why are we gambling? We have a vaccine that's safe, that's effective."Rasmussen agrees."Save the ventilators for the people who have COVID," she said. 3015

With concerts, sporting events, and large gatherings on hold this summer, people are looking to the great outdoors for fun. Right now, national parks and other public lands are in the federal spotlight for another reason.“It's going to be a huge difference maker,” said Will Shafroth, CEO and President of the National Park Foundation. Shafroth is talking about the Great American Outdoors Act, a bill the Senate recently approved in a bipartisan 73-25 vote.“This is historic. I’ve been working on these issues since 1981, and I can tell you that in terms of the amount of money dedicated to any particular conservation purpose, this is the most significant bill to ever pass Congress,” Shafroth said.“At a time where there’s a lot of division about a lot of different things, this is something that Democrats and Republicans agree on,” he said.The bill would provide funding to maintenance backlogs across various federal lands. The National Park Service alone has almost billion in deferred repairs.“The wear and tear on these places is dramatic,” he said.“Seasonal housing really ranges from exceptional, to trailers that are falling apart in the middle of nowhere,” Shannon Dennison said. Dennison has worked at a number of national parks in the past.“The last time that the park service had a major infusion of funding into the agency and into the facilities was 1956,” she said.Also known as Mission 66, the decade long program was intended to expand visitor services. Dennison said that was the last major investment.“I think it's been a challenge to go 54 years without putting major investment into our facilities while we're seeing rising visitation,” she said.Visitation at parks has gone up over the years. In 2019, national parks saw nearly 328 million visits, up 9 million from 2018 and the third highest year on record.Even though these spaces were closed for a short time this year due to COVID-19, people are opting to turn to the outdoors since large gatherings are discouraged.“Being outdoors is one of the safest places to be, and it's also helping to contribute to people's mental health so the parks are seeing even more of an impact during the pandemic,” said Bonnie Clark, an Associate Professor of Anthropology at the University of Denver.The legislation would provide billions of dollars to help with renovations and repairs, coming from energy production.“Essentially what happens is that when these oils and gas leases are done on federal land, they are paying money to be able to access and use these resources because they belong to everybody,” Clark said.This was one of the key debates.Dennison hopes the act paves an easier path for these projects.“Sometimes it can be difficult to get an entire pot of money for one entire project,” she said. “My hope is there will be a little more flexibility in how those funds can be applied based on the park level.”The legislation will now go on to the House of Representatives for a vote. 2974

White House officials have told congressional leaders and appropriators that President Donald Trump does not want any additional relief funding sent to Puerto Rico, a congressional leadership aide told CNN on Monday.While there are no talks to cut funds that have already been appropriated, a White House aide said negotiations have focused on keeping Puerto Rico relief funding out of a supplemental spending bill that would fund relief efforts in parts of the south that were ravaged by hurricanes this year.That aide noted Puerto Rican officials haven't yet spent all the money Congress has set aside for them, and said the administration is moving to stop any more money from going to help the island "because they don't need it and will most likely not be able to spend it."Trump's latest positioning on Puerto Rico was first reported by Axios. The White House has been making this known on Capitol Hill for "a while now," the congressional leadership aide said.Trump has previously taken aim at Puerto Rican officials?for their management of the billions in relief funds his administration has appropriated for storm recovery, accusing the island's leaders of spending some of that money for reasons other than hurricane clean-up."The people of Puerto Rico are wonderful but the inept politicians are trying to use the massive and ridiculously high amounts of hurricane/disaster funding to pay off other obligations," Trump tweeted on October 23. "The U.S. will NOT bail out long outstanding & unpaid obligations with hurricane relief money!"More than a month earlier, the President had repeatedly dismissed a widely cited death toll that placed the number of lives lost in Hurricanes Irma and Maria around 3,000 by claiming Democrats had exploited the numbers to make his administration look bad. There has been no evidence to indicate that partisan politics has played a role in the calculation of the death tally, and George Washington University, which conducted the study to calculate the death toll, released a statement at the time that said it stands by its work.Talks over stopping future funding for Puerto Rico come as lawmakers look to avoid a government shutdown when temporary spending bills expire in early December. The funding fight could be the last of Trump's presidency waged by a Republican-controlled Congress, as Democrats have an incoming majority in the House.The White House did not immediately respond to a request for comment. A spokesman for Puerto Rican Gov. Ricardo Rossello could also not be reached for comment.In October, the government of Puerto Rico rolled out a five-year economic blueprint that included billion in federal hurricane recovery relief. The plan was approved by a federal control board, which oversees the island's finances. The board's executive director Natalie Jaresko said at the time the funds would not be budgeted for debt payments, but rather to help stimulate the economy.In February, Puerto Rico received billion in federal aid under a disaster relief package signed by Trump.The funding for the devastated island was part of a billion package agreed upon by Senate leaders as part a two-year budget deal to avert a government shutdown. The relief deal covered a number of major disasters across the US, including Hurricanes Maria, Irma and Harvey, and wildfires in California.Puerto Rico had estimated it would need billion to rebuild the devastated island after two destructive hurricanes hit, shredding its power grid and infrastructure. 3555

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