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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 Mollie Tibbetts went for a jog and never returned, her death realized the worst fears of many runners, especially women, who lace up their sneakers unsure of what they may face on the road.But runners across the country aren't letting fears of a similar situation stop them. Instead, they are dedicating their runs to the 20-year-old University of Iowa student and sharing hopeful messages on social media tagged #MilesforMollie."This run is for you Mollie. We are with you. We will not allow fear to stop us from doing the things we love," University of Iowa alumna Sarah Hemann Bishop posted on Twitter. She included a picture of her sneakers, which have "Miles for Mollie" written on the side.A funeral was held Sunday for Tibbetts in her hometown of Brooklyn, Iowa, where she was last seen alive on July 18. Police say Cristhian Bahena Rivera told them he saw Tibbetts running and "pursued her in his vehicle." Later, he parked the car and started running near her. He is charged with first-degree murder."I find so much joy in running and as a female, I know I have to run with an added sense of caution, especially when running alone. It is unfair," Bishop told CNN. "I joined #milesformollie to show that we are not afraid. Mollie inspires us to be strong and brave." 1287

White House adviser Stephen Miller is pushing to expedite a policy that could penalize legal immigrants whose families receive public benefits and make it more difficult to get citizenship, three sources familiar with the matter tell CNN.The White House has been reviewing the proposal since March at the Office of Management and Budget, which is the last stop for regulations before they are final. But concerns over potential lawsuits have delayed the final rule, and the draft has undergone numerous revisions, multiple sources say.The crux of the proposal would penalize legal immigrants if they or their family members have used government benefits -- defined widely in previous drafts of the policy.The law has long allowed authorities to reject immigrants if they are likely to become a "public charge" -- or dependent on government. But the draft rule in its recent forms would include programs as expansive as health care subsidies under the Affordable Care Act, as well as some forms of Medicaid, the Children's Health Insurance Program, food stamps and the Earned Income Tax Credit.The rule would not explicitly prohibit immigrants or their families from accepting benefits. Rather, it authorizes the officers who evaluate their applications for things like green cards and residency visas to count the use of these programs against applicants and gives them authority to deny visas on these grounds -- even if the program was used by a family member.Two non-administration sources close to US Citizenship and Immigration Services, which would publish and enforce the proposal, say that Miller has been unhappy by the delay and has pushed the agency to finish it quickly. The sources say Miller even instructed the agency to prioritize finalizing the rule over other efforts a few weeks ago.Miller is an immigration hardliner within the administration, a veteran of Attorney General Jeff Sessions' Senate office who has been at President Donald Trump's side since the early stages of his presidential campaign.But two other administration sources downplayed the idea of any instructions to defer other policies until it's done, though they acknowledged Miller is keenly interested in the rule.The White House and Department of Homeland Security did not respond to a request for comment.Earlier this year, DHS spokesman Tyler Houlton said the administration is concerned about taxpayer dollars."The administration is committed to enforcing existing immigration law, which is clearly intended to protect the American taxpayer," Houlton said. "Any potential changes to the rule would be in keeping with the letter and spirit of the law -- as well as the reasonable expectations of the American people for the government to be good stewards of taxpayer funds."In one illustration of how many avenues there may be to challenge the complex rule, it was sent over to the Office of Management and Budget designated as not "economically significant" despite the possible impact to millions of immigrants and federal spending.Executive director of the pro-immigration group America's Voice Frank Sharry alleged that Trump and Miller are using a "deeply cynical and cruel strategy" and accused Republicans of "race-baiting.""Trump and Miller have concluded that the best 2018 political strategy is a divisive and desperate three-step: 1) do something cruel to immigrants; 2) sit back as Democrats, the fact-based media and the majority of Americans denounce the cruelty; 3) step in and claim that the President is standing up for his white base and against 'the other' while working to define Democrats as doing the opposite," Sharry said. "They did this on DACA. They did this on family separation. Now they are planning to do the same on public charge."The-CNN-Wire 3775

When Mark Urquiza died recently from complications due to the coronavirus, his family didn’t hold back their thoughts on who was to blame.“Mark, like so many others, should not have died from COVID-19. His death is due to the carelessness of the politicians who continue to jeopardize the health of brown bodies through a clear lack of leadership, refusal to acknowledge the severity of this crisis, and inability and unwillingness to give clear and decisive direction on how to minimize risk,” read Mark’s obituary, printed in the Arizona Republic on July 6. 567

When United Flight 93 crashed in Shanksville, PA, on Sept. 11, 2001, John Gerula was one of the first on the scene as a volunteer firefighter. The experience inspired John, still in high school, to enlist in the Marines. He shipped out to Iraq two years later, and today he bears the invisible wounds of war.Over the course of 18 months in Fallujah and Operation Phantom Fury, Gerula survived 21 improvised explosive device blasts, resulting in a severe traumatic brain injury that gave him migraines and memory loss, and post-traumatic stress that left him anxious, isolated and abusing alcohol.“I would spend a lot of time by myself at home on my property, just away from people,” Gerula says. “I didn't like large crowds, just the things that brought me back to what caused my issues, the flashbacks and everything.”That all changed this summer when Oliver, Gerula’s service dog, came into his life.”He can sense when I start to breathe heavy, when my heart rate's high, things of that nature, he comes up to me allows me to pet him,” Gerula says. “Since I’ve had Oliver, I’ve not had a drop of alcohol. I gave up drinking altogether. So he has made huge changes in my life.”Gerula and Oliver are among the first four pairs of veterans and service dogs to graduate from American Humane’s “Shelter to Service” program, created to combat the staggering statistics of 20 veterans committing suicide daily due to PTSD and TBI, and the 670,000 dogs euthanized every year in America’s animal shelters.“We saw a great opportunity to uplift the healing power of the human-animal bond by taking incredible dogs who were abandoned, who needed a second chance at life, giving them unbelievable, rigorous training, and then matching them with our veterans, allowing these veterans a chance for healing, hope, compassion, and love,” says American Humane’s President and CEO Robin Ganzert.Ganzert’s organization is currently training its second “Shelter to Service” class while advocating for a bill on Capitol Hill to establish national training standards and speed up the service dog waitlist, which currently runs from 18 to 24 months.And Gerula has a message to veterans seeking the help with their own struggles.“Don't give up,” he says. “The best thing to do is to keep going and just go do every option you can.” 2346