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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 it comes to our cars, the cost of gas, oil changes, tires, insurance, and those dreaded repairs all add up. Many drivers don't realize how much their car really costs them.Kat Coughlin knows how expensive an older car can become."The tie rod, the tires, the transmission went out," she said about her older Taurus. "I think we spent about ,000 trying to repair it."Repairs like that can blow the budget. So it helps to know the true cost of owning a car, not just the monthly cost that the salesman puts on the sales sheet.AAA adds up all the costs and feesA new study by AAA finds the average cost of owning a new car is ,469 a year for 2017, when you factor in depreciation, insurance, gas and maintenance costs.AAA says a lot of people buy a car just based on emotions, looking only at that monthly payment of, say, 0 a month. But AAA says you are really paying 0 a month, on average.The agency says drivers don't stop to think what it will cost to maintain the car over a year or two, whether or not it is off the manufacturer's warranty.Bobby Drake is the head mechanic at an AAA repair shop."Even if it's a relatively new car you still have a lot of maintenance," he said.He says many people add to those costs by postponing maintenance, to save a few bucks now.For instance, he sees them wait for the brakes to wear down to metal, and start grinding. That will require costly new rotors in most cases, he says, turning a 0 brake-pad job into a 0 brake and rotor job."Follow the manufacturer's recommended maintenance, and that will definitely save you a lot of money in the long run."Differences between vehicle typesMeantime AAA says some types of vehicles cost a lot more to operate than others.Assuming gasoline at .34 a gallon, AAA says you can expect to pay the following amounts. 1848

While officials in Puerto Rico placed the official death toll from last year's Hurricane Maria at 64, researchers from Harvard believe the death toll was actually in the thousands. According to Harvard's study, there were an estimated 4,645 deaths directly or indirectly tied to the hurricane, which struck the island in September. Harvard estimated a mortality rate of 14.3 deaths per 1.000 people from September 20 through December 31, 2017 in Puerto Rico. Harvard said in its study that it believes its estimate is rather conservative due to a "survivor bias."Harvard conducted the study by performing a random survey of 3,299 households in Puerto Rico. "In our survey, interruption of medical care was the primary cause of sustained high mortality rates in the months after the hurricane, a finding consistent with the widely reported disruption of health systems," the study says. "Growing numbers of persons have chronic diseases and use sophisticated pharmaceutical and mechanical support that is dependent on electricity. Chronically ill patients are particularly vulnerable to disruptions in basic utilities, which highlights the need for these patients, their communities, and their providers to have contingency plans during and after disasters."Part of why there the death toll might have been underreported is due to how hurricane-related deaths are counted. In order to have a death counted as storm related, bodies had looked at by a medical examiner, which required a body to be transported to San Juan, or the medical examiner to travel to remote locations. With a lack of electricity and blocked roads, some bodies were likely buried before the government could count fatalities. Maria is considered the third-costliest hurricane in US history.  1816

White House comms director Alyssa Farah says a document claiming ending the pandemic was an administration accomplishment was “poorly worded.” She says President Trump does not believe the pandemic is over. “The intent was to say that it is our goal to end the virus.”— Kaitlan Collins (@kaitlancollins) October 28, 2020 328

Wisconsin authorities are urging hunters to be on the lookout for clues related to missing 13-year-old Jayme Closs, whose parents were found fatally shot last month in their home."As hunting season opens on Saturday, we ask that hunters report anything suspicious such as clothing, weapons or anything you think it just not right on your property," the Barron County Sheriff's Department said this week in a statement.The bodies of Jayme's parents, James and Denise Closs, were discovered October 15 after a mysterious 911 call led deputies to their home in northwestern Wisconsin. No one spoke during the call, but the dispatcher heard yelling in the background.When the dispatcher called back, the call went to Denise Closs' voicemail. Police arrived to find the door kicked in, but Jayme was nowhere to be found, and investigators believe she was abducted and may be in danger.Thousands of people have joined search parties for Jayme, and the FBI is offering a reward of ,000 for information on her whereabouts.Investigators continue to follow up on leads, review recovered video from the area and explore digital evidence, authorities said."There is still hope in this department on this case, and the community support and prayers that we have been given continues to fuel our drive and determination to bring Jayme home," the sheriff's office statement said. 1375