The manner in which all hospital patients are admitted and death certificate and death investigation data provided indicates that the Evers Administration is lying about not knowing how many COVID-19 deaths were of nursing home residents. Insurance claims processing and patient accounts both require that the medical provider list the patient's "point of origin"--the "source of the referral for an admission or visit." In addition, death certificate and death investigation data reviewed by "The Dan O'Donnell Show" indicates that all COVID-19 victims had home addresses listed and easily discoverable.
The Evers Administration has come under fire for quietly updating the number of nursing home patients who died of COVID-19 over the past year from 1,956 to 2,927.
"If you visited our data webpages recently, you may have noticed some changes," said Deputy DHS Secretary Willems Van Dijk, who added in a media update on Thursday that one area which saw significant changes "is the percentage of cases or deaths that live in group housing. When case and death data were put into our disease surveillance system, it was common for some fields to be left empty or boxes to be unchecked due to the inability of the disease investigator to collect that particular information."
This, multiple sources told the "Dan O'Donnell Show," is not possible.
"It is required that every patient who comes to the emergency room or is admitted to the hospital has a point of origin," said one source, who works in medical coding. "They are very specific, and Medicare/Medicaid will not accept a claim without it."
The Wisconsin Department of Health Services' (DHS) own ForwardHealth Medicaid management program will not process "institutional claims" (i.e. those from health care providers) if a provider does not "enter a code indicating the source of the admission in the Point of Origin field" in the online claim processing form.
Similarly, Epic Systems claim processing software--which is used by most health care providers in Wisconsin--will not allow a patient's account to be closed without entering the correct point of origin codes. Visit Code 5 indicates that the patient was admitted "as a transfer from a Skilled Nursing Facility (SNF), Intermediate Care Facility (ICF), Assisted Living Facility (ALF) or Nursing Facility (NF) where he or she was a resident."
Visit Code 1 indicates a referral from a physician, Visit Code 2 refers to a patient who came from a clinic or physician's office, Visit Code 4 is a "transfer from a hospital (different facility), while Visit Code 6 indicates that the patient was admitted to the "facility as a transfer from another type of health care facility not defined elsewhere in this code list."
"Every patient who is admitted has a code," said a source who admits patients to a hospital in Wisconsin. "We know where they're coming from and have their home addresses logged. All of that information is mandatory."
Epic Systems software also includes Discharge Destination codes to indicate the place to which the patient was discharged. Discharge Destination Code 3 indicates a discharge to a nursing home or assisted living facility.
Sources who work with the software indicate that the codes are universal in Wisconsin and most other states. This means that every patient would have a code indicating their point of origin and the Evers Administration is not telling the truth about being unable to immediately determine where COVID-19 victims who were referred to hospital emergency rooms lived.
"There is no possible way they can say they don’t know it is right in their chart where they came from and where they are going," said a source. "On every single patient."
For those victims who died of COVID-19 without ever being admitted to a hospital, Governor Evers himself claimed that it was impossible for the state's medical investigators to determine a home address.
"Our local folks got lots of death certificates and death investigations that just had a street name on it," he told the Milwaukee Journal Sentinel this week. "How do we know that is a nursing home?"
This, too, appears to be a lie. In October, the Milwaukee County Medical Examiner's Office provided "The Dan O'Donnell Show" with a list of every single COVID-19 death the office had logged since the pandemic began. Every single victim had a home address listed. Milwaukee County is the only county in Wisconsin that has maintained such a comprehensive list, but its data indicates that medical examiners across the state also collect the home addresses of every COVID victim and do not, as Evers suggested, merely provide state investigators with "death certificates and death investigations that just had a street name on it."
Dan O'Donnell covered this story extensively on Wednesday's show. Click on the player below to listen and click here to subscribe to "The Dan O'Donnell Show" on iHeartRadio