Martha Miles, one of the first to die, gasped for air. She pressed her nursing home call buzzer but got no help.
Ed Windholtz, Imelda Balbach, Byron Eggemeyer – farmer, nurse, engineer – died hundreds of miles apart within the span of a week in seemingly isolated COVID-19 outbreaks.
The deaths across a scattering of Midwestern nursing homes began surging around Thanksgiving. In the span of a week, the count of the dead nearly tripled in Michigan. Then residents started dying by the dozen in Ohio and Indiana. By Valentine’s Day last winter, the death toll had climbed into the hundreds.
A USA TODAY investigation has traced the casualties back to one nursing home chain, Trilogy Health Services, owned by a real estate venture with a new business plan for the cutthroat world of elder care.
The deal promised a historic investment opportunity, then delivered the highest death rates reported by any large nursing home chain at the height of the pandemic.
Residents at Trilogy’s 115 campuses died of COVID-19 last winter at twice the national average for nursing homes, USA TODAY found, based on figures facilities must file weekly with the federal government.
Presented with USA TODAY’s findings, the company said it had mistakenly reported hundreds of deaths during the surge. Trilogy offered a revised tally that would reduce its COVID-19 death count by more than 40%. The company declined to provide documentation needed to vet those claims but said Wednesday it had filed new numbers with the federal government.
Even by its own drastically lower numbers, Trilogy’s death rates still would have ranked well above the national average for nursing homes during the winter surge.
Until now, such pervasive failures escaped notice. In a first-of-its-kind analysis, USA TODAY has revealed ownership webs invisible to consumers. Problems across chains eluded federal officials overseeing nursing homes, who were focused on individual facilities during the pandemic.
Reporters scored the performance of every nursing home in America to probe questions of corporate responsibility left unanswered by dozens of research papers on COVID-19’s more than 140,000 nursing home deaths.
Trilogy’s outcomes did not appear to be driven by residents who were older, or more fragile, factors accounted for in USA TODAY’s analysis.
Its track record cannot be explained solely by its presence in states hard hit by COVID-19, either. If anything, academic studies on the spread of the coronavirus suggest Trilogy’s smaller nursing homes should have been safer.
Trilogy had another unusual distinction from the start. A company specializing in real estate acquired it in a test of a business model new to a large nursing home chain.