LIMA — Miriam Endsley had stopped eating. She was down to almost 50 pounds, and at age 92, was tired.
Tired of fighting for her life.
There was so much she had enjoyed — growing up on a farm, teaching school, fussing over grandchildren and being married for 59 years to her true love, the late Keaton Endsley.
But now, it was time to let go, she told her children.
At 9:26 p.m. Aug. 12, the “cookie grandma,” as the grandkids referred to her, passed away at Springview Manor Nursing Home in Lima.
“She was a Christian woman, and she was prepared to go home,” said her son, Lyle Endsley.
However, Lyle wasn’t prepared for what he would learn.
The last months of Miriam’s life had been especially difficult for Lyle and his sister, Cynthia Thomas. Due to the COVID-19 virus, Ohio Gov. Mike DeWine and then-Ohio Department of Health Director Dr. Amy Acton imposed strict rules on care facilities. In mid-March, families were forbidden to visit their loved ones. It wasn’t until mid-July that outdoor visits were allowed.
“I would check weekly to see how mom was doing,” Lyle said. “She was tested for the virus every week. They always called me, and she was always negative.”
When he picked up her death certificate, however, it listed COVID-19 as a secondary cause of death.
Lyle was stunned.
“At no time did anyone ever say that she tested positive for COVID, but yet on the death certificate, it’s got a secondary reason as COVID,” Lyle said. “It just reinforces what a lot of us think — the numbers are being inflated to get more government funds. This is ridiculous. My mom did not die of COVID. It shouldn’t be in her death certificate. If anything, she died of loneliness because we weren’t able to see her until she got on Hospice. It is just an outrage, and it’s inaccurate.”
It’s no secret Ohio nursing homes have been struggling financially. Even before the pandemic, around 55% of them were operating at a loss, according to a report by the American Health Care Association. Much of that can be traced to the gap between what Medicaid pays for care and the true cost of care.
The AHCA report notes that more than 60% of all nursing home residents rely on Medicaid to cover their care but Medicaid only reimburses facilities for about 70% to 80% of costs. That leaves nursing homes left to figure out how to make up the difference.
COVID money from the government has been welcome, with around 96% of nursing homes receiving some government funding to help address virus-related costs, the AHCA says.
That has people like James Gillen, of Lima, doubting the number of deaths attributed to COVID-19. He points to the death of an Allen County woman on Aug. 30 and asked if it was COVID-19 or old age that resulted in her death.
“It was an 100-year-old woman who first tested positive for the virus on May 27 but wasn’t hospitalized. How long must one live after testing positive for COVID to no longer be counted in the COVID death total?” Gillen wrote in the Your View column of The Lima News.
It’s a question Allen County Health Services hears often.
“That’s certainly not happening. There is no inflation. There really isn’t anything to gain from inflating those numbers,” said Tami Gough, the agency’s public information officer.
Convincing the public such is the case is another thing.
“We’ve heard the jokes about a memo going around saying the cause of death in all car accidents will henceforth be listed as COVID-19,” said Gough.
Identifying what can be counted as COVID-19 can be complicated, Gough said. Some people who get COVID-19 die of COVID-19. Some people who get COVID die of something else. And then there are people who die because of disruptions created by the pandemic.
Invariably, some deaths not caused by the virus will be counted as if they were, while others that were caused by the virus will be missed.
“It’s a slippery slope,” Gough said. “There are elderly or perhaps very ill people with an underlying condition like high blood pressure or obesity or diabetes. COVID may be what put them over the edge,” she said.
Concern about the accuracy of the number of people testing positive for COVID-19 came under the spotlight in early August when both DeWine and his wife, Fran, tested positive for the virus just before they were to greet President Donald Trump on the tarmac at Burke Lakefront Airport in Cleveland. Later that day, they both took different tests that came back negative.
“There is conflicting federal and state testing, and just last week, the Centers for Disease Control and Prevention announced new nationwide testing programs, so analyzing the numbers can be confusing,” said Patrick Schwartz of LendingAge Ohio, a non-profit group that advocates for long-term facilities and hospices.
That lack of clarity has fueled a political divide on the seriousness of the pandemic. On one side are people ranging from conspiracy theorists all the way to President Trump, who tout the numbers as being exaggerated. The other side consists of medical experts, including those at the CDC, who view the numbers as startling and advocate strong safety measures.
Ohio’s two U.S. senators, Republican Rob Portman and Democrat Sherrod Brown, are in the latter group.
“Senator Portman believes medical experts are best positioned to make these types of judgments,” said Meghan Dugan, a spokesperson for Portman.
Brown was more direct. He blames President Trump for the distrust that some Ohioans have in the numbers.
“The notion that medical professionals would intentionally misrepresent death rate figures of this virus is asinine,” Brown told The Lima News in an e-mail. “The president consistently betrays the American people and his lies are making an already unprecedented public health crisis worse. Period.”
As for Lyle Endsley, he’s convinced the numbers are loose at best. He points to discrepancies in the reporting of his mother’s death.
“When I questioned that COVID was on the death certificate, I was informed Mom was swabbed on Aug. 11 and the results came back positive on the 13th. Mom died on the 12th. I asked why the family was never notified and was told it was very hectic and busy day.
“Here’s what doesn’t make sense. Mom’s death certificate estimates she had COVID for five days. The dates just don’t add up,” Endsley said. “And if we’re to believe the death certificate, that it was five days, why were we allowed to spend time with someone who allegedly had COVID? And if she was swabbed on the 11th, my sister would have known. She was with mom the entire day.”
Shanna Barnes, executive director of Springview Manor, referred questions to its corporate office, Trilogy Health Services. It decided not to comment at this time.
Endsley said he had no complaints about the care his mother received at Springview Manor, only the death certificate.
“What are we to believe here?” Endsley asked. “Mom was placed in Hospice two weeks prior because she stopped eating. She lost the will to live and her little heart could not circulate and keep her going. To me, it’s inaccurate to say COVID played a role in her death.”