Initial estimates for the number of fatalities in nursing homes across the U.S. last year may have been greatly underreported. According to a new study published Friday, the government's initial count may have missed more than 16,000 COVID-19 deaths.

The study conducted by JAMA Network Open, a peer-reviewed publication of the American Medical Association, said the discrepancy is about 14% higher than what the government said was the death toll in nursing homes last year.

Apart from the deaths, the study also found that there may be an estimated 68,000 additional COVID-19 cases there were not included in federal reports. Most of those that were omitted were cases that happened before the federal government published its reporting requirement in May 2020.

For the study, researchers compared the numbers recorded by the federal government to those tracked separately by states of nursing homes within their jurisdictions. According to their findings, the true impact on nursing homes across the country last year resulted in 592,629 positive cases and 118,335 deaths.

Researchers found that before the federal reporting requirement took effect, about four in 10 deaths went unreported. In terms of location, missing deaths and positive cases were higher in northeastern states, which were hit hardest by the coronavirus pandemic's first wave in the spring of last year.

When the first wave hit the U.S., the government had taken months to come up with a standardized reporting protocol. Even when the requirements took effect, most nursing homes were only given the option - not mandated - to submit reports.

The authors of the study said the purpose of the report is to ensure that the true impact of the pandemic is not forgotten.

"We would just lose a sense of those people's lives in the history books. That just didn't feel right to us," the study's lead author, Karen Shen, from Harvard University, said.

Nursing homes have partly blamed the government for their lack of immediate action. Nursing homes associations said the federal government took too long to provide support and accurate data - information that could have hastened their responses to the crisis. The American Health Care Association called on the government to enhance its data collection and sharing efforts to avoid similar issues in case another public health emergency occurs.