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NY AG Report Says Cuomo Admin May Have Undercounted COVID-19 Nursing Home Deaths by ‘as Much as 50 Percent’; Ties Cuomo Order to 4,000 Deaths


NEW YORK, NEW YORK - SEPTEMBER 08: New York state Gov. Andrew Cuomo speaks at a news conference on September 08, 2020 in New York City. Cuomo, though easing restrictions on casinos and malls throughout the state, has declined to do so for indoor dining in restaurants in New York City despite pressure from business owners, citing struggles by the city to enforce the state's previous orders.

New York Governor Andrew Cuomo (D) hasn’t been telling the truth about his administration’s efforts to combat the coronavirus (COVID-19) pandemic, according to a bombshell report issued Thursday by New York Attorney General Letitia James (D).

“Among those findings were that a larger number of nursing home residents died from COVID-19 than the New York State Department of Health’s (DOH) published nursing home data reflected and may have been undercounted by as much as 50 percent,” a press release summarizing one of the topline findings of the report notes.

“[T]his preliminary data for the 62 facilities and time periods noted above suggests that COVID-19 resident deaths associated with nursing homes in New York state appear to be undercounted by DOH by approximately 50 percent,” the report itself notes.

The numbers are based on a sample of New York State’s nursing home facilities and the data is admittedly incomplete because investigations are ongoing. But the report is clear that the New York State Department of Health did not publicize the correct number of nursing home deaths from COVID-19.

A table contained in the report outlines the extent of the problem as it’s known so far:

The report was careful when assigning blame for the inaccurate count.

“The DOH reporting system explicitly requires facilities to correct inaccurate reporting,” James notes. “Either such correction was not made by a number of facilities, or data were not reflected in DOH’s published data for other reasons.”

James has been investigating the nursing home response to the deadly pandemic in the Empire State since March of 2020–based on numerous complaints about the facilities’ ability to adequately provide for individuals under their supervision and care.

Notably, the report also faults the Cuomo administration for widely-criticized guidance that directed nursing homes to accept COVID-19 patients issued in late March of last year.

“Government guidance requiring the admission of COVID-19 patients into nursing homes may have put residents at increased risk of harm in some facilities and may have obscured the data available to assess that risk,” the executive summary of the 76-page report notes.

“No resident shall be denied re-admission or admission to the nursing home solely based on a confirmed or suspected diagnosis of COVID-19,” Cuomo’s March 25 order reads. “NHs [Nursing Homes] are prohibited from requiring a hospitalized resident who is determined medically stable to be tested for COVID-19 prior to admission or re-admission.”

The statistics contained in the section on the March 25 order requiring the admission of COVID-19 patients into nursing homes paint a much starker and more accurate picture of the harm caused by the order. Indeed, the section itself is titled: “At Least 4,000 Nursing Home Residents Died After DOH’s March 25 Guidance on Admission Practices.”

The attorney general’s report notes that those 4,000 deaths likely underestimate the problem as well because the very order linked to those deaths also obscured the proper counting and collection of necessary data:

Data linking the number of nursing home deaths to the admissions policy contained in the March 25 guidance is obscured by that same guidance, which also prohibited nursing homes from requiring COVID-19 testing as a criterion for admission. This phenomenon was compounded by both the March 21 directive that largely paused the testing of downstate residents, and the under-reporting of nursing home deaths generally (as previously discussed). OAG’s investigation to date has not revealed an admission from any nursing home operator that they could not care for referred residents. However, using the DOH publicized data, 4,000 nursing home deaths occurred after the issuance of the March 25 guidance, including some in 323 facilities that apparently had no reported COVID-19 infections before receiving admissions or re-admissions of hospital residents who had been diagnosed with COVID-19

The report also provides some cover for the March 25 directive:

Many nursing home industry and other commentators have criticized DOH’s March 25 guidance as a directive that nursing homes had to accept COVID-19 patients who were infectious. At the same time, the March 25 guidance was consistent with the CMS guidance on March 4 that said nursing homes should accept residents they would have normally admitted, even if from a hospital with COVID-19, and that patients from hospitals can be transferred to nursing homes if the nursing homes have the ability to adhere to infection prevention and control recommendations.

And, the report notes, the nursing home crisis wasn’t entirely the government’s fault.

James also notes that New York’s excessive nursing home deaths were exacerbated by a “[l]ack of compliance with infection control protocols” which increased the potential for harm “in some facilities.”

“During phase one investigations, OAG received multiple reports through the COVID-19 hotline and direct communications to OAG that several nursing homes failed to implement proper infection controls to prevent or mitigate the transmission of COVID-19 to vulnerable residents,” the report notes.

Such lack of compliance included failing to properly isolate residents who tested positive for COVID-19, failing to screen or test employees for the virus, forcing sick employees back to work and failing to “obtain, fit and train caregivers with PPE”.

AG James said investigations are ongoing.

“As the pandemic and our investigations continue, it is imperative that we understand why the residents of nursing homes in New York unnecessarily suffered at such an alarming rate,” James said in a press release. “While we cannot bring back the individuals we lost to this crisis, this report seeks to offer transparency that the public deserves and to spur increased action to protect our most vulnerable residents. Nursing homes residents and workers deserve to live and work in safe environments, and I will continue to work hard to safeguard this basic right during this precarious time.”

[image via Spencer Platt/Getty Images]

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