New York underestimated COVID-19 nursing home deaths by 50%, AG report says

Beyond the health department’s undercoverage of deaths, the investigation also found that failure to follow infection control protocols by nursing homes put residents at risk, and facilities that had lower pre-pandemic staffing rates had higher COVID-19 death rates. James’ office continues to investigate the allegations, including a further examination of practices in more than 20 nursing homes where the reported conduct “was of particular concern.”

“As the pandemic and our investigations continue, it is imperative that we understand why residents of New York City nursing homes have suffered needlessly at such an alarming rate,” James said in a press release unveiling the report. “While we cannot bring back the people we have lost in this crisis, this report seeks to provide the transparency the public deserves and to spur increased action to protect our most vulnerable residents.”

In early March 2020, the office began receiving COVID-related negligence complaints and on April 23, the Attorney General set up a hotline to receive complaints of abuse and neglect. According to James’ office, the hotline received 770 complaints through August 3 and 179 more through November 16.

The more in-depth investigations into specific nursing homes are the result of preliminary findings which include:

• Insufficient personal protective equipment for nursing home staff.
• Insufficient COVID-19 testing for residents and staff during the early stages of the pandemic, placing residents at increased risk of harm.
• The current model of state reimbursement provides a financial incentive for owners of for-profit nursing homes to transfer funds to related parties instead of investing in higher levels of staff and equipment, increasing instead of this their results.
• Lack of compliance of the nursing home with the decree requiring communication with family members.

The report also found that March’s New York guidelines requiring the admission of COVID-19 patients to nursing homes may have increased the risk of others in collective facilities contracting the virus, a notion that a state-commissioned internal report released last year was rejected. as a possibility.

Lawmakers and epidemiologists have been skeptical of the Health Department’s report, released in July, which absolved Cuomo’s administration of blame for thousands of nursing home deaths attributed to COVID-19. The report concluded that a controversial note released by the health agency at the end of March, as the pandemic escalated, was not to blame. Instead, the report concluded that the deaths had occurred because staff working in the homes had introduced the infectious disease to the facilities, months earlier, before the spread of the coronavirus in the state was known.

Since the publication of that report, lawmakers have called for an independent investigation into the matter, challenging the reliability of an internal review of state practices. In fact, lawmakers have even questioned whether the attorney general’s office could be impartial in an investigation. Assemblyman Richard Gottfried had questioned the effectiveness of James’ office, arguing that he works regularly with the Department of Health and represents state agencies in prosecutions and other investigations.

The controversial memo released by the DOH on March 25 prohibited nursing homes from denying admission or readmission to residents based solely on a positive or suspected diagnosis of COVID-19. If a COVID-19 positive patient in a hospital was medically stable and needed nursing home care, many nursing homes believed the directive required them to accept that person.

The DOH report from last July – disclaiming any responsibility for the deaths – said the findings were supported by responses to the investigation submitted to the agency by the nursing homes. Yet the DOH has since refused to provide The Times Union with the underlying nursing home records forming the basis of the July 6 report. DOH cited two exemptions in denying the Times Union’s request, but declined to comment on how those exemptions applied to the specific documents sought.

The state-reported death toll does not include residents who were infected, transferred to hospitals, and then died.

The Empire Center for Public Policy, a fiscally conservative Albany think tank, has filed a lawsuit to force the Department of Health to provide information on hospital deaths, which the think tank said , were readily available in the daily “HERDS” surveys completed by nursing homes and submitted to the state.

The health department has asserted in continued responses to the Empire Center’s request that delays were inevitable as it was engaged in a months-long “diligent search” for the material.

The calls for data have been bipartisan. Senator James Skoufis, chairman of the chamber committee of inquiry, warned on Monday that he would support the use of the subpoena power to obtain answers on COVID-19 nursing home deaths ahead of a hearing on 3 February. The next day, the hearing on the health budget was postponed from February 3 to February 25, at the request of the governor’s office.