New York State has underreported the number of nursing home resident deaths from COVID-19 by as much as 50%, according to a report released today by New York State Attorney General Letitia James.
The State Department of Health’s published nursing home fatality data does not reflect the deaths of nursing home residents infected with COVID-19 who died after being transferred to hospitals, according to the report.
As of Jan.26, the State Department of Health is reporting 8,711 COVID-19 deaths, both confirmed and presumed, among residents of nursing homes and long-term care facilities.
The AG’s report also says 4,000 nursing home deaths occurred after the State Department of Health’s controversial March 25 guidance prohibiting nursing homes from denying admission to COVID-positive individuals — including deaths at 323 facilities that apparently had no reported COVID-19 infections before admitting or re-admissions COVID-positive patients pursuant to the March 25 DOH guidance.
DOH rescinded March 25 guidance on May 10, after its disclosure sparked outrage from families and nursing home residents’ advocates. Between March 25 and May 8, 6,326 hospital patients were admitted to 310 nursing homes, the AG’s investigation found.
The peak of those admissions corresponds to the peak single day in reported nursing home resident COVID-19 deaths, the report notes. But, it continues, “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.”
The state’s March 25 guidance was consistent with CDC guidance then in effect, the AG notes.
The guidance also came at a time when state health officials had serious concerns about hospital capacity in the downstate region due to the pandemic.
“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,” said James.
“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,” the attorney general said.
The report prompted State Senate Minority Leader Robert Ortt (R-North Tonawanda) to call for the resignation of State Health Commissioner Dr. Howard Zucker.
“For months, Gov. Cuomo and his administration have refused to be transparent or take any responsibility for actions they have taken during this public health crisis — including the deadly March 25, 2020 order to send COVID-positive patients into nursing homes,” Ortt said.
“By underreporting COVID deaths in nursing homes by as much as 50%, the Department of Health has betrayed the public trust,” he said.
The governor’s office did not respond to a request for comment. A DOH spokesperson could not immediately be reached for comment.
The AG’s investigation into nursing homes’ responses to the COVID-19 pandemic also found:
- Lack of compliance with infection control protocols put residents at increased risk of harm during the COVID-19 pandemic in some facilities.
- Low staffing levels at nursing homes, which directly impact the number of hours staff spend caring for residents, affected COVID-19 fatality rates, the AG’s investigation found. Nursing homes that entered the pandemic with low staffing ratings from the U.S. Centers for Medicaid and Medicare Services (CMS) had higher COVID-19 fatality rates than facilities with higher CMS Staffing ratings.
- Insufficient personal protective equipment (PPE) for nursing home staff put residents at increased risk of harm during the COVID-19 pandemic in some facilities.
- Insufficient COVID-19 testing for residents and staff in the early stages of the pandemic put residents at increased risk of harm in some facilities.
- The current state reimbursement model for nursing homes gives a financial incentive to owners of for-profit nursing homes to transfer funds to related parties (ultimately increasing their own profit) instead of investing in higher levels of staffing and PPE.
- Lack of nursing home compliance with the executive order requiring communication with family members caused avoidable pain and distress.
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