State report absolves Cuomo on nursing home deaths as critics pounce

Coronavirus

A state report says Cuomo's directive had little effect on the Covid-19 death toll at nursing homes. Critics say the report is flawed and an attempt to protect Cuomo's reputation

Gov. Andrew Cuomo’s coronavirus press briefings have, at times, captivated a national audience with his firm leadership and calming response to a virus that has killed more than 32,000 New Yorkers.    

His name started to pop up on political talk shows while pundits discussed presidential candidates and his approval rating soared to all-time highs.

All that glowing attention has taken a sharp turn, however, as criticism grows over his controversial order in late March to require all nursing homes to accept Covid-19 patients from hospitals if they had the capacity to care for them. The order came at a time when state officials faced uncertainty over whether there would be enough hospital beds to carry them through this pandemic.

Against the backdrop of constant criticism of the order from Republican leaders at the state and local levels of government, the state Department of Health took on the task to find out what, if any, impact has his directive had on the nearly 6,500 people that the state says died in nursing homes of Covid-19. In other words, how many deaths could the stay pin on the order?

That report, released earlier this month, concluded Cuomo’s order did not have a significant impact on the number of deaths.

Rather, it was visitors early in the pandemic and one-quarter of the 158,000 nursing home employees across the state that got infected with the virus who caused the spread.

The report essentially absolved Cuomo and his administration of any blame for the number of nursing home deaths. In fact, the report noted that the governor only followed the federal government’s guidance that states, “Nursing homes should admit any individuals that they would normally admit to their facility, including individuals from hospitals where a case of COVID-19 was/is present.”

Critics of the state report told News 4 Investigates that it failed to advance public health and used fuzzy data to form conclusions, including undercounting the death toll. They also criticized the report’s unknown author(s) for failing to even try to quantify the degree to which Cuomo’s directive did contribute to the death toll.

Steps to take in the future to protect public health if another pandemic were to occur? That was missing, too, critics said.

Several GOP lawmakers have demanded an independent review of the state report. The terms “whitewash” and “mistake” have been used by Republicans and experts to describe the report.

“This was a flawed report because it put protecting the governor’s reputation ahead of protecting public health,” said Bill Hammond, a senior fellow for health policy at Empire Center, an Albany-based nonpartisan think tank.

“I was particularly disappointed that it does not honestly count the nursing home deaths, which that’s what the report was supposed to be all about.”

Cuomo has bushed off any criticism of the report, saying they have latched onto a “political conspiracy theory.”

“It was pure politics,” he said during a briefing when he was asked about the criticism of the report.

“And now the report has the facts and the facts tell the exact opposite story.”

The report, which omits the author, was developed with the help of national consultants, McKinsey and Company, although the state health department refused to say how much the firm got paid

State officials said outside sources did review the report and stood behind the conclusions, including Kenneth Raske, the president of the Greater New York Hospital Association, Northwell Health CEO Michael Dowling and David L. Reich, president and COO of the Mount Sinai Hospital.

“The conclusions of the NYSDOH report of the root causes of nursing home fatalities in New York State are well supported by the data detailing nursing home staff COVID-19 illness, and epidemiological patterns, especially considering evidence of the duration of contagiousness for COVID-19 patients,” Reich was quoted as saying in a state-issued press release.

Nonetheless, Cuomo in May rescinded his order and prevented hospitals from releasing any Covid-19 patient to a nursing home unless that person twice tests negative for the virus.

The most-mentioned problem critics have about the state’s report is how state officials calculated a nursing home death.

New York is one of a small handful of states that only counted a nursing home death if the person had physically died inside such a facility. Anyone who contracted Covid-19 at a nursing home only to die later at a hospital from the disease was not counted in the state’s death toll.

In fact, some believe the true nursing home death toll surpasses 10,000 people, far more than the nearly 6,500 reported by the state.

Richard Mollot, executive director of the nonprofit Long Term Care Community Coalition that advocates for nursing home residents, said the way the state counted nursing home deaths “doesn’t make any sense whatsoever.”

“There is blame to go around at every single level for people who suffered and who died unnecessarily as a result of Covid-19, especially in nursing homes.

Mollot said what gets lost in the political fights is discussion of any lessons that can be learned from this debacle.

For example, infection control has long been a problem at nursing homes, he said, and yet it continues to be one of the most-cited deficiencies.

“We definitely should have been prepared better,” he said.

“I think that there was ample evidence besides the fact that we didn’t know whether or not to wear masks, we know about basic infection control, we knew how to control a virus and what were the things that spread a virus and too many nursing homes let it happen.”  

Stephen Hanse, president and CEO of the New York State Health Facilities Association that represents more than 450 nursing homes and assisted-living facilities statewide, said that while he does not necessarily disagree with the state report’s conclusions, it did not contain any reflection on what could have been done to save more lives.

For example, Hanse said one of the key problems nursing homes faced early in the pandemic was the lack of personal protective equipment, such as masks, gloves and smocks.

“That’s why I go back to the fact that as we move forward, as we learn from what we’ve gone through in this, it’s critical that policymakers allocate more resources in an equal fashion to nursing homes and assisted-living facilities as they do to hospitals,” Hanse said.

Republicans in Congress have also chimed in on the controversy.

Rep. Steve Scalise, a Louisiana Republican who heads a Covid-19 specific subcommittee, said members on June 15 had requested information that Cuomo’s team used to justify the directive on nursing homes back in March.

He wrote in a July 9 letter to Cuomo that no one on the subcommittee has heard from Cuomo’s administration on their request.

“NYSDOH’s report appears to be little more than your administration’s latest attempt to deflect criticism and shift blame for the consequences of your deadly nursing home order,” Scalise wrote.

“But blame-shifting, name-calling and half-baked data manipulations will not make the facts or the questions they raise go away. The families of those affected by your March 25 order deserve answers about why it was put in place and, rest assured, we will not give up until we get those answers.”

Rich Azzopardi, a spokesman for the Cuomo administration responded to this criticism in a NY Post article by calling the GOP lawmakers “craven political hacks.”

The state legislature will soon take on its own review of nursing home deaths during the pandemic.

Both the Assembly and Senate will hold hearings on Aug. 3 and again on Aug. 10; this nursing home directive by Cuomo is among the topics to be discussed.

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