ALBANY — New York Attorney General Letitia James on Thursday released a searing report that found the state Department of Health underreported nursing home deaths related to the coronavirus by as much as 50 percent.
The 76-page report released Thursday morning follows a months-long investigation by the attorney general’s office’s into allegations of patient neglect and other conduct that jeopardized the health and safety of residents and employees, including information that nursing homes failed to properly isolate residents who tested positive for COVID-19 and demanded sick employees continue to work or face retaliation or termination.
Beyond the health department’s undercounting of deaths, the investigation also found nursing homes’ lack of compliance with infection-control protocols put residents at risk, and facilities that had lower pre-pandemic staffing ratings had higher COVID-19 fatality rates. James’ office continues to investigate the allegations, including a deeper examination of practices at more than 20 nursing homes where reported conduct “presented particular concern.”
“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 news release unveiling the report. “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.”
In early March 2020, the office began receiving complaints of COVID-related neglect and on April 23, the attorney general set up a hotline to take complaints of abuse and neglect. According to James’ office, the hotline received 770 complaints through Aug. 3 and another 179 complaints through Nov. 16.
The deeper investigations into specific nursing homes are as a 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, which put residents at increased risk of harm.
- The current state reimbursement model gives a financial incentive to owners of for-profit nursing homes to transfer funds to related parties instead of investing in higher levels of staffing and equipment, instead increasing their bottom lines.
- Lack of nursing home compliance with executive order requiring communication with family members.
The report also found that New York’s guidance from March requiring admission of COVID-19 patients into nursing homes may have increased the risk of others at the congregate facilities contracting the virus, a notion that a state-commissioned, internal report released in last year dismissed as a possibility.
Lawmakers and epidemiologists alike have been skeptical of the Department of Health report, issued 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 memo issued by the health agency in late March, as the pandemic surged, was not to blame. Instead, the report concluded the deaths occurred because staff working at the homes had brought the infectious disease into the facilities, months earlier, before the spread of coronavirus in the state was known.
Since that report was released, legislators have called for an independent investigation into the matter, challenging the reliability of an internal review of state practices. In fact, lawmakers even questioned whether the attorney general’s office could be impartial in an investigation. Assemblyman Richard Gottfried had challenged the efficacy of James’ office considering it regularly works with the health department and represents state agencies in lawsuits and other investigations.
The controversial memo issued by DOH on March 25 disallowed nursing homes from denying admission or readmission to residents based solely on a positive or suspected COVID-19 diagnosis. If a COVID-19-positive patient at a hospital was medically stable and needed nursing home care, many nursing homes believed the directive required them to accept that person.
DOH’s report last July – absolving itself of blame for the deaths – said the conclusions were supported by survey responses submitted to the agency by nursing homes. Yet DOH has since refused to provide the Times Union with the underlying nursing homes records forming the basis of the July 6 report. DOH cited two exemptions in denying the Times Union’s request, but refused to say how those exemptions applied to the specific records sought.
The number of deaths the state has reported does not include residents that were infected, transferred to hospitals, then passed away.
The Empire Center for Public Policy, a fiscally conservative Albany think tank, has filed a court case seeking to force the Department of Health to provide the information about hospital deaths, which the think tank contends have been readily available in daily “HERDS” surveys that are filled out by nursing homes and submitted to the state.
The health department has asserted in ongoing responses to the Empire Center’s request that the delays are unavoidable as it’s been engaged in a months-long “diligent search” for the material.
Calls for the data have been bipartisan. Democratic state Sen. James Skoufis, chair of the chamber’s Investigations Committee, warned on Monday that he would support using subpoena power to get answers on nursing home COVID-19 deaths ahead of a Feb. 3 hearing. The next day, the health budget hearing was rescheduled from Feb. 3 to Feb. 25, at the request of the governor’s office.