One year in: A look at decisions during NY’s nursing home crisis

Coronavirus

NEW YORK — When Gov. Andrew Cuomo started his daily briefings on the emerging COVID-19 crisis on March 2, 2020, he publicly worried about the explosion of need for ICU beds and ventilators. 

Elderly people who’d been hospitalized for the virus would need somewhere to go.

“What Cuomo was trying to do back then was say ‘Listen! I have a hospital crisis,'” said elder care attorney, Howard Krooks.  “‘I have to have someplace to send people, with or without COVID.'”

The New York State Health Department’s mandate on March 25, 2020 noted it was following federal guidelines from the Centers for Disease Control and Prevention.  Nursing home patients who’d been treated for COVID at the hospitals must be allowed back into their facilities.

Stuart Almer, president and CEO of Gurwin Healthcare System in Commack, Long Island, braced for the tough battle ahead against a silent killer.

“Knowing how hard to control COVID is, intuitively, it just would make sense that it would be a concern to bring positive patients back into the facility,” Almer said. “That mandate from March 25th really was the greatest single day of impact we had.  Because that was a game changer for us.  It really upset the families the most.”

Almer’s Gurwin Jewish Nursing and Rehabilitation Center has 460 beds, making it a large nursing home.

He said New Yorkers need to keep that number in context when learning Gurwin lost 45 residents in the nursing home to COVID and 15 others who were treated at the hospital.

“We were proactive in procuring as much PPE (personal protective equipment) as we could get and stockpiling it early on,” Almer noted.  “We have the most caring, heroic staff.”

But Attorney General Letitia James is now investigating whether a “liability shield” that was included in the state budget last April was too protective of nursing home operators, possibly not giving them the incentive to buy enough PPE or hire enough staff during the emergency.

“The provision, it appears, was drafted and advocated for by the Greater New York Hospital Association, which is a key contributor to the Governor,” said Professor Nina Kohn of Syracuse University, who has written extensively about elder care.

“It protects the entire corporate chain and it protects them from civil and criminal liability,” she said.

Cuomo senior advisor Richard Azzopardi told PIX11 it was necessary last spring.

“The immunity was needed to get the nursing homes and hospitals to work as one system,” he said. “Everyone was telling us we had to quadruple the size of our hospital system.”

“Many states did some form of these laws.  The provision was negotiated with the legislature.  111 members voted for it.”

As the death toll mounted in nursing homes, Gov. Cuomo started taking more heat, even as he reminded New Yorkers in April 2020 that the elderly were the most vulnerable to the insidious virus.

Dr. Howard Zucker, the state’s Health Commissioner, pointed out that staff sometimes worked at more than one facility and could carry the virus into nursing homes unwittingly.

Zucker said 98 percent of the state’s long-term care facilities had already been infected with novel coronavirus before the controversial March 25 mandate was issued.

It later emerged that 9,000 nursing home residents had returned to their facilities after hospital treatment for COVID, but the state said their “infectivity level” was low by that point.

Even Stuart Almer acknowledged, “We can’t draw a straight line from the mandate to what occurred.”

As Gov. Cuomo’s national profile and popularity grew, from his deft handling of daily briefings and many aspects of the COVID crisis, the one area that continued to dog him was the decision about nursing homes.

The New York Times and Wall Street Journal recently reported that when nursing home mortality rates were presented to Cuomo’s top aides last June, they were concerned to see New York’s tally at 9, 250 compared to New Jersey’s 6,150.  New York is a much bigger state.

Cuomo’s counsel said last week the June 2020 data wasn’t all included in a July Department of Health report, because some figures weren’t verified.

Yet families and even nursing home staff were already questioning the nursing home fatality figures featured on the Department of Health website.  There was concern facilities weren’t reporting all the deaths.  And there was growing evidence that nursing home patients who died in hospitals weren’t being counted with people infected in the facilities.

“We do have indications there were political reasons for withholding those numbers,” Professor Kohn said.

During contentious New York State Assembly and Senate hearings in August, Dr. Zucker said he wasn’t prepared to give lawmakers a precise count on nursing home fatalities, because numbers were still being evaluated.

Soon after, the Department of Justice under then-President Donald Trump sent letters to the Democratic governors of  several states, seeking their nursing home mortality data.

Cuomo’s key aide, Melissa DeRosa, later said the administration withheld data from state lawmakers, because it feared the Trump White House would use the numbers for political purposes.

Probably the greatest damage done to the administration came in January 2021, when Attorney General James issued her report on nursing homes in the pandemic.

She concluded the State Department of Health may have been under-reporting deaths linked to nursing homes by as much as 50 percent.

Gov. Cuomo and Commissioner Zucker appeared at a press conference the next day, and Cuomo apologized for creating a “void” in information.

Zucker said there was never any “under counting.”  He said the state’s mortality rates remained the same.

Yet the numbers connected to nursing homes and other long-term care facilities were almost immediately updated in late January to include more than 4,000 additional deaths.

A year into the crisis, more than 15,000 people have died at long-term care facilities and rehabs.

Yvonne Parson, who lost her 93-year-old father James Hutcherson at the New York State Veterans Home in St. Albans, Queens, has retained a lawyer.

She was upset to see a bill charging her for the experimental treatment of Hydroxychloroquine and Azithromycin last April.

A study had shown Hydroxychloroquine could cause heart problems in patients.

They’re waiting for records, attorney Jeff Adams said.

“We’re having an extremely hard time getting them,” Adams said. “People in nursing homes are often those who are least protected by society.”

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