NYS Health Dept.: nursing home workers brought in COVID19

"Dedication may have inadvertently led to unintended consequences"

Tom Puckett
July 06, 2020 - 12:44 pm

Photo credit Photo by 1st Sgt. Rodolfo Armando Barrios Quinones/VA Caribbean Healthcare System

Albany, NY (WBEN) New York hospitals released more than 6,300 recovering coronavirus patients into nursing homes during the height of the pandemic under a controversial, now-scrapped policy, state officials said Monday, but they argued it was not to blame for one of the nation’s highest nursing home death tolls.

Gov. Andrew Cuomo’s administration, which has taken intense criticism over the policy, instead contended the virus’ rampant spread through the state’s nursing homes was propelled by more than 20,000 infected home staffers, many of whom kept going to work unaware they had the virus.

“Facts matter. And those are the facts,” state Health Commissioner Dr. Howard Zucker said in a news conference.

New York’s report came more than a month after The Associated Press did its own count finding that hospitals around the state released more than 4,500 recovering coronavirus patients to nursing homes under a March 25 Health Department directive that required nursing homes to take recovering coronavirus patients.

The health department says it conducted an in-depth analysis of self-reported nursing home data that finds that COVID-19 fatalities in nursing homes were related to infected nursing home staff.  The NYSDOH analysis found:

  • The timing of staff infections correlates with the timing of peak nursing home resident mortality across the state;
  • Nursing home employee infections were related to the most impacted regions in the state;
  • Peak nursing home admissions occurred a week after peak nursing home mortality, therefore illustrating that nursing home admissions from hospitals were not a driver of nursing home infections or fatalities;
  • Most patients admitted to nursing homes from hospitals were no longer contagious when admitted and therefore were not a source of infection; and,
  • Nursing home quality was not a factor in nursing home fatalities.     

The directive was intended to help free up hospital beds for the sickest patients as cases surged. But several relatives, patient advocates and nursing administrators who spoke to the AP at the time blamed the policy for helping to spread the virus among the state’s most fragile residents. To date, more than 6,400 deaths have been linked to the coronavirus in New York’s nursing home and long-term care-facilities.

Cuomo, a Democrat, reversed the directive under pressure on May 10, but he has argued for weeks that infected home workers, not released COVID-19 patients, were to blame for a coronavirus spread through nursing homes that he compared to “fire through dry grass.”

“It is that the staff got infected. They came to work and they brought in the infection,” Cuomo said on MSNBC’s “Morning Joe” on June 23. “Now, how do you fix that in the future? I don’t know that you really can.”

New York’s health commissioner echoed those remarks in his news conference Monday, saying: “There’s no reason to place blame. If you were to place blame, I would blame coronavirus.”

While New York’s report doesn’t rule out whether the March 25 directive played any role in the thousands of nursing home deaths, it notes that the virus was already present in many homes before they accepted COVID-19 patients from hospitals. Over 80% of the 310 nursing homes that admitted such patients already had a confirmed or suspected case among residents or staffers, the report says.

The average patient had been hospitalized for nine days, the report says — the same period that it likely takes for the virus to no longer be contagious, according to the federal Centers for Disease Control and Prevention.

The state report also says nursing home resident deaths peaked on April 8 — around the same time as COVID-19 deaths statewide, but nearly a week before the peak of COVID-19 patients from hospitals — a sequence of events the report casts as “suggesting the policy was not the cause.”

Nonetheless, the state’s data show over 1,000 COVID-19 patients entered nursing homes between March 25 and April 8.

Meanwhile, more than 20,000 home staffers were infected with COVID-19 in New York between March and late April when the policy was in effect.

New York officials have said that the March 25 directive was never intended to force nursing homes to take patients they weren’t equipped to care for, and that they should have spoken up if that was the case. Officials also have noted that some other states, including neighboring New Jersey, had similar policies.

Michael Dowling, CEO of hospital chain Northwell Health — which sent more than 1,700 COVID-19 patients to nursing homes, according to the AP’s count — said those who claim that nursing home admission policies from hospitals caused the fatalities are “not supported by the facts.

Stephen Hanse, who runs a big association of New York nursing homes, acknowledged Monday that no one decision or issue can be blamed for the virus’ toll in nursing homes.

But “bringing in even one instance of COVID to a nursing home is in no one’s best interest,” said Hanse, president of the New York State Health Facilities Association and the New York State Center for Assisted Living.

Stephen Hanse, President and CEO of the New York State Health Facilities Association and the New York State Center for Assisted Living (NYSHFA/NYSCAL), a state wide association representing over 450 nursing homes and assisted living facilities issued the following statement in response to today’s Department of Health press conference regarding the impacts of the Department’s March 25th Advisory.

“During today’s press conference the statement that ‘facts matter’ was continuously repeated. Regarding long-term care and COVID-19 the facts are clear – due to their advanced age and struggles with multiple chronic diseases, nursing home and assisted living residents are the most vulnerable population and the least able to withstand the insidious COVID-19 virus.At the onset of the COVID-19 virus, nursing homes and assisted living facilities were not the top priority. The principal focus of policymakers was on bolstering hospital resources and ramping up hospital bed capacity. This strategy included the Department of Health’s March 25th Advisory. As we learn more about the COVID-19 virus every day, policymakers now know that the men and women residing in nursing homes and assisted living facilities are the most at risk to infection from the COVID-19 virus. Consequently, it is essential that nursing homes and assisted living providers receive the full support and assistance from elected officials and policymakers to ensure they have the necessary resources to defeat this virus and safeguard their residents and staff. For too long, nursing homes and assisted living providers have been subjected to significant Medicaid cuts. These cuts must stop. Policymakers must renew their commitment to fully support and fund nursing home and assisted living care for the most vulnerable in our communities. As Commissioner Zucker stated today, outbreaks of COVID-19 in nursing homes were not the result of inadequate quality in nursing homes. As such, we are all in this together – providers, policymakers and the public. Together, each of our individual actions must be directed at safeguarding our most vulnerable and lead us to collectively overcome our present circumstances and create a stronger and safer future.”

Congressman Tom Reed issued a response, "This is a blatant attempt by Governor Cuomo to sidestep an ounce of accountability. As we’ve said all along, an independent investigation is needed to fully evaluate the impact of New York’s disastrous nursing home policies. Justice is not served when the individuals who were responsible for the state’s deadly edicts are reviewing their own conduct. Placing the blame squarely on the staff who care for our grandparents -- when the state knowingly created COVID hotspots by forcing homes to accept COVID-positive patients -- is a slap in the face to those who lost a loved one. Even a cursory review of ADMA’s dire warning to New York State makes it clear what really contributed to New York’s horrific death toll."

 

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