XPost: alt.tv.pol-incorrect, alt.rush-limbaugh, alt.politics.usa
XPost: sci.med.diseases

The state attorney general, Letitia James, said it’s likely that the
Cuomo administration failed to report thousands of Covid-19 deaths of
nursing home residents.

ALBANY, N.Y. — For most of the past year, Gov. Andrew M. Cuomo has
tried to brush away a persistent criticism that undermined his national
image as the man who led New York through the pandemic: that his
policies had allowed thousands of nursing home residents to die of the
virus.

But Mr. Cuomo was dealt a blow when the New York State attorney
general, Letitia James, reported on Thursday morning that Mr. Cuomo’s administration had undercounted coronavirus-related deaths of state
nursing home residents by the thousands.

Just hours later, Ms. James was proved correct, as Health Department
officials made public new data that added more than 3,800 deaths to
their tally, representing nursing home residents who had died in
hospitals and had not previously been counted by the state as nursing
home deaths.

The state’s acknowledgment increased the overall death toll related to
those facilities by more than 40 percent. Ms. James’s report had
suggested that the state’s previous tally could be off by as much as 50 percent.

The findings do not change the overall number of Covid-19 deaths in New
York — more than 42,000, the most of any state — but the recalculation
in the number of nursing home deaths illustrates how unprepared the
nursing home industry was in the first and deadliest weeks of the
pandemic.

Mr. Cuomo, a third-term Democrat, had long dismissed the critiques of
his policies governing those facilities as partisan attacks from the
Trump administration and other Republican adversaries.

But the report by Ms. James, a fellow Democrat, casts a renewed light
on the state’s decision to send nursing home residents who had been hospitalized with the coronavirus back to the nursing homes, a policy
that Mr. Cuomo has defended as following federal guidelines.

At the same time, Ms. James’s assertion of an undercount of deaths gave credence to theories that the state may have intentionally played down
the number of those deaths to avoid blame.

“This is shocking and unconscionable,” said Assemblyman Richard N.
Gottfried, the Democratic chairman of the Assembly Health Committee.
“But not surprising.”

Dr. Zucker said that the state website had always been clear that
deaths it listed did “not include deaths outside of a facility.”

“The word ‘undercount’ implies there are more total fatalities than
have been reported,” he said. “This is factually wrong.”

He also asserted that the lack of data on hospital deaths of nursing
home residents was due to concern and caution about the accuracy of
data that nursing homes supplied — an issue also raised by the attorney general. “D.O.H. does not disagree that the number of people
transferred from a nursing home to a hospital is an important data
point,” he said.

The new data released by Dr. Zucker puts the total number of deaths
connected to nursing homes at 12,743.

Ms. James’s findings would seem to put her in rare conflict with Mr.
Cuomo; she was the governor’s preferred candidate after Eric T.
Schneiderman suddenly resigned as attorney general in 2018, and she
readily embraced Mr. Cuomo’s political backing.

Her report seemed certain to inspire more questions about the handling, oversight and performance of the state’s nursing homes in the early
stages of the pandemic. Indeed, on Thursday, Mr. Cuomo’s critics in
Washington and Albany had already seized on the attorney general’s
report as evidence of his dishonesty, amid calls for Dr. Zucker to
resign.

“This is now more than a nursing home scandal,” said Representative
Elise Stefanik, a conservative Republican from upstate New York. “This
is a massive corruption and cover-up scandal.”

Deaths in nursing homes and other long-term care facilities have
accounted for about a third of the nation’s some 430,000 Covid-19
deaths. Federal and state authorities have made vaccinating staff and
residents at such facilities a top priority, though that effort has
been slower than hoped.

But even as state officials in New York tackle vaccine shortages, the
count of deaths in the state’s nursing homes remained a source of
controversy. Mr. Cuomo had been accused of obscuring a more accurate
estimate of nursing home deaths, because the state’s count only
included the number of deaths at the facilities, rather than accounting
for the residents who died at a hospital after being transferred there.

For its report, Ms. James’s office surveyed dozens of homes and found consistent discrepancies between deaths reported to the attorney
general’s investigators and those reported to and officially released
by the Health Department.

In one instance, an unnamed facility reported to the Health Department
that it had 11 confirmed and presumed deaths on site through early
August. The attorney general’s survey of that same facility, however,
found 40 deaths, including 27 at the home and 13 in hospitals.

Another facility reported one confirmed and six presumed Covid-19
deaths to the Health Department, according to the report. The attorney general’s office, however, said the facility reported to its
investigators that there were more than four times that number — 31
dead — by mid-April.

The attorney general’s report also scrutinized immunity provisions
granted to health care providers codified by Mr. Cuomo in the state
budget. The report said the protection of immunity may have prompted
some nursing homes to make financially motivated decisions at the
height of the pandemic, like admitting patients even when the
facilities were facing staff shortages or were unequipped to care for
them.

Indeed, Ms. James’s office is still investigating and weighing legal
action stemming from complaints made to her office about shortcomings
and neglect that may have placed residents at risk. Those include
allegations of nursing homes that failed to isolate Covid-19 patients,
maintain stockpiles of personal protective equipment, properly screen
employees for the virus or ensure adequate staffing levels even before
the pandemic.

The report also cast a critical eye on perhaps the governor’s most
criticized decision since the beginning of the pandemic last year: a
March 25 directive from the Health Department that ordered nursing
homes to accept and readmit patients who had tested positive.

The Health Department responded in July with a report that sought to
absolve the state from any blame resulting from the March directive.
The report concluded that most of the patients sent back to nursing
homes “were no longer contagious when admitted and therefore were not a
source of infection.” The Health Department concluded that the virus
was instead spread by employees who did not know they were contagious.

While acknowledging that Mr. Cuomo’s memo to nursing homes was
consistent with federal guidance, the attorney general’s report said
the governor’s policy “may have put residents at increased risk of harm
in some facilities.” Under the policy, some nursing homes stopped
testing residents for the coronavirus, a factor that might have
obscured data reported by the facilities, the report found.

For its part, the Health Department also cited Ms. James’s findings on
the March 25 memo, saying the report had found no evidence that the
policy outlined in the directive “resulted in additional fatalities in
nursing homes.”

Ms. James’s report also found a number of homes that “failed to comply
with critical infection-control policies,” including failing to isolate residents who had tested positive for the virus or screen employees for
it.

The state’s reporting of nursing homes deaths has been the focus of a
lawsuit by a conservative economic think tank, the Empire Center for
Public Policy, which has sued, seeking to force the Health Department
to release more complete data.

Last year, the Democratic-controlled Legislature held hearings partly
in an attempt to pry the data from the administration, to no avail.

Dr. Zucker was supposed to testify next week during a state budget
hearing, where lawmakers were expected to press him on nursing home
deaths, but his appearance was recently pushed back to late February.

The Democratic chairman of the investigations and government operations committee in the State Senate, James Skoufis, who has accused the
Health Department of stonewalling investigators, suggested on Thursday
that he would use a subpoena to compel the release of data from Dr.
Zucker’s office.

“The D.O.H. commissioner’s unresponsiveness to the Legislature’s many
questions and concerns is insulting and unacceptable,” the senator said
in a statement.

The attorney general asked 62 nursing homes — about a tenth of the
state’s total — for information about on-site and in-hospital deaths
related to the virus; investigators then cross-referenced that
information with public reports of deaths issued by the Health
Department. The deaths reported to the attorney general’s office at
most of those facilities totaled 1,914, compared to the state’s much
lower count of 1,229.

Ms. James said that her office was investigating those circumstances
“where the discrepancies cannot reasonably be accounted for by error or
the difference in the question posed.”

The attorney general said she was continuing to conduct investigations
of more than 20 nursing homes across the state that “presented
particular concern,” noting that “other law enforcement agencies also
have ongoing investigations relating to nursing homes.”

Under normal circumstances, the attorney general’s office “would issue
a report with findings and recommendations after its investigations and enforcement activities are completed,” Ms. James said in her report.
“However, circumstances are far from normal.”

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Trump won.

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