May 11, 2020

USA: NY Governor Cuomo Admits He Was Wrong To Order Nursing Homes To ACCEPT Covid19 Patients. NY Withheld Nursing Home Covid19 Details For Weeks. Thousands Died. This Secrecy Impacted Lives

NY Post
written by Post Editorial Board
Sunday May 10, 2020

Gov. Andrew Cuomo has finally admitted — tacitly and partially, anyway — the mistake that was state health chief Howard Zucker’s order that nursing homes must admit coronavirus-positive patients.

On Sunday, Cuomo announced a new regulation: Such patients must now test negative for the virus before hospitals can return them to nursing homes. Yet the gov also admitted that COVID-19 cases might still go to the facilities via other routes, and didn’t explicitly overrule Zucker’s March 25 mandate that homes must accept people despite their testing status — indeed, couldn’t even require a test pre-admission.

The gov’s people say that a home that simply can’t accommodate coronavirus patients never had to take them — though they are obliged to help those people find a place that will, with help available from the state if needed. That is: Zucker’s mandate was never more than a “don’t discriminate” rule.

But Zucker publicly presented it as “must accept” — and Cuomo’s remarks regularly implied there must be something wrong with a home that couldn’t handle corona patients.

So, while the gov’s people imply that some homes simply misunderstood the rules, the real message to operators was that declaring themselves overwhelmed would put their licenses at risk.

Notably, the chief of one Cobble Hill facility not only had his request for PPE denied, he got turned down cold when he then asked to transfer patients.

Then, too, Zucker’s Department of Health has issued other heartless orders during this crisis — the now-rescinded “don’t even try to resuscitate” mandate to EMTs for cardiac-arrest cases, as well as telling at least one home it was OK to keep staffers on the job after they’d tested positive.

Also telling: The gov has ordered an investigation that’s plainly supposed to pin all the blame on nursing and adult-care facilities: It’s led by state Attorney General Tish James, who got her job with Cuomo’s crucial assistance — and it’s only looking at what homes did wrong.

We’re sure James will uncover plenty of real horrors: Everyone (who cared to know) has long been aware that many New York nursing homes leave a lot to be desired. But that was all the more reason for Zucker & Co. to focus on policing and assisting these facilities from the start — rather than issuing edicts that led to repeated and needless tragedies.
USA Today
written by David Robinson, Stacey Barchenger, Kelly Powers, New York State Team
Saturday May 2, 2020

ALBANY, N.Y. – On March 29, as New York and other states began ordering nursing homes to admit medically stable residents infected with the coronavirus, national trade groups warned it could unnecessarily cost more lives.

The health directives put “frail and older adults who reside in nursing homes at risk” and would "result in more people going to the hospital and more deaths,” the American Health Care Association and affiliates said at the time.

A month later, it appears government officials should have heeded the dire call to pursue different pandemic emergency plans.

The deadly virus has spread like wildfire through many nursing homes across the Northeast, and state officials are scrambling to better protect those most vulnerable to COVID-19, the disease caused by the virus.

The death toll is devastating, according to interviews with nursing home officials, patients' families, health care advocates, government officials and from an examination of state records by the USA TODAY Network Atlantic Group, a consortium of 37 Gannett-owned daily newspapers across the Northeast.
  • At least 3,043 people have died inside New York nursing homes due to COVID-19 complications, or about 17% of the state’s 18,015 deaths as of Wednesday.
  • In Pennsylvania, about 65% of coronavirus deaths were nursing home residents, and New Jersey had 3,200 residents of long-term care homes die due to complications from the virus, about 40% of the statewide total.
  • About 58% of the deaths in Delaware lived in nursing homes, and 46% of the fatalities in Maryland were at nursing homes, prompting Gov. Larry Hogan to order residents and staff members at nursing homes to be tested for coronavirus.
Meanwhile, advocates and residents’ relatives have criticized state and federal officials, as well as some nursing homes, for failing to address the crisis as deaths mounted.

“To have a mandate that nursing homes accept COVID-19 patients has put many people in grave danger,” said Richard Mollot, executive director of the Long Term Care Community Coalition in New York.

“We know facilities have a lot of infection-control problems, we know that facilities have low staff, so what do you think was going to happen when the staff were further strained in caring for these patients?”

Amid the pushback, New York Health Commissioner Dr. Howard Zucker on Wednesday issued an advisory warning nursing homes they could face fines or lose their license if they didn’t properly isolate COVID-19-infected residents, citing state health law.

The letter noted nursing homes incapable of isolating contagious residents should transfer them to other medical facilities and stop admitting additional residents.

New Jersey’s Health Commissioner Judith Persichilli took a similar step on April 13, clarifying how the state’s nursing homes could deny admitting infected patients.

“People just can't go back until the spread in the nursing homes slows down and until they can take care of their residents appropriately,” Persichilli said the day the revised guidelines were distributed.
USA Today, Lohud
written by David Robinson, New York State Team
Wednesday April 15, 2020

Gov. Andrew Cuomo this week described the importance of transparency in establishing his credibility to lead New Yorkers through the novel coronavirus pandemic.

He cited his daily briefings filled with detailed charts on infections, hospitalizations and deaths as the foundation of that sense of trust between leader and citizen.

“Here’s all the information. I work for you. I give you all the information, no spin, no gloss, no sugar, no glazing,” he said on Monday. “I’m not worried you can’t handle the facts.”

But many details about the coronavirus crisis unfolding in New York’s nursing homes have been missing from the daily briefings, including the names of facilities with outbreaks and deaths tied to COVID-19, the disease caused by coronavirus.

State health officials on Monday released the county-level death toll in assisted living facilities and nursing homes. The coronavirus has killed more than 2,722 people living in such facilities, or about 25% of all virus-related deaths statewide.

It offered the first localized glimpse of the issue, and it came in response to USA TODAY Network New York questioning.

Yet the names of hundreds of nursing homes with coronavirus outbreaks remain a mystery to the public, leaving advocates, relatives and loved ones of some of the most vulnerable New Yorkers in the dark.

Health Commissioner Dr. Howard Zucker on Monday said the decision to withhold the nursing home names was based on privacy concerns linked to the federal Health Insurance Portability and Accountability Act of 1996, known as HIPAA.

Yet at least two other states, Minnesota and Connecticut, have released names of nursing homes with coronavirus cases.

Patient advocates and health experts suggested New York should follow the example, as well as include the number of cases and deaths in each facility.

“I don’t think there is anything with invading privacy,” said Dr. Ravina Kullar, an Infectious Disease Society of America expert.

“If one of your family members are in the nursing home, then it should be up to that individual on what to do with their loved one,” she added.

Jim Malatras, a member of New York’s COVID-19 task force, said Tuesday the state would release the names of nursing homes and assisted living facilities in the future.

He asserted the outstanding privacy concern is that some counties have just one confirmed COVID-19 death in a nursing home, suggesting that made it easier to identify the victim.

It is an argument disputed by Adam Marshall, staff attorney for the Reporters Committee for Freedom of the Press.

“There are numerous (HIPAA) exceptions that allow covered entities to release even protected health information, including basically to try to control the spread of infectious diseases,” he said.

In other words, the public needs to know which nursing homes have COVID-19 outbreaks in order to ask questions about what is being done to protect the residents, as well as the community, from the virus.

What New York did and didn’t do to protect nursing homes

In many ways, the lack of early public reporting of outbreaks in nursing homes hindered the public health response, advocates and experts said.

Kullar asserted notifying the public of nursing home outbreaks early protects relatives’ and loved ones’ rights to be involved in decisions affecting residents, some of whom have dementia and other cognitive issues requiring the added advocacy.

“It’s all about transparency, and we’re not seeing this with nursing homes,” she said.

Mollot suggested authorities in New York and other states should have relocated and isolated more infected nursing home patients into COVID-19 only sites.

“It really is kind of infuriating to see leaders come on TV and do these press conferences,” Mollot said. “Because by not having a system that reports infections and deaths in these facilities, then we can pretend in essence that’s not happening.”

Asked about the thousands of nursing home deaths due to the virus, Cuomo on Tuesday said “you cannot stop it” because of the existing health issues among the elderly and disabled in the facilities.

In addition to banning visitors, Cuomo’s policies required nursing home staff wear masks and undergo screening every day, including taking their temperatures.

Yet he noted the virus could elude the screening if a contagious worker didn’t have a fever at the time.

“You can’t hermetically seal a nursing home, you can’t put it in a bubble and say I can protect these vulnerable people,” Cuomo said.

Brian Lee, executive director of the advocacy group Families for Better Care, asserted many states withheld details about COVID-19 in nursing homes because officials were “trying to protect providers from potential litigation in a post-pandemic world.”

Lee said the potential for a wave of coronavirus litigation could cripple the nursing home industry, and contrasted the handling of the pandemic to other infectious diseases.

“If there was a scabies outbreak, or norovirus outbreak, or any other kind of outbreaks in these facilities, health departments would be talking about and how many people were affected and naming facilities,” Lee said.

“It’s because of this explosive coronavirus issue that they’re interested in protecting the providers,” he added.
UPDATE 5/11/20 at 6:01pm: Added info below.
UPDATE 5/11/20 at 10:45pm: Added info below.

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