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Good Morning

Rising heat on nursing homes

State Health Commissioner Howard Zucker, left, joins Gov.

State Health Commissioner Howard Zucker, left, joins Gov. Andrew M. Cuomo at a news briefing about COVID-19 on April 30. About 6,500 people died of the virus in nursing homes in the state; it's unclear how many such residents died in hospitals. Credit: Office of the Governor / Darren McGee

Across the state, about 6,500 fathers, mothers, grandparents, aunts and uncles have died — often alone — behind closed doors of nursing homes, due to the coronavirus pandemic.

An untold number of additional nursing home residents died of COVID-19 in hospitals, too.

The tragedy is staggering, the toll horrifying.

We need answers, and concrete next steps. Hopefully, some will come Monday, when the State Legislature holds its second hearing on how nursing homes handled the pandemic.

Last week, the State Legislature held a hearing that brought the issue center stage. But disappointingly, too many questions went unanswered.

Monday, state officials and other witnesses must do better.

With the real possibility of another wave of the pandemic impacting New York, and the knowledge that nursing homes once again likely would be at the epicenter, clear and complete information, data, communication and planning are necessary so that everyone is properly prepared.

State data incomplete

But as of now, state officials still haven’t told us how many nursing home residents have died from COVID-19.

Beyond those who died of COVID-19 in nursing homes, the state hasn’t reported how many other nursing home residents died in hospitals or elsewhere. Even at last week’s hearing, state Health Commissioner Howard Zucker refused to provide that information, saying he couldn’t guarantee the data’s accuracy.

That’s absurd. It also doesn’t bode well that there are discrepancies in how the state Department of Health and Gov. Andrew M. Cuomo are reporting the state’s total COVID-19 deaths.

There has to be a clear answer. If the state can’t provide accurate data for where people died, especially society’s more vulnerable members, how can we trust that any of the official record-keeping is complete? If such statistics do exist, the state must make them public. And if records cannot be clarified, we need to know why.

Zucker pointed to a report released last month by the Department of Health that stated that infected nursing home employees were primarily responsible for spreading the coronavirus in their facilities. That same report came to the conclusion that the state’s March policy requiring nursing homes to admit COVID-19 patients coming from hospitals was not responsible for the spread.

But experts, advocates and others have cast doubt on that conclusion. No matter what, the policy was risky. Nursing homes were taking in both non-COVID-19 patients, and the COVID-19 patients who were discharged from hospitals, thereby putting all residents at risk.

The policy was effectively reversed in May, when the state started requiring a negative test before a patient went to a nursing home. But the state must rethink how it handles this situation going forward, perhaps by establishing facilities to isolate and care for coronavirus patients or finding better options if hospital beds are needed in a crisis. Put a plan in place, and clearly communicate how it will work, now.

What state must do now

But while that controversial policy has taken up much of the nursing home conversation, there’s much more to do.

Start with staff. The work they do is difficult and often thankless, and they deserve adequate protection, training and compensation. There must be enough personal protective equipment for all nursing home staff. As of now, the state is requiring health care facilities to maintain a 90-day reserve. State officials must ensure every home has the equipment it needs. Nursing home operators also should work with labor unions to find ways to incentivize nursing home staff to continue working through these times. Many workers did just that throughout the pandemic, but they must be compensated fairly. Nursing homes also must have access to rapid testing, and contact tracing. 

Let’s not forget about the emotional and social needs of nursing home residents and their families. When the state ordered homes to close their doors to visitors at the start of the pandemic, too often all communication shut down, too. The stories of people dying alone and of confused residents not understanding why family members didn’t visit anymore, and the images of spouses and children waving through windows, were heart-wrenching. While staff members tried to keep the information flowing, the situation was overwhelming, with no clear protocols for how and when to provide information. There must be guidelines for nursing homes for communicating with the state, and their residents and families. The state also must require that the homes provide virtual visitation. A recent $1 million state grant for technology for nursing homes should help. Meanwhile, the state should promulgate additional guidelines to encourage in-person visitation at all of the state’s nursing homes, assuming there’s a safe and appropriate way to do it. As of now, Zucker said, only 117 nursing homes have limited visitation.

The state, which heavily regulates nursing homes, must expand its oversight efforts, to make sure its 613 facilities are doing what they need to do so staffs and patients are better protected. And the state must ensure the lessons learned from this disaster translate into new regulations as needed. There were lives that didn’t need to end this way.

Nursing home residents, staff and their families deserve more. And we all deserve answers.

— The editorial board