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Delve deeper on nursing homes

State Attorney General Letitia James released her report

State Attorney General Letitia James released her report on New York nursing homes last week. Credit: Getty Images/Michael M. Santiago

12,743. It’s the answer to a question that has been asked for months: How many nursing home residents died in New York State due to COVID-19?

That’s 46% higher than the total the state had previously reported, which included only residents who physically died in the homes themselves. It took a scathing report from Attorney General Letitia James on Thursday to force state officials to release their own statistics — something they should have done months ago.

James’ interim report, which looked at a number of issues related to nursing homes, is deeply troubling. It paints a picture of long-term care facilities that were ill-prepared before the pandemic, with staffing shortages, a lack of personal protective equipment and inadequate infection controls.

Accountability for such significant shortcomings falls not only on the nursing homes, but also on the state, which is supposed to serve as regulator and enforcer. Yet, in a 1,600-word response last week, Health Commissioner Howard Zucker took no such responsibility, instead standing up for the state and blaming the Trump administration. Gov. Andrew M. Cuomo, who has defended his actions for months, didn’t take direct responsibility for the findings, dismissing criticism over the issue as a "political football."

But it’s not. James is a Democrat, and the critiques have come from both sides of the aisle.

James’ report extrapolated from a sampling of nursing homes that the discrepancy on the number of resident deaths could be as high as 50%. It noted that in one case a facility reported, as of May, deaths of 16 nursing home residents to the state Department of Health. But as of July, DOH had published on its website just one death in that home. The death toll was later changed on the website to 11, which did not reflect one suspected case and four more who had died in the hospital.

The report also addressed Cuomo’s controversial March directive that told nursing home operators to accept patients with COVID-19 from hospitals as long as they were able to. Such guidance, James said, may have led to an "increased risk" to residents.

Among James’ other disturbing allegations: that for-profit nursing homes may have made financially motivated moves, especially related to insufficient staffing and resident care, in part because the state had enacted provisions that gave the homes immunity.

James’ investigation must be only the beginning. She should dive deeper to understand what happened at each home, and audit the data on deaths. The State Legislature must push Zucker for answers during hearings next month. Other issues, like the how nursing homes are managed, the limited resources some are given and the differences between for-profit and not-for-profit models must be addressed, too.

In this crisis, there’s plenty of blame to go around. But the state must take the lead in making necessary reforms, improving enforcement and data collection and making sure facilities are prepared for the next pandemic.

Thousands of our most vulnerable residents died, leaving behind thousands more family members who continue to grieve. The state owes them more.

— The editorial board

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