On Monday, Governor Andrew Cuomo responded to the clamor of legislators calling for repeal of his executive powers and for investigation into his handling of COVID-19 in nursing homes.

He conceded that the public and press had raised many concerns and questions, and said, “I understand that they were not answered quickly enough, and they should have been prioritized and those requests prioritized sooner. I believe that.”

However, he also said, “there was a lot going on,” “everybody was overwhelmed,” and “nursing homes and hospitals were also in the middle of Hell, and in the middle of a pandemic.”

Cuomo went on, “But the void we created by not providing information was filled with skepticism, and cynicism, and conspiracy theories which furthered the confusion … Most of all, the void we created allowed for disinformation and that created more anxieties for the families of loved ones.”

Cuomo had begun his lengthy response at Monday’s press conference by saying, “Emergency powers have nothing to do with nursing homes.”

On the balance of power, Cuomo said that the State Legislature could reverse any of his actions with a vote of 50 percent in the Assembly and the Senate. “They have never reversed a single action,” he said.

Cuomo also said the virus could not be managed by county or state boundaries and that decisions to control it are politically difficult. “It’s difficult to close schools. It’s difficult to close restaurants. It’s difficult to impose curfews. But otherwise people die and these decisions should not be politicized,” he said.

Cuomo described “a toxic political environment” in 2020 as the Department of Justice in August sent letters to four Democratic governors, asking for information on public nursing homes at the same time the state’s legislature made a similar request.

“We paused the state legislators’ request while we were finishing the DOJ request. We told both houses …,” said Cuomo.

He also asserted that the state’s health department “has always fully and publicly reported all COVID deaths in nursing homes and hospitals.”

He noted that nursing-home residents make up just 1 percent of the United States population but account for 36 percent of COVID-19 deaths.

“New York is 34 in nursing home deaths as a percentage of total deaths — 34 out of 50 states,” Cuomo said.

Cuomo then went over his views on his March 25 executive order, rescinded with a May 10 order, which had said that “[n]o resident shall be denied re-admission or admission to the nursing home solely based on a confirmed or suspected diagnosis of COVID-19. Nursing homes are prohibited from requiring a hospitalized resident who is determined medically stable to be tested for COVID-19 prior to admission or re-admission.”

Cuomo said at least 12 other states had also followed the March guidance from the federal Center for Medicaid and Medical Services and from the Centers for Disease Control and Prevention.

The reasoning at the time, Cuomo said, was that residents leaving hospitals were not likely to be contagious because the viral load was low and they would be cared for in areas separate from others “under the right precautions.”

He stressed that a nursing home had to agree to take the patient. Cuomo also said the concern at the time was not having enough hospital beds since it was expected 140,000 New Yorkers would be hospitalized with COVID-19 and that the state had fewer than 50,000 hospital beds.

Cuomo said that 365 of the state’s 613 nursing homes received a person from a hospital and “98 percent of those 365 already had COVID in their facility.”

He asserted, “COVID did not get into the nursing homes by people coming from hospitals. COVID got into the nursing homes by staff walking into the nursing homes when we didn’t even know we had COVID.”

Asymptomatic visitors could have brought the virus into nursing homes, too, he said, because, at the time, “the guidance was, you can only be contagious if you have symptoms — if you’re sneezing, if you’re coughing. That turned out to be wrong.”

Cuomo also asserted that the rate of death was the same both before the March 25 order and after it was rescinded.

Going forward, Cuomo said, “Our focus, I believe, is going to be on the for-profit nursing homes, low-performing hospitals but also for-profit nursing homes. I have long believed that there’s a tension in a for-profit nursing home because those institutions are trying to make money. If you’re trying to make profit, it’s too easy to sacrifice patient care.”

The solution, Cuomo said, would be legislative and should be done in this budget cycle.

“I don’t want to leave it to these for-profit owners to decide what’s right and what’s wrong ….,” he said. “If you’re a for-profit nursing home I believe it should be mandated, how much you put back into the facility and how much profit you can make.”

“When it comes to the COVID-19 pandemic, one thing is consistent — politicians are placing blame for the effects of the virus at the feet of other politicians, policymakers and providers, but nobody is focusing blame for the consequences of the virus where it truly belongs — with the virus itself, the state’s ‘hospital centric’ approach to combating the virus and historic underfunding of long-term care,” said Stephen Hanse in a statement on Monday.

Hanse is the president and chief executive officer of the New York State Health Facilities Association and the New York State Center for Assisted Living, representing over 400 nursing homes and assisted-living facilities, which together have 60,000 employees serving over 65,000 elderly and frail New Yorkers.

Hanse went on, “At the onset of the pandemic, the state failed to immediately focus fully on the needs of nursing homes and instead implemented a ‘hospital centric’ approach that led to limited access to testing, extensive staffing, and PPE shortages in nursing homes ….

“Almost 80 percent of New York’s nursing home resident care is paid for by Medicaid. The state has cut Medicaid reimbursement to nursing homes for over 12 years in a row — creating a reimbursement void that was only exacerbated by the state’s primary focus on hospitals throughout the pandemic!”

Hanse says that the statewide average daily cost of providing around-the-clock nursing-home care is $266 while the average Medicaid reimbursement for 24-hour care is $211, resulting in nursing homes being reimbursed $8.79 per hour.

“Most folks pay their babysitter more than $8.79 per hour,” said Hanse, concluding, “Policymakers and legislators must stop the blame game, work in partnership with nursing-home providers, and view long-term care as an investment not an expense.”

Poll results

Cuomo’s handling of the pandemic is still getting strong approval, although not his handling of nursing-home data, and approval is stronger among Democrats than among Republicans, according to results from a Siena Research Institute poll released on Tuesday.

Sixty-one percent of New Yorkers — 83 percent of Democrats, 25 percent of Republicans, and 52 percent in other parties — approve of the job Cuomo is doing overall to address the COVID-19 pandemic, the poll found, which is down slightly from 63 percent last month.

Cuomo scored well for communicating with New Yorkers, at 67 percent, and for providing accurate information at 61 percent.

However, opinion was split on his handling of the vaccine roll-out — 61 percent thought it was excellent or good and 36 percent found it fair or poor — and on implementing the right plans for reopening — 48 percent approved and 50 percent did not.

Asked about “making public all data about COVID-related deaths of nursing home patients,” only 39 percent of surveyed New Yorkers said Cuomo did an excellent or good job while 55 percent said he did a fair or poor job.

Fifty-four percent of Democrats approved, 17 percent of Republicans, and 30 percent of New Yorkers in other parties.