Week XLIX: As criticism mounts on nursing-home death counts, McCoy quotes Churchill: ‘When the eagles are silent, the parrots begin to jabber’

— Photo from Daughters of Sarah Senior Community Facebook page
A wedding is performed in front of a window at the Daughters of Sarah facility so that a resident can see the ceremony. Nursing homes were closed to visitors to prevent the spread of COVID-19.

ALBANY COUNTY — COVID-19 infection rates and hospitalizations continued to decline from the post-holiday surge locally, statewide, and nationwide in Albany County’s 49th week of coping with the coronavirus.
Much of the week’s focus turned to the cascading criticism of Governor Andrew Cuomo’s handling of nursing home death counts, which has been front and center since the office of Attorney General Letitia James issued a report on Jan. 28 that found more nursing-home residents died of COVID-19 than data from the state’s health department reflected.

The health department had released counts of all COVID-19 deaths but had not listed hospital deaths of nursing-home residents as nursing-home deaths. The state’s health commissioner, Howard Zucker, released that information hours after the attorney general’s report.

More information on nursing-home deaths has come out since a Supreme Court justice, responding to a petition from the Empire Center, required the health department to provide full COVID-19 death tolls in New York nursing homes.

Including the hospital deaths, the nursing home COVID-19 toll has gone from the originally reported number of roughly 8,500 to over 15,000.

Last Thursday, a New York Post story reported that Secretary to the Governor Melissa DeRosa had said the Cuomo administration withheld the state’s nursing-home death toll so the numbers would not be “used against us” by the federal government.

Albany County Executive Daniel McCoy used a quote from Winston Churchill to express on Friday how he felt about the news.

“When the eagles are silent, the parrots begin to jabber,” he said.

On Monday, the governor, in his first public response to the clamor that followed the story — as both Democrats and Republicans called for a revocation of Cuomo’s emergency powers — took a similar tack, saying the void his administration had created with lack of nursing-home information was filled with disinformation, causing anxiety.

At his Wednesday press conference, Cuomo denigrated Ron Kim, a Democratic assemblyman from Queens, who had been on the now highly publicized call with DeRosa and commented on it to The Post.

On Wednesday evening, Cuomo’s office released a transcript of the Feb. 10 conference call between members of his administration and state legislators. 

 

Nursing home deaths In Albany County

McCoy, at his press conference on Friday morning, described his own decision-making process in releasing information on the COVID-19 deaths at Shaker Place, the county’s nursing home.

In April, McCoy had been defensive about not revealing earlier the positive tests for COVID-19 at the county’s nursing home although, after that, he made those numbers part of his regular daily reports.

In recent months, McCoy has daily released the number of people newly infected as workers or residents of congregant settings. His daily reports on any COVID-related deaths have included solely information on the person’s gender and decade of age.

When the first Shaker Place resident died of COVID-19 this past spring, McCoy said on Friday, he was faced with a choice of reporting it or not. He said he had learned from being at war, “It eventually comes out.”

McCoy went on, “I wanted to be transparent … I self-consciously decided, ‘I’m going to read it out because people have a right to know.’ When you’re going through a health-care crisis … if that’s a disconnect, it’s not going to work.”

On April 17, 2002, the state had released a report on nursing-home fatalities from COVID-19, whether the patients died at the facility or at a hospital; Albany County was listed then with three nursing-home deaths. Specific nursing homes were listed in the report then only if six or more deaths occurred there; no specific nursing homes in Albany County were listed last April.

As of Feb. 4, 2021, that same Department of Health webpage lists Albany County as having 94 confirmed COVID nursing-home deaths with 28 out-of-facility nursing home deaths, such as at a hospital; it also lists one COVID-presumed death for an Albany County nursing home.

As of Feb. 4, Shaker Place is listed by the state’s Department of Health as having 10 confirmed COVID nursing home deaths and five confirmed out-of-facility COVID deaths.

The other eight Albany County nursing homes had the following confirmed COVID-19 deaths reported by the State’s Department of Health as of Feb. 4:

— Nine at Bethlehem Common Care Center, four out-of-facility;

— Seven at Daughters of Sarah, two out-of-facility;

— Seven at Eddy Village Green;

— Eleven at Hudson Park Rehabilitation and Nursing Center, one out-of-facility;

— Eleven at Our Lady of Mercy Life Center, two out-of-facility, and one COVID-presumed death at the facility;

— Fifteen at St. Peter’s Nursing and Rehabilitation Center;

— Twenty-one at Teresian House Nursing Home, seven out-of-facility; and

— Three at The Grand Rehabilitation and Nursing Center at Guilderland, seven out-of-facility.

The state’s webpage also lists the confirmed and presumed COVID-19 deaths for adult care facilities, of which seven are listed for Albany County: Atria Guilderland, Atria Shaker, Elderwood Village of Colonie, Massry Residence at Daughters of Sarah, Peregrine Senior Living at Colonie, Promenade at University Place, and Terrace at Beverwyck.

The tally for confirmed COVID-19 deaths and for presumed COVID-19 deaths for all seven of these adult care facilities in Albany County is zero.

McCoy said on Friday that “things change” during the evolving pandemic and said he couldn’t speak for others.

“We had our issues with the Department of Health … the data wasn’t matching up,” he said of the state numbers.

Nursing homes are required to report deaths only to the state, not to the county and Albany County sometimes was unaware of nursing-home deaths right away.

“It made our job harder ...,” said McCoy. “If you know you have an outbreak, you can get there.”

He concluded, “I can only lead with the information I’m given.”

 

Transcript: “We froze”

Last Friday, the governor’s office released a transcript of the remarks that DeRosa had made during a Zoom conference call with state legislators, upon which The New York Post first reported.

“I was explaining that when we received the DOJ inquiry,” DeRosa said of the federal Department of Justice in a statement, “we needed to temporarily set aside the legislature’s request to deal with the federal request first. We informed the houses of this at the time. We were comprehensive and transparent in our responses to the DOJ, and then had to immediately focus our resources on the second wave and vaccine rollout.”

The state legislature had made its request in August.

According to the transcript, Senator James Skoufis, a Democrat representing District 39 in the Hudson Valley, prompted DeRosa’s response by stating, “You’re not going to convince me that you could not have done this audit faster than six months’ time. I believe you started the audit a few weeks ago when this all started to bubble over.”

“I don’t know that this is going to satisfy you, but it’s the truth and the truth works almost every time,” DeRosa responded. “The letter comes in at the end of August and right around the same time, President Trump turns this into a giant political football.

“He starts tweeting that we killed everyone in nursing homes, he starts going after Murphy, starts going after Newsom, starts going after Gretchen Whitmer,” she said, naming Democratic governors Philip Murphy of New Jersey, Gavin Newsom of California, and Whitmer of Michigan. 

“He directs the Department of Justice to do an investigation into us,” DeRosa went on about Trump. “He finds one person at DOJ, who since has been fired because this person is now known to be a political hack, who sends letters out to all of these different governors.

“And basically, we froze, because then we were in a position where we weren’t sure if what we were going to give to the Department of Justice or what we give to you guys, what we start saying was going to be used against us while we weren’t sure if there was going to be an investigation.”

DeRosa went on to say the federal investigation was never formally opened.

She also went on to describe “a massive data dump.”

“On April 17,” DeRosa said, “DOH sent out a notification to all of the nursing homes it regulates and says prospectively, tell us anyone that died in the facility, anyone you think died of COVID in the facility … And the nursing homes took that to mean I’m going to look backward and guess, essentially, that you believe was confirmed COVID in a hospital and that you think was presumed in a hospital. 

“All of a sudden, at the end of April, you get a massive data dump from 600 nursing homes where they’re reporting back to January and saying presumed COVID.

“And DOH, in the middle of what was still the height of the pandemic, while we were scrambling on a daily basis to make sure that hospitals weren’t overwhelmed and collapsing, when we were trying to make sure that people were getting the care that they needed, when we were still making major decisions about what sectors of the economy would be safe to reopen or close, when there was still massive PPE shortages and while we were being shot at on a daily basis from Donald Trump — that we needed to go through these reams of data ….

“And none of it was reliable. It was based on initials. It was based on the data that they thought they died in the hospital because they didn’t know for sure. It was based on comorbidities … all these things and they’re guessing that because it was around that time, maybe it was COVID. This was a massive undertaking and it was happening while we were still at the height of the pandemic. That’s when that data dump happened.

“So, I'm just asking for a little bit of appreciation of the context … We are going to try to do better …. So, we do apologize. I do understand the position that you were put in. I know that it is not fair. It was not our intent to put you in that political position with the Republicans.” 

 

Calls for revocation of power

On Friday, Senate Republicans demanded a special session to revoke Cuomo’s emergency powers and repeated their call for immediate investigation into the “nursing home cover-up.” Some Democrats chimed in, too.

Press releases arrived fast and furious on Friday; among them were these statements.

“The leaked tape of the secret meeting held between administration officials and legislative Democrats confirms that not only did Cuomo’s office deliberately withhold information from the public and the Legislature, they did it to obstruct justice and dodge a federal investigation,” said GOP Senator Robert Ortt.

“This obstruction of justice must be investigated on the federal and state levels and my colleagues in the majority should finally use their subpoena power to get the truth under oath,” said Republican Senator Jim Tedisco.

“It’s crystal clear that Governor Cuomo and his highest appointed official, Secretary DeRosa, along with New York State Health Commissioner Dr. Howard Zucker, among others, formed a clique within state government dedicated to burying the awful truth about preventable nursing home deaths,” said Gerard Kassar, chairman of the state’s Conservative Party.

The minority leader of the Albany County Legislature, Frank Mauriello, said, “Gov. Cuomo has betrayed our trust and failed the state of New York. I’m calling for his immediate resignation.”

“New Yorkers expect their state government to function on basic, bedrock principles — including transparency,” said Democratic Assemblywoman Patricia Fahy who represents much of Albany County. “Rather than pointing fingers and continuing to politicize what has been a tragic number of lives lost, the state legislature and the governor must work together to restore New Yorkers’ faith in openness and more broadly, good government at the state level.

“Like most New Yorkers,” her statement went on, “I appreciated the governor’s leadership at the height of the pandemic given an absence of leadership from the White House.

“That said, the state legislature needs to revisit the emergency authorities granted when the pandemic began, and I support the efforts to restore the balance of power.”

On Wednesday, Assemblyman Chris Tague, a Republican from Schoharie, who earlier called for the National Academy of Television Arts and Sciences to vacate the Emmy Award it had given Cuomo for his handling of the pandemic, on Wednesday called for the U.S. Department of Justice to “immediately appoint a special prosecutor in the Southern District of New York following the revelation that the U.S. Attorney in that jurisdiction is the mother-in-law of Melissa DeRosa.”

DeRosa’s mother-in-law, Audrey Strauss, was appointed U.S. Attorney for the Southern District by Cuomo in June 2020.

 

“The void we created”

On Monday, Cuomo responded to the clamor of legislators calling for repeal of his emergency 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.”

 

“Politicians are placing blame”

“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 or independents — 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.

More Regional News

  • “This variant was first identified in Nelson Mandela Bay, South Africa, in samples dating back to the beginning of October 2020,” reports the CDC, and also says, “Currently there is no evidence to suggest that this variant has any impact on disease severity.”

  • Movie theaters in New York City will be brought in line with the rest of the state at 25-percent capacity, weddings and catered events can be held at 50-percent capacity, billiard halls — having won a lawsuit — can reopen statewide at 50-percent capacity, and nursing homes will be open to visitors.

  • ALBANY COUNTY — The Albany County Soil and Water Conservation District invites all schools in the

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