Cuomo silent on who approved coronavirus nursing home policy

By Bruce Golding

Andrew Cuomo

He once likened the threat of coronavirus to seniors to “fire through dry grass,” but Gov. Andrew Cuomo still won’t say who came up with his administration’s controversial policy forcing nursing homes to admit COVID-19 patients and how many of more than 6,000 resident deaths to date came as a result of it, according to a new report.

The head of a medical society that represents nursing homes and other long-term care facilities also accused New York officials of ignoring the industry’s advice before issuing that fateful March 25 mandate from the state Department of Health, ProPublica reported Tuesday.

“The Cuomo administration would not say who conceived of the order or answer the question of whether it believed the order had led to additional deaths,” the report says.

Christopher Laxton, of the Society For Post-Acute and Long-Term Care Medicine (AMDA), told the news organization that Cuomo and his Health Commissioner Howard Zucker “unaccountably failed to include clinical expertise in operational leadership when these policies were formed and we don’t know why.”

Laxton said other states, including California, had adjusted their policies on discharging coronavirus patients to nursing homes in response to industry concerns about potentially spreading the deadly disease.

And a Columbia University expert, Dr. Charles Branas, told ProPublica that the March 25 directive may have increased the state’s COVID-19 death toll by an as-yet-unknown order of magnitude and cited an Associated Press estimate on the number of coronavirus patients who were admitted to nursing homes as a result of the order.

“If you introduce 4,500 people sick with a potentially lethal disease into a vulnerable and notoriously imperfectly monitored population, people are apt to die,” said Branas, chairman of the Epidemiology Department at Columbia’s Mailman School of Public Health.

Branas also said the since-abandoned policy “looks like it was intended as a ‘reverse triage’ strategy to clear acute and critical care hospital beds, regardless of whether those beds had people with COVID-19 or not.”

“Possibly, the positive trade-off they had in mind with the policy was that more lives would be saved with additional open critical care beds than would be lost in transfer to nursing homes,” he added.

Cuomo rescinded the DOH mandate on May 10 and ordered coronavirus testing of nursing home workers amid mounting criticism and calls for independent investigations of his nursing home policies related to the pandemic.

The ProPublica report also highlighted how Rensselear County Executive Steve McLaughlin defied Cuomo’s order and refused to admit any coronavirus patients to Van Rensselaer Manor, a nursing home run by the county, which lies east of Albany.

The 320-bed facility hasn’t had any deaths from COVID-19, compared with 18 at Diamond Hill, a privately run, 120-bed nursing home also in Rensselaer.

“Uncalled for, unnecessary, should never have occurred, and wouldn’t have but for a tragically misguided order from the state,” McLaughlin said of those fatalities.

DOH spokesman Jonah Bruno told ProPublica that a “thorough review” of the impact of the coronavirus on nursing homes was underway.

“Science will determine whether the spread in nursing homes came as a result of returning residents or from asymptomatic staff who were already there,” he said.

Bruno denied that the state ignored outside advice, saying officials began holding weekly webinars with health care professionals on Feb. 2 and also spoke with experts, doctors, nurses, family members and advocates.

“There’s been no shortage of industry, expert or stakeholder opinions in anything we’ve done during the most devastating global pandemic in a century,” he said.

The state also told ProPublica that New York ranks 35th among the 50 states in terms of its percentage of nursing home deaths compared to total coronavirus fatalities.

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Cuomo silent on who approved coronavirus nursing home policy