Honesty is the best policy, and the Cuomo administration deserves every last bit of criticism for refusing to level with New Yorkers about COVID-19’s shockingly high death toll among nursing home residents.
Time and time again, journalists, families, legislators and watchdog groups pressed the governor for a full tally of New York’s nursing home deaths.
And each time, these perfectly reasonable queries were rebuffed, leading even the most level-headed of observers to wonder just what it was the state was hiding.
It took a bombshell report from state Attorney General Letitia James to get the state to reveal this deeply-held secret: that the true nursing home death toll is much higher than previously acknowledged.
It’s a finding that punctures one of the big myths of the Cuomo pandemic story – that New York somehow did a better job of protecting its frailest, most vulnerable residents than other states.
So go ahead and blame the Cuomo administration for making a bad situation worse.
I won’t stop you.
I’d simply ask that you spare a little outrage for the nursing home industry itself.
James’ report is more than a blistering critique of the Cuomo’s administration’s many nursing home-related failures.
It’s an indictment of nursing homes, and the chronic understaffing, poor infection control and lack of oversight that made these facilities fertile ground for a virus that disproportionately kills sick and elderly people.
“People have been screaming about these things for years,” Schenectady resident Mark Buddle, who posts nursing home-related commentary on the Twitter feed Better Nursing Homes for New York State, said. “And they’ve been ignored. But the pandemic brought these issues to the fore.”
I’ve spoken to Buddle a few times during the pandemic, and our conversations have centered on the state’s restrictive nursing home visitation policies. But his dissatisfaction with nursing homes predates the pandemic, and he told me he was “thrilled” with James’ report for casting a light on longstanding problems.
James’ report suggests that low staffing levels are a big problem at nursing homes, observing that “preliminary investigations reflect many examples where for-profit nursing homes’ pre-pandemic low staffing model simply snapped under the stress of the pandemic.”
According to the report, insufficient staffing levels prompted some nursing homes to pressure employees to work even if they were sick, “in violation of infection control protocols.”
“Thus, poor initial staffing before the pandemic meant even less care for residents during the pandemic: subtraction of any caregivers from an already under-staffed facility results in increased interaction among possibly infectious staff and residents, with less time for the staff to adhere to proper infection control precautions,” the report explains.
That’s a pretty damning assessment of how understaffing at nursing homes might have fueled COVID-19 outbreaks at nursing homes.
Indeed, James’ report states that nursing homes with lower staffing levels saw more COVID-19 deaths.
Buddle told me that he’s seen overworked staff say they’re going to skip certain tasks, like taking a resident to use the bathroom, and that having just one person call in sick can lead to diminished quality of life for residents.
“Nursing homes run right on the edge all the time,” Buddle said. “Staffing is huge.”
James’ office also found that poor infection control protocols put residents at increased risk of harm.
Among other things, some homes failed to properly isolate residents who tested positive for COVID-19, failed to adequately screen or test employees for COVID-19, failed to provide staff with personal protective equipment and failed to train employees in infection control protocols.
Nursing homes are in desperate need of an overhaul, as James’ report makes clear.
Ignoring the systematic problems highlighted by her investigation would be a mistake, and signal that it’s OK to cut corners and skimp on care when it comes to caring for the oldest New Yorkers.
The time to reimagine nursing homes has come, and Buddle is optimistic that James’ report, with its alarming critique of the state’s nursing home industry, will kickstart an effort to do just that.
“Hopefully this won’t end here,” he said. “Hopefully it will keep going forward.”
Reach Sara Foss at [email protected]. Opinions expressed here are her own and not necessarily the newspaper’s.