The Facts on Andrew Cuomo’s Nursing Home Policy

The Facts on Andrew Cuomo’s Nursing Home Policy

By Anna Lynn and James Agresti

Wednesday morning on ABC’s The View, New York Governor Andrew Cuomo gave a factually misleading explanation for the thousands of people who died with Covid-19 in NY nursing homes.

After co-host Sunny Hostin praised Cuomo’s book Leadership Lessons from the COVID-19 Pandemic as “absolutely fantastic,” she said to the governor:

There has been a lot of confusion about an alleged March 25th order that directed nursing homes to accept in New York, infected Covid patients, possibly leading to the death of more than 6,000 seniors. Now you say in your book that that was a lie—that New York state never demanded or directed that any nursing home accept a Covid-positive patient. The Department of Justice however is now supposedly looking into this issue. Can you explain what really happened?

Cuomo replied:

Yea, what a shock that the Department of Injustice sends a letter a few days before an election trying to advance a political theory. I was shocked and amazed that the Trump administration was capable of such a thing. Sunny, they have played politics on this from day one, right? They have done a terrible job on Covid from day one, and they want a counter-defense, and what they were saying was, “Well, a lot of people died in nursing homes in Democratic states. It’s not just New York, it’s all the Democratic states.”

The truth is a lot of people did die in nursing homes in Democratic states. The truth is people are dying today in nursing homes in Republican states. It’s just that Democratic states had the disease worse and earlier, and older people are more vulnerable to Covid, right? We were introduced to Covid in the state of Washington in a nursing home.

If you look at how many people died in New York nursing homes, New York is number 46 out of 50 states in the percentage of deaths in nursing homes. The way the law works is no nursing home in New York can accept a patient if they don’t believe they can care for that patient adequately, and if they can do it within the safety of their facility.

So the conspiracy they’re trying to spread just has no factual basis. But yes, people in nursing homes died, and they’re playing politics with the issue, which I think is especially cruel because people who lost loved ones in a nursing home, they’re dealing with it, and now they also have to deal with the confusion or the pain of maybe government did this.

Hostin’s choice of words and Cuomo’s entire statement are incompatible with the facts of this matter. The Cuomo administration’s March 25th order is not “alleged” but a fact. This order explicitly states:

No resident shall be denied re-admission or admission to the NH [nursing home] solely based on a confirmed or suspected diagnosis of COVID-19. NHs are prohibited from requiring a hospitalized resident who is determined medically stable to be tested for COVID-19 prior to admission or readmission.

That mandate was at direct odds with two key scientific facts about C-19 that were widely known since the outset of the pandemic:

1. Elderly people and those with chronic ailments—who are the very definition of nursing home residents—are extremely vulnerable to the virus.
2. The virus is highly transmissible, and thus, it can easily sweep through large groups of sickly and/or aged people who live together.

Including an estimated 18 days between infection and death, over 5,900 nursing home patients in NY were lost by the time Cuomo rescinded this policy. The fact that Cuomo repealed this mandate belies his claim that it did no harm.

Furthermore, Cuomo’s statistics on NY nursing home deaths are greatly understated because his Department of Health excluded people who caught the disease in a nursing home but died “outside of the facility.” Thus, Cuomo’s “official” figure may undercount the real one by thousands of deaths.

While rejecting calls for an independent investigation, Cuomo has repeatedly blamed others for the nursing home carnage in his state, but none of his explanations hold water:

• Cuomo first faulted nursing homes, stating that they were only required to readmit C-19 patients “if they have the ability to provide the adequate level of care.” However, Cuomo’s order:
  • unequivocally states in underlined text, “No resident shall be denied re-admission or admission to the NH [nursing home] solely based on a confirmed or suspected diagnosis of COVID-19.”
  • often made it impossible for homes to know if they could provide appropriate care by banning them from “requiring a hospitalized resident who is determined medically stable to be tested for COVID-19 prior to admission or readmission.”
  • never mentioned or implied that it is illegal under NY State law for nursing homes to accept someone they cannot care for properly.

• Cuomo then claimed that his order “followed President Trump’s CDC guidance,” but the truth is that this guidance:
  • doesn’t recommend putting C-19 patients into nursing homes.
  • states that C-19 patients “should go to a facility with adequate personal protective equipment supplies and an ability to adhere to infection prevention….”

• Cuomo’s top aide, Melissa DeRosa later said that his policy was “in-line directly” with directives from the Trump administration’s Centers For Medicare & Medicaid Services (CMS), but to the contrary:
  • 12 days before Cuomo’s order, CMS warned that homes must be “vigilant in identifying any possible infected individuals” and “follow CDC guidance.”
  • CMS administrator Seema Verma directly responded to DeRosa’s claims, stating that the CMS was “clear and unmistakable” in stating that nursing homes should reject people that they cannot care for, and “any insinuation to the contrary is woefully mistaken at best and dishonest at worst.”

• After that, Cuomo claimed that NY “had more people die” because the Trump administration “missed the boat and never told us that this virus was coming from Europe and not from China.” In reality, the Trump administration issued a near-total ban on travel from Europe on the same day that the World Health Organization declared C-19 a pandemic (March 11). Yet, Cuomo did not announce a stay-at-home order until more than a week later on March 20.

• Finally, Cuomo’s Department of Health published a report that returned to blaming nursing homes while claiming that his policy was not a “significant factor” in fatalities. However, the report:
  • misinterprets association as causation by arguing that a “link between the timing of staff infection and nursing home fatalities” proves the nursing home staff transmitted the virus to residents.
  • uses a false measure of timing based on the number of homes with an infected staff member instead of the actual number of infected staff members.
  • uses grossly incomplete data that excludes residents who caught the virus in nursing homes but died “outside of the facility,” a figure that could number in the thousands.

So in the face of proven scientific facts and crystal clear guidance from federal health agencies, Cuomo forced C-19 carriers into the vicinity of the people who are most vulnerable to the virus.

Cuomo and his surrogates then used a series of falsehoods to cast blame for his policy on others. Now, he is impugning people who would hold him accountable for his actions.

Anna Lynn is a writer and researcher for Just Facts, a think tank dedicated to publishing rigorously documented facts about public policy issues. James D. Agresti is the president of Just Facts.