Cuomo advisers amended report on Covid-19 nursing home deaths

The changes Mr. Cuomo’s aides and health officials made to the nursing home report, not previously disclosed, reveal that the state had a fuller record of the deaths outside the facility in nursing homes as early as the summer. The health department opposed calls from state and federal lawmakers, media outlets and others to release the data for another eight months.

State officials now say more than 15,000 residents of nursing homes and other long-term care facilities have been confirmed or believed to have died from Covid-19 since March last year – counting both those who died in long-term care facilities and those who later died in hospitals . That figure is about 50% higher than the previous official death toll.

Mr Cuomo is now facing mounting political pressure on both the way his government is handling the pandemic in nursing homes and allegations that he sexually harassed two former staffers. Republicans and some Democrats have called on the governor to resign or be impeached.

Mr. Cuomo declined calls for his resignation and apologized for his conduct. Regarding the deaths in nursing homes, Mr. Cuomo has said his government followed federal guidelines and acted to maintain hospital capacity.

Federal prosecutors in Brooklyn asked the Cuomo government for information on deaths in nursing homes in February, The Wall Street Journal reports. Federal prosecutors expressed interest in the July report, people familiar with the case said.

In response to questions from the Journal, administrative officials said on Thursday that Mr. Cuomo’s advisers advocated not including data on deaths outside the facility because they were concerned about its accuracy.

“The data outside the facility was omitted after DOH could not confirm that it was sufficiently verified,” Beth Garvey, a special counsel and senior adviser to Mr. Cuomo, said in a statement.

An official familiar with switching back and forth between the Department of Health and Mr. Cuomo’s advisers said Health Commissioner Howard Zucker agreed that the data outside the facility should not be included in the report.

[The Department of Health] was comfortable with the final report and fully believes in the conclusion that the main driver that Covid introduced to nursing homes was brought in by the staff, ”said Gary Holmes, a health department spokesman.

The health department updated the report on Feb. 11 to include the deaths outside the facility of nursing home residents, saying the conclusions were unchanged by the new data.

State lawmakers from both parties have said the mortality data outside the facility was critical for them to evaluate nursing home policies that could prevent future fatalities. They said the Cuomo government’s decision to delay the release is a cover up of data the governor knew would be detrimental to his political status.

Melissa DeRosa, Mr Cuomo’s top assistant, explained the delay to state lawmakers at a Feb. 10 meeting. She said the state was setting aside a legislative request for the data over a US Department of Justice investigation. Ms. DeRosa said the state was concerned that the information would be politicized by former President Donald Trump’s administration, according to a transcript.

The Justice Department began requesting information through its Civil Rights Division in August about deaths in nursing homes from New York and other Democratic-leaning states.

The first report in July was the product of a health department investigation into the factors that contributed to the death toll in nursing homes. The agency conducted the investigation in response to complaints from state lawmakers and people who lost loved ones that a March 25 health department directive promoted the spread of the virus among members of the state’s most vulnerable population.

That guideline said no nursing home could refuse to take residents back or admit new residents from hospitals purely because of a Covid-19 diagnosis.

The July report concluded that nursing homes were already full of the virus by the time of the March 25 policy and attributed its spread to the staff who took it to work.

Several of Mr. Cuomo’s top advisers – who were members of his Covid-19 task force – reviewed and requested changes to the report, the Journal previously reported.

They include Ms. DeRosa; Dr. Zucker; Jim Malatras, a longtime adviser named Chancellor of New York’s public college system in August; and Linda Lacewell, the Superintendent of the New York State Department of Financial Services.

The report’s lead author was Eleanor Adams, who until August worked from the Health Department’s Metropolitan Area Regional Office in a unit focused on infection control in healthcare facilities, one of the people said. Dr. Adams has since been a senior advisor to Dr. Zucker.

The first draft of the report submitted to Mr Cuomo’s team for review included data on both the deaths of nursing home residents in hospitals and the deaths of residents in nursing homes, according to people familiar with the preparation of the report.

While health department officials agreed to delete that data, they opposed requests from Cuomo assistants to amend the report to downplay the March 25 guideline’s role in spreading the virus, some of the people said .

The published report concluded that the guideline “was not a significant factor in the number of fatalities in nursing homes.”

“Covid task force officials have not asked for the report to conclude that the March 25 order was irrelevant,” Ms. Garvey said in a statement. The members of the task force, knowing that the report had to withstand rigorous public scrutiny, were very careful not to overdo the statistical analysis presented in the report. Overall, ensuring the public’s confidence in the conclusion was the ultimate goal of DOH and the Covid task force in releasing the report. “

The March 25 order came as hospitals rushed to make room for an expected wave of coronavirus patients.

Nursing home operators, who were only aware of the policy after it was enacted, immediately objected, saying it would introduce the virus into their facilities. A national group representing caregivers in nursing homes said at the time that the March 25 guideline was “not at all in line with the principles of patient safety.”

A New York State Health Department spokeswoman, Jill Montag, said in August that the decision to issue the guideline was “made on merit by public health experts from DOH and following. [Centers for Medicare and Medicaid Services] and [Centers for Disease Control and Prevention] guidelines. Health department officials did not provide an updated statement on Thursday.

CMS and CDC guidelines said at the time that nursing homes could accept residents diagnosed with Covid-19 if they could take the necessary precautions to avoid transmission.

The Cuomo government withdrew the directive in May.

The July report said the number of nursing home residents who died of Covid-19 was low compared to other northeastern states as measured as a percentage of the total population. But the other states counted nursing home residents who died in hospitals, as well as those who died in nursing homes.

In January, a report from the New York Attorney General said the state had undercounted nursing home deaths and said the governor’s directive may have spread the disease.

—Lisa Schwartz and Corinne Ramey contributed to this article.

Write to Joe Palazzolo at [email protected], Jimmy Vielkind at [email protected] and Rebecca Davis O’Brien at [email protected]