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Update: NY Nursing Homes and COVID-19 Inspections & Enforcement

“It’s absolutely horrifying,” Mayor Bill de Blasio said. “It’s inestimable loss, and it’s just impossible to imagine so many people lost in one place.”

After New York State nursing homes were "forced" to take COVID-19 positive residents in March, 2020, the State's deaths from the disease in nursing homes continued to rise. 

Particularly hard hit by the pandemic, nursing homes and adult residential facilities house the most vulnerable population under one roof. Although many fought hard to keep the disease out, the State ordered them in March to let infected residents in. Many facilities considered themselves unable to adequately protect their staff and other residents under such circumstances. In the midst of this conflict, the State announced punishments, including loss of licensure, if facilities did not comply. 

The conflict [see previous Colligan Law post] was addressed by the Governor again on May 4, 2020. In the daily press briefing, it was announced that facilities unable to safely comply with the State's order to accept COVID-19 positive residents, do not have to do so. Instead, they were invited to contact the New York Department of State for help. The Governor said if a facility cannot safely accept a COVID-19 individual "for any reason," they should know that the State has available beds in all regions of the State, will facilitate a transfer of the individual to another location that can safely handle them, and help the facility with anything it may need to address its problems. Reasons he listed included being: low on healthy staff able to report to work, unable to quarantine, unable to properly ventilate, and inadequate availability of PPE.

While sounding helpful, the Governor also warned that in contacting the New York State Department of Health to report itself unable, a facility was inviting an investigation. 

In the same briefing, however, the Governor announced that statewide, New York State Department of Health was already launching site-by-site in-person inspections of all nursing home and residential facilities anyway. In Western New York, 6 facilities are now being visited by State teams every week. The inspections will include testing of every resident and staff person for COVID-19, review of all health practices and precautions, PPE availability, cleaning and sterile procedures, and accurate reporting of COVID-19 deaths. 

State data on nursing home deaths are understood to be severely under-reported. If a patient became fatally infected in a nursing home, but COVID-19 testing was unavailable, that death was not reported as a COVID-19 nursing home death. If a patient became fatally infected with coronavirus in a nursing home, but was transferred to a hospital where they passed away, the death was documented as a hospital COVID-19 death instead. The Governor states this testing and hospital reporting is changing to be more accurate. 

The Isabella Geriatric Center is an example of how accurate reporting changes the numbers. Previous reporting methods reflected the location suffered thirteen COVID-19 deaths as of Friday. Under the new, more accurate COVID-19 nursing home and adult residential facility death reporting rules, the number for that one location rises to at least ninety-eight individuals. 

"[New York State] Department of Health said it has received “outbreak reports” from 239 nursing homes, including at least six facilities with death tolls of 40 patients or more."