ALBANY — The State Comptroller’s Office released a highly critical audit of the state Department of Health and its response to nursing homes amid the COVID pandemic on Tuesday.
Among key findings, the DOH:
- Was ill-prepared to respond to infectious diseases even before the pandemic hit New York in March 2020;
- Was part of Gov. Andrew Cuomo’s deliberate under-reporting of the horrific death toll in nursing homes;
- Stuck on a federal directive to investigate nursing homes for infection control issues;
- knew that one of its key information systems was incomplete and unreliable long before the pandemic, but took no steps to fix it;
- Interference on the controller’s audit while it was in progress
The audit also blamed public health underfunding during Cuomo’s decade as governor for leaving the DOH without critical information systems and staff who could have helped limit the spread of COVID. -19 in nursing homes.
More than 15,000 deaths of nursing home residents in New York over the past two years are attributed to COVID.
The DOH submitted a lengthy response to the draft report, defending its actions in detail and, in some cases, refuting what it inferred from the wording. With the Comptroller’s Office adding its own rebuttal to some of DOH’s points, DOH’s response spans 13 pages, or about a quarter of the final audit.
One point the DOH agreed on was improvement: It said it appreciated the audit’s stated goal, promoting stronger infection control policies.
Some specific objections raised by the DOH:
- The audit did not fully consider all of DOH’s improvement efforts, all types of information used by DOH to respond to the pandemic, and the practical trade-offs between different types of data.
- Cuomo’s executive office, not the DOH, determined what DOH data was made public; The DOH’s internal use of data has not been limited by public obfuscation.
- The audit does not address the challenges that existed in the early days of the pandemic, nor does it acknowledge the progress made by the DOH in improving data collection protocols.
- The DOH disagrees with the assertion that it was not fully cooperative with the audit.
- The audit does not address the complexities of compiling and analyzing multiple types of data from multiple sources through multiple systems during a pandemic.
Finally, the DOH addresses the allegation that the state misled the public, as Cuomo and his top aides, including then-Health Commissioner Dr. Howard Zucker, were accused of doing. Nothing that was made public was false, the DOH says. On the contrary, it was accurate as far as he went.
The DOH also noted that Kathy Hochul, who became governor in August after Cuomo resigned, ordered more data to be released publicly. It gradually did so, with COVID data now available online that wasn’t easily or at all accessible under Cuomo.
The audit includes a letter from Kathryn Garcia, Hochul State’s director of operations, saying that upon taking office, Hochul ordered his administration to “radically change course” and prioritize transparency, cooperation and communication.
As he released his office’s audit on Tuesday, State Comptroller Thomas DiNapoli had harsh words for the state’s handling of the COVID crisis in nursing homes. In a prepared statement, he said:
“The pandemic has been devastating and deadly for New Yorkers living in nursing homes. Families have a right to know if their loved one’s death from COVID-19 has been counted, but many still don’t have answers from the state Department of Health. Our audit findings are extremely troubling. The public has been deceived by those at the highest levels of state government by twisting and suppressing the facts when New Yorkers deserve the truth. The pandemic is not over and I hope the current administration will make changes to improve accountability and protect lives. An important step would be for the DOH to provide families who have lost loved ones with answers as to the actual number of nursing home residents who have died. These families are still grieving and they deserve nothing less.
Critics have accused Cuomo of obscuring the death toll to enhance his stature as a leader battling the worst public health crisis in a century. (He is credited as the author of a book on exactly this topic, published in October 2020.)
The dam broke in January 2021, when a bombshell report from the state attorney general’s office revealed that the state Department of Health had underreported deaths in homes by up to 50%. nurses and blamed the Cuomo administration for decisions that could have increased the death toll.
Less than a week later, a judge ordered full disclosure of the data at the request of the Empire Center for Public Policy, a think tank that sought information from the court after the Cuomo administration rejected and delayed his request for months.
The state in one day overthrew its official nursing home The COVID death toll is 45% higher.
Bill Hammond, the Empire Center principal investigator who backed the case, said Tuesday:
“As the comptroller’s report makes clear, New Yorkers have a lot to learn about what went wrong with the state’s response to the pandemic. This audit raises questions about the preparedness of the Department of Health that go beyond Governor Cuomo’s actions and require careful consideration. [State Health Commissioner Dr. Mary] Bassett, Governor Hochul and the Legislature should convene an NTSB-style investigation into the deadliest public health disaster in state history.
State Attorney General Letitia James in a prepared statement Tuesday said:
“This audit confirms many of the findings we discovered last year about the state’s response to COVID, including that the DOH and the former governor underestimated the number of nursing home deaths until at 50%. I am grateful to Comptroller DiNapoli for bringing much-needed transparency to this crucial issue. My office will continue to monitor nursing home conditions and ensure the safety of our most vulnerable residents. If anyone has concerns about care home conditions, I urge them to contact my office.
The state lists the following COVID-related nursing home deaths for counties in the region through March 14, 2022. (Assisted living facilities and other aged care facilities are counted separately and had a number much lower than nursing homes.)
- Albany 141
- Fulton 57
- Herkimer 68
- Montgomery 89
- Rensselaer 100
- Saratoga 45
- Schenectady 46
- Warren 72
- washington 50
A list of deaths at individual facilities is available at https://coronavirus.health.ny.gov/long-term-care-fatalities
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