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Audit finds state still has work to do to address nursing home pandemic issues

State Comptroller Tom DiNapoli
Matt Ryan
New York NOW file photo
State Comptroller Tom DiNapoli

A New York Comptroller’s Office audit has found that the state’s nursing homes still lag in preparedness for another pandemic or infectious disease outbreak.

It comes two-and-a-half years after a scandal surrounding thousands of nursing home deaths during the COVID-19 pandemic that contributed to former Gov. Andrew Cuomo’s resignation.

Comptroller Tom DiNapoli said a follow-up audit to a 2022 report by his office found the state health department has made some improvements since the height of the COVID-19 pandemic. But he said there’s still a way to go to make up for what he calls a decade of neglect in health department funding and staffing.

“What we found is that the Department of Health has made limited progress, some progress, but (there are) still opportunities to do a lot more,” DiNapoli said. “Mistakes were made. And we need to learn from those mistakes, so we can be sure they don't get repeated when, God forbid, we have whatever the next infectious outbreak will be.”

He said the health department needs to “look again” at the 2022 audit and be “more aggressive in implementation of those recommendations.”

DiNapoli said the health department is still not fully using infection control data to try to detect or identify any emerging infectious diseases and to develop plans to manage any future outbreaks. He said the audit finds data collection from the nursing homes is still lagging and that numbers, including causes of death among residents, are still “inaccurate, inconsistent, and incomplete.”

“They definitely need to be more effective in terms of the reporting and validating the accuracy,” he said.

Accurate counting of residents’ deaths at the height of the pandemic was at the heart of scandal under Cuomo. State Attorney General Tish James found that the Cuomo administration had underreported deaths by 50%, a conclusion that was confirmed by the comptroller’s 2022 audit.

Critics contend a controversial March 2020 order that required nursing homes to accept residents who had COVID back from hospitals contributed to the deaths, something Cuomo and his aides deny.

Dr. Howard Zucker, who was health commissioner under Cuomo, recently answered questions about the decision before a U.S. House subcommittee examining pandemic policies. 

Governor Kathy Hochul answers questions from the media on December 20, 2023. State Labor Commissioner Roberta Reardon is to her left.
Karen DeWitt
New York State Public Radio
Gov. Kathy Hochul answers questions from the media on Dec. 20, 2023. State Labor Commissioner Roberta Reardon is at left.

Gov. Kathy Hochul, who became the state’s chief executive in August 2021 after Cuomo resigned, said she concurs with the comptroller’s findings. She blamed her predecessor for the shortcomings and said she’s taken steps to improve things.

“I 100% agree with the comptroller’s assessment,” said Hochul, who added that the “decade of disinvestment” included a failure to keep pace with Medicaid reimbursement rates.

The governor said her actions include raising reimbursement rates by 7.5% and offering bonuses to health care workers.

She also said she’s changed the leadership at the health department and raised salaries to attract new talent to an agency that she said was “basically starved to death” during a years-long hiring freeze imposed by the former governor.

Hochul said she’s working to ensure greater transparency with data, so that the public knows what’s going on inside nursing homes. And she vowed to do better if another pandemic or infectious disease outbreak hits.

“A lot of lessons were learned the hard way,” Hochul said. “Mistakes that were made in the past will not be made again, I can assure you that.”

Over a year ago, the governor said she was undertaking her own review of the state’s management of the pandemic, including nursing home policies, emergency closures, mask mandates and other decisions. But that report is yet to be finalized.

DiNapoli said families of loved ones who died during the chaos in the state’s nursing homes at the height of the pandemic, and who are still left wondering, may never get a satisfying answer.

“And that's very sad, and very troubling,” he said. “I don't know that we'll ever get a complete answer on some of what happened during that crisis time, that emergency time.”

That fact, he said, only underscores the importance of doing better if there’s a next time.

Karen DeWitt is Capitol Bureau chief for the New York Public News Network, composed of a dozen newsrooms across the state. She has covered state government and politics for the network since 1990.