An affordable price is probably the major benefit persuading people to buy drugs at www.americanbestpills.com. The cost of medications in Canadian drugstores is considerably lower than anywhere else simply because the medications here are oriented on international customers. In many cases, you will be able to cut your costs to a great extent and probably even save up a big fortune on your prescription drugs. What's more, pharmacies of Canada offer free-of-charge shipping, which is a convenient addition to all other benefits on offer. Cheap price is especially appealing to those users who are tight on a budget
Service Quality and Reputation Although some believe that buying online is buying a pig in the poke, it is not. Canadian online pharmacies are excellent sources of information and are open for discussions. There one can read tons of users' feedback, where they share their experience of using a particular pharmacy, say what they like or do not like about the drugs and/or service. Reputable online pharmacy canadianrxon.com take this feedback into consideration and rely on it as a kind of expert advice, which helps them constantly improve they service and ensure that their clients buy safe and effective drugs. Last, but not least is their striving to attract professional doctors. As a result, users can directly contact a qualified doctor and ask whatever questions they have about a particular drug. Most likely, a doctor will ask several questions about the condition, for which the drug is going to be used. Based on this information, he or she will advise to use or not to use this medication.

More Exact Colonial Pipeline Hack Details

It is prudent to review several sources for the real evidence and details and most often non-government companies are the ‘go-to’ places for that. Government spins stuff but private cyber experts offer up great context and such is the case below.

FBI Confirms Darkside Behind Colonial Pipeline Ransomware ... source

As a primer, CISA is a government agency launched by the Trump administration for all the right reasons.

Alert (AA20-049A)

Ransomware Impacting Pipeline Operations

But read on.

The US Cybersecurity and Infrastructure Security Agency (CISA) has issued an Alert that offers a set of best practices to protect against ransomware-induced business disruptions. The Alert was prompted by the attack against Colonial Pipeline, and it includes in its introductory section the preliminary conclusion that DarkSide ransomware affected Colonial’s IT systems only, and had no direct effect on the company’s OT networks. The best practices CISA advocates are familiar. The Alert closes with a statement strongly discouraging any victim from paying the ransom their attackers demand: “Paying a ransom may embolden adversaries to target additional organizations, encourage other criminal actors to engage in the distribution of ransomware, and/or may fund illicit activities. Paying the ransom also does not guarantee that a victim’s files will be recovered.”

FireEye yesterday published a report on DarkSide that emphasizes the group’s ransomware-as-a-service model. It’s a selective operation (criminal applicants for affiliate status are, for example, interviewed before being given access to DarkSide’s control panel) but it’s also not a monolithic one. FireEye’s Mandiant unit currently tracks five “clusters” of DarkSide threat activity. The affiliate model DarkSide uses shares criminal profits: “Affiliates retain a percentage of the ransom fee from each victim. Based on forum advertisements, this percentage starts at 25 percent for ransom fees less than $500,000 USD and decreases to 10 percent for ransom fees greater than $5M USD.”

Colonial Pipeline’s website came back online late yesterday, newly armored with a reCAPTCHA landing page. The company published an update in which it reported progress toward resumption of refined petroleum deliveries, with some 967,000 barrels delivered to Atlanta, Belton and Spartanburg in South Carolina, Charlotte and Greensboro in North Carolina, Baltimore, and Woodbury and Linden (close to the Port of New York and New Jersey). Some lines have been operated under manual control since Monday, at least, and have been moving existing inventory. As the company prepares to restart deliveries, they’ve taken delivery of an additional two million barrels, which they’ll ship once service is restored.

The company appears also to be addressing some concerns about its pipelines’ physical security, having “increased aerial patrols of our pipeline right of way and deployed more than 50 personnel to walk and drive ~ 5,000 miles of pipeline each day.” (hat tip to CyberWire)

Related reading:

Colonial Pipeline using vulnerable, outdated version of Microsoft Exchange: report
Pipeline operators were warned about potential attacks in 2020

“Energy Sector…developed the 2011 Roadmap to Achieve Energy Delivery Systems Cybersecurity…sector’s vision that “by 2020, resilient energy delivery systems are designed, installed, operated, and maintained to survive a cyber-incident while sustaining critical functions…”

 

Operation Choke Point 2.0 is Emerging

I was just thinking about this old Obama administration program this week as it is a web tag it used years ago. Additionally, there was a time that Congressman Darryl Issa came to Clearwater to speak, an event I attended and he spoke on this disgusting program among other topics.

Well, Kelsy Bolar is on the case and a big hat tip to her for the alarm she is sounding. Let’s keep in mind the moves that Bank of America made in partnership with the FBI to report their own customers’ banking records for that they asserted went to Washington DC to begin a revolution at the Capitol on January 6. You can imagine that this program is quite the top in the halls of Congress by progressives.

Operation Choke Point: The Government's Covert War on ...

Here goes:

Amongst the record-breaking number of executive actions taken by President Joe Biden was one related to a little-known, frightening Obama-era program called Operation Choke Point. The program, dubbed so under former Attorney General Eric Holder, uses the power of the federal government to target legal yet leftist-disfavored businesses. These include gun sellers, pawnshops, and short-term money lenders.

The Trump administration did its best to end this blatantly unconstitutional program that sought to discriminate against legal industries. In 2017, the Justice Department declared the program “formally over.” At the end of Trump’s term, the Office of the Comptroller of the Currency established the Fair Access rule to solidify its culmination.

Operation Choke Point... DOJ Cuts Businesses From Banks

But on Jan. 28, the Office of the Comptroller of the Currency under President Biden announced it would pause the Trump-era rule intended to prevent another Operation Choke Point from happening again.

The Backstory of Operation Choke Point

The Trump administration rule appeared innocuous enough, instructing banks to “conduct risk assessments of individual customers, rather than make broad-based decisions affecting whole categories or classes of customers when providing access to services, capital, and credit.”

Under Operation Choke Point, federal regulators instructed banks to do the opposite — to openly discriminate against entire industries the Obama administration found objectionable. Weaponizing the power of banking regulators at the Federal Deposit Insurance Corp. and the Office of Comptroller of the Currency, the Obama administration realized it could block entire industries from the banking system that it didn’t like. This made it difficult — if not impossible — for politically unfavored businesses such as gun sellers and short-term lenders to operate.

Essentially, by using the power of federal banking regulators to intimidate banks from providing their services to these industries, the administration choked off their access to the financial system, leaving them paying more for essential banking services, or unable to use a bank at all.

The Obama administration claimed the program was intended to root out fraud by cutting off “high risk” industries from the banking system. But the administration didn’t make any differentiation between legal and illegal “high risk” industries, intentionally grouping lawful industries such as firearms sellers with patently illegal activities like Ponzi and credit-card schemes.

Different agencies within the Obama administration denied wrongdoing in various ways. At least one bank, however, admitted to choking off three legal enterprises at the government’s behest. Dozens of business owners — many of them gun sellers and short-term lenders — said their bank accounts and access to credit card processing platforms were suddenly stymied or shut down with no explanation and no opportunity for recourse.

Given its stained reputation, we shouldn’t expect the Biden administration to bring back Operation Choke Point under the same shameless name. But the return of the larger strategy behind Operation Choke Point appears here to stay.

Whereas seven years ago the idea of using the powers of the federal government to choke certain Americans from public life was controversial enough for the Obama administration to deny wrongdoing, in today’s era of social justice and cancel culture, it’s applauded.

Build Your Own Banks

Within corporate America, an employee was run out of Boeing over an article he published 33 years beforehand arguing women shouldn’t serve in combat (a position many Americans hold today). In the media, a Jewish, pro-Israel, pro-choice, bisexual writer was choked from The New York Times for not being leftist enough.

In Hollywood, a conservative actress was choked from Disney for expressing politically incorrect views on her private social media account. In the beauty blogging world, a conservative blogger was ousted from her role as a Sephora representative.

For all intents and purposes, Operation Choke Point is happening every day on a massive scale. Yet instead of “just” choking off access to capital and banking services, we’re witnessing a stranglehold on information, speech, and the broader marketplace of ideas. Concerningly, the government is now playing an active role.

As exemplified by Parler and the recent Twitter purge, Big Tech is choking conservatives off their social media platforms while Democrats cheer it on. In an attempt to choke conservatives out of entire industries of employment, critical race theory training and pledges are being forced on schools, government workplaces, and the armed forces.

This Dynamic Is Now Worse

Signs of Operation Choke Point’s formal resurrection are symbolic of the larger attempt by government actors to choke politically disfavored industries and individuals from the mainstream. While cancel culture has led to a politicized economy, the federal government’s arbitrarily targeting of individuals, groups, and entire companies will increase the politicization of the country, where the only acceptable views are from those in power.

Operating in the dark corners of the federal bureaucracy, Operation Choke Point bypasses public input and the legislative process, leaving politically unpopular individuals and businesses to fend for themselves. If the Biden administration’s rule reversal is any sign, the next four years won’t be about unifying the country to “Build Back Better.”

After being choked from essential services in the economy, conservatives and right-of-center businesses will have no choice but to Build Your Own — if that’s even still tolerated or allowed. Build your own banks, build your own credit card processing companies, build your own web hosting platforms, build your own social media platforms, build your own companies, build your own media, build your own schools, and build your own country — because you’re choked from “ours.”

Of course, all this will do nothing to further the causes of bipartisanship, unity, and healing President Biden claims to desire. Capitalizing on the trend of cancel culture, a return of Operation Choke Point would devastate an already damaged country. By abusing the powers of federal regulators, Operation Choke Point 2.0 would solidify what most right-of-center Americans already know: Instead of unity, Democrats want you choked from everyday life.

Three years ago, former President Obama infamously claimed his administration “didn’t have a scandal that embarrassed us.” While it’s tempting to point to Operation Choke Point to refute this, perhaps Obama was right. With Biden sitting by Obama’s side, the Obama administration wasn’t the least bit embarrassed about using its powers to choke legal businesses from existence. Indeed, it was the entire goal and they appear poised to do it again.

U.S. Investment Funds Fuel China’s Economy to Our Peril

In part from the WSJ:

Shock waves rippled through the investment world when China halted the initial public offering of Ant, which would have been the world’s biggest. The decision was signed off by President Xi Jinping after controlling shareholder Jack Ma infuriated government leaders by criticizing government financial regulation in an October speech, The Wall Street Journal reported.

For the past several years, the retirement savings of America’s police, firefighters and teachers have increasingly found their way to private companies in China such as Ant. Anxious to meet ambitious return targets in a low-yield world, large North American pension funds have committed growing sums to both global private-equity managers active in China and managers local to China, according to pension officials and their advisers and investment reports.

This has contributed to a larger boom in Chinese deal making for U.S. institutional investors. Private-equity-backed deals of $300 million or more in China involving exclusively U.S.-based investment managers totaled nearly $13 billion between 2010 and 2019, according to Preqin data. Deal activity peaked in 2018 at $3.78 billion. For investors and investment managers world-wide in 2020, private-equity investment in internet and technology in China was $52 billion, according to consulting firm Bain & Co.

Outlook 2021: How to invest in China's equity market ...  source

***

To put a finer point on the matter:

China overtook the U.S. as the world’s top destination for new foreign direct investment last year, as the Covid-19 pandemic amplifies an eastward shift in the center of gravity of the global economy.

New investments by overseas businesses into the U.S., which for decades held the No. 1 spot, fell 49% in 2020, according to U.N. figures released Sunday, as the country struggled to curb the spread of the new coronavirus and economic output slumped.

China, long ranked No. 2, saw direct investments by foreign companies climb 4%, the United Nations Conference on Trade and Development said. Beijing used strict lockdowns to largely contain Covid-19 after the disease first emerged in a central Chinese city, and China’s gross domestic product grew even as most other major economies contracted last year.

The 2020 investment numbers underline China’s move toward the center of a global economy long dominated by the U.S.—a shift accelerated during the pandemic as China has cemented its position as the world’s factory floor and expanded its share of global trade.

While China attracted more new inflows last year, the total stock of foreign investment in the U.S. remains much larger, reflecting the decades it has spent as the most attractive location for foreign businesses looking to expand outside their home markets.

Foreign investment in the U.S. peaked in 2016 at $472 billion, when foreign investment in China was $134 billion. Since then, investment in China has continued to rise, while in the U.S. it has fallen each year since 2017.

The Trump administration encouraged American companies to leave China and re-establish operations in the U.S. It also put Chinese investors on notice that acquisitions in the U.S. would face new scrutiny on national security grounds—cooling Chinese interest in American deal making.

In 2020, the Washington Post reported:

The federal retirement fund is about to invest in China. Some former U.S. military leaders object.

National security adviser Gen. James Jones watches as President Barack Obama and South Korean President Lee Myung-Bak hold a joint press availability in the Rose Garden at the White House in 2009.

The retirement savings program for federal and military personnel is preparing to more than double the number of countries represented in its investment fund that tracks international stock markets.

One of the countries to be added is China — and that’s a problem for some people.

Eight former senior military leaders have issued an open letter seeking to prevent the change, which is set to take effect in the second half of this year. The letter has rekindled a controversy that has flared several times since the Thrift Savings Plan first committed to broadening its international stock fund, called the I Fund.

The result, the letter said, will be that a portion of money in the fund will be invested in Chinese companies including “weapons manufacturers, U.S.-sanctioned entities and other malevolent enterprises of the Chinese Communist Party.”

“It is especially intolerable to those of us who have proudly served the Nation in uniform that our retirement investments will help its enemies threaten our comrades-in-arms and the country we love,” said the letter, whose signers include two former White House national security advisers, retired Commandant of the Marine Corps Gen. James L. Jones and retired Navy Vice Adm. John M. Poindexter.

The letter was released in coordination with the Committee on the Present Danger: China, which defines its mission as “to educate and inform American citizens and policymakers about the existential threats presented from the Peoples Republic of China under the misrule of the Chinese Communist Party.” The group, a successor to similarly named Cold War-era organizations, was reconstituted last year by Stephen K. Bannon, former chief strategist to President Trump, and others who hold hawkish views on China.

The letter was meant to draw the attention of current military leaders, Trump, Congress and TSP investors, said Frank Gaffney Jr., vice chairman of the group, in a phone interview.

 

Biden Leaving Troops in Afghanistan Past the May Deadline

For many many months, the Trump administration was negotiating a peace deal with the Taliban. Frankly, all that the Taliban has agreed to, they have violated. Trump also issued a schedule to lower troop levels in Afghanistan to only a small tight residual number in May of 2021 along with contractors. With the new possible threat(s) of the Taliban and their growing connection to al Qaeda, Biden has decided to leave troop levels in the region at the present level with an increase in Syria and possibly Iraq. All the while, Iran just hosted a Taliban leader for talks where the topic(s) are unknown. Further, Taliban officials have been meeting in Moscow with Russian officials. Those details are found here. 

President Biden also has another immediate issue before him and that is the release of a U.S. contractor that went missing in Afghanistan about a year ago. Mark Frerichs, a navy veteran went missing about a year ago while he was working as a contractor on an engineering project. It is thought he is in the custody of the Haqqani network. The U.S. State Department is offering a $5 million reward that leads to Frerichs’ return. 

So, it is rather fitting that just this week, a very old FOIA request for former Defense Secretary Donald Rumsfeld documents have been released. Frankly, the questions which were referred to at the Pentagon as ‘snowflakes’ reflects his frustration of the layers of bureaucracy  within the Department of Defense and his anger at getting real answers and challenging the quality of intelligence reports. Sound familiar? It is clearly a problem that after 20+ years has not found a quality solution. Just read a few of his snowflakes and judge for your self.

***Donald H. Rumsfeld - U.S. PRESIDENTIAL HISTORY

35 of the most notable items from the new collection is below from the National Archives. 

A follow-on DNSA publication covering the rest of Rumsfeld’s tenure as secretary will appear through ProQuest later in 2021.

One such snowflake was written on March 3, 2003. At 8:16 AM, Rumsfeld wrote to Senior Military Assistant LTG Bantz J. Craddock and Department of Defense General Counsel William Haynes with the subject “KSM”. He wanted to know, “Do we know where the information to find Khalid Sheikh Mohammed came from? Was it from GTMO detainees?” There is no response from either Craddock or Haynes in the DOD release to the Archive, though Rumsfeld’s question is likely a push back to the false claims made by CIA Director George Tenet that the Agency’s resort to torture of Abu Zubaydah led to the capture of Khalid Sheikh Mohammed.

The Senate Select Committee on Intelligence torture report would later reveal that key intelligence on KSM as the mastermind of the 9/11 attacks came from the FBI’s non-coercive, rapport-building interrogation of Abu Zubaydah.[1] This success was prior to the CIA’s contract psychologists, James Mitchell and Bruce Jessen, taking over the interrogation at the CIA “Detention Site Green” in Thailand, which was created to house Zubaydah in 2002.  Their approach to Zubaydah would include 83 water board sessions yet fail to produce any valuable intelligence.  CIA clandestine services chief Jose Rodriguez (and perhaps Gina Haspel, who would later become DCI, though CIA redactions of documents continue to obscure her role) ordered the destruction of the torture videotapes, commenting that “the heat from destoying [sic] is nothing compared to what it would be if the tapes ever got into public domain.”

Later on March 3, under the subject “Contingencies”, Rumsfeld wrote to Under Secretary of Defense for Policy Doug Feith, stating, “We need to plan what we will do if Saddam Hussein is captured. We need to plan what we will do if we catch an imposter.” There is no record of Feith’s answer in the DOD release to the Archive.

Throughout Rumsfeld’s tenure, his snowflakes circulated daily through the highest levels of the Pentagon. With scant limitations on their subject matter, the all-encompassing documents are sometimes an hourly paper trail inside the Office of the Secretary of Defense during six years of tremendous consequence for U.S. foreign policy. The declassified documents also provide an account that at times contradicts DOD public statements.  For example, The Washington Post published a selection of the memos in the six part series “The Afghanistan Papers” in September 2019 revealing that officials misled the American public about the war in Afghanistan.

The entire corpus of snowflakes also details many aspects of the day-to-day operations of the Pentagon, the modernization of the U.S. armed forces, and Rumsfeld’s personal agenda against bureaucracy. “Bureaucracy is driving people nuts,” he wrote in an April 8, 2002, memo at 7:41AM. “If we can take two or three layers out of this place, we will be a lot better off.” In a separate April 8 letter, the secretary suggested cutting all major Pentagon programs by at least 20 percent. (The DOD budget increased by 37.54 percent between FY2001 and FY2006.) On March 11, 2002, Rumsfeld wrote to colleagues, “I am getting tired of seeing the word ‘joint’ everywhere.”

Rumsfeld, Snowflake by Snowflake - Open Source with ...

Other topics in the collection include:

  • the military budgeting process and efforts to rein in defense spending;
  • military planning, procurement, and expenditures;
  • nuclear issues – weapons, proliferation, safety;
  • decision making on military wages, benefits, tours of duty, and veterans issues;
  • military intelligence;
  • Defense Department relations with the CIA and Homeland Security;
  • Rumsfeld’s relations with the State Department and National Security Council;
  • U.S. relations with NATO;
  • U.S. military relations with Russia, former Soviet republics, and other countries;
  • Rumsfeld’s interactions with the news media, Congress, and the public;
  • Guantanamo detainees, interrogation, and torture;
  • concerns about the International Criminal Court and U.S. liability for war crimes;
  • the hunt for Osama bin Laden and other terrorists;
  • the Joint Strike Fighter program; and
  • the emergency landing of a U.S. EP-3 at Hainan Island in 2001

Donald Rumsfeld’s Snowflakes, Part 1: The Pentagon and U.S. Foreign Policy, 2001-2003 will be a critical research tool for historians and will be available through many college and research libraries. Part II, which covers the last three years of Rumsfeld’s tenure as secretary of defense from 2004 to 2006, will be published in 2021. Learn more about accessing the Digital National Security Archive through your library online and how to request a free trial here.

 

March 11, 2002
April 8, 2002
September 12, 2003
October 23, 2003

A few more:

October 10, 2001
Rumsfeld requests a daily report on the location of Osama bin Laden.

 

November 8, 2001
Rumsfeld inquires: “Why doesn’t Pakistan sever its relationship with [sic] Taliban?”

 

November 29, 2001
Rumsfeld accuses career employees in the OSD of undermining his decisions and working too slowly.

 

January 5, 2002
Rumsfeld complains to George Tenet about the CIA.

 

February 15, 2002
Rumsfeld directs his staff to develop a white paper on detainees and the Geneva Conventions.

 

March 11, 2002
Rumsfeld suggests further classification review of the already pre-reviewed Annual Report to the President and the Congress.

 

March 11, 2002
Rumsfeld says the DOD annual report is not conclusive or upbeat enough.

 

March 12, 2002
Rumsfeld recounts his conversation with Russian MoD Sergei Ivanov at a Washington Wizards basketball game.

 

March 14, 2002
Rumsfeld asks how to fix the requirements process.

 

March 16, 2002
Rumsfeld inquiries into U.S. nuclear policy.

 

March 26, 2002
Under the subject “Business As Usual”, Rumsfeld questions whether the Department should cut educational programs while at war.

 

March 28, 2002
Rumsfeld pushes to lift restrictions on contractors providing force protection.

 

March 28, 2002
Rumsfeld proposes a weekly meeting on Afghanistan, stating that it is “drifting”.

April 3, 2002
Rumsfeld’s thoughts on the Middle East.

 

April 8, 2002
Rumsfeld instructs his staff to create a list of all the major “processes” at the Pentagon and shorten them by atleast 20 percent.

 

April 9, 2002
Rumsfeld expresses concern about a “zero defect mentality” in promotion process.

 

 

April 12, 2002
Rumsfeld ruminates on the creation of a new Homeland Security Department.

 

April 15, 2002
Rumsfeld details a conversation with Henry Kissinger about the ICC.

 

April 15, 2002
Rumsfeld contacts Tenet about the ICC.

 

April 23, 2002
Rumsfeld considers possibly renegotiating a Russia-NATO arrangement.

 

April 23, 2002
Rumsfeld proposes using contractors to train the Afghan army.

 

April 23, 2002
Rumsfeld asks if a DOD chart of the PPB system is a joke, or whether it should be.

 

May 5, 2002
Rumsfeld tells Hank Crumpton to “speak up”.

 

May 22, 2002
Rumsfeld circulates a letter comparing interrogation techniques in Afghanistan to Guantanamo.

 

August 8, 2002
Rumsfeld questions whether it is right for pilots to use amphetamines.

 

August 17, 2002
Rumsfeld ruminates on the U.S. and Western Europe “stopping proliferation, reducing weapons of mass destruction and contrubitng to peace and stability” around the world.

 

August 19, 2002
Rumsfeld addresses the President, Vice President, CIA Director, and National Security Advisor on U.S. policy towards Iran and North Korea.

 

October 1, 2002
Rumsfeld sends handwritten notes from an interview with a detainee to Fieth.

 

March 3, 2003
Rumsfeld requests a contingency plan for the possibility of capturing an imposter of Saddam Hussein.

 

March 3, 2003
Rumsfeld contacts Tenet about the intelligence that led to capturing KSM.

 

March 26, 2003
Rumsfeld requests material to brief the President privately on a post-Saddam Iraq.

 

OAG Report: Gov. Cuomo Created the Covid Death Panel

During Novel Coronavirus Briefing, Governor Cuomo ...

Remember Andrew Cuomo was thought to be a good candidate for president of the United States?

Remember he wrote a book about his stellar job in dealing with the pandemic in New York?

Remember he received an award for his daily virus briefings?

Remember when he blamed President Trump?

Remember when the Mercy ship, the Javits Center and the Samaritan’s Purse built field hospitals and offered doctors and beds for several thousand patients?

Remember when he issued an executive order providing qualified immunity to all front line personnel and himself for wrongful death, malpractice and criminal malfeasance?

Opposition to Samaritan's Purse Central Park field ...

All true….but enter the New York Inspector General report, freshly released….

Frankly, this is the scandal of the decade…read on.

ALBANY, N.Y. (AP) — New York may have undercounted COVID-19 deaths of nursing home residents by as much as 50%, the state’s attorney general said in a report released Thursday.

Attorney General Letitia James has, for months, been examining discrepancies between the number of deaths being reported by the state’s Department of Health, and the number of deaths reported by the homes themselves.

Her investigators looked at a sample of 62 of the state’s roughly 600 nursing homes. They reported 1,914 deaths of residents from COVID-19, while the state Department of Health logged only 1,229 deaths at those same facilities.

If that same pattern exists statewide, James’ report said, it would mean the state is underreporting deaths by nearly 56%.

An Associated Press analysis published in August concluded that the state could be understating deaths by as much as 65%, based on discrepancies between its totals and numbers being reported to federal regulators. That analysis was, like James’ report, based on only a slice of data, rather than a comprehensive look at all homes in the state. Full article here.

In part of the report summary:

Overview of Findings

The report includes preliminary findings based on data obtained in investigations conducted to date, recommendations that are based on those findings, related findings in pre-pandemic investigations of nursing homes, and other available data and analysis. Based on this information and subsequent investigation, OAG is currently conducting investigations into more than 20 nursing homes across the state. OAG found that:

  • A larger number of nursing home residents died from COVID-19 than DOH data reflected;
  • Lack of compliance with infection control protocols put residents at increased risk of harm;
  • Nursing homes that entered the pandemic with low U.S. Centers for Medicaid and Medicare Services (CMS) Staffing ratings had higher COVID-19 fatality rates;
  • Insufficient personal protective equipment (PPE) for nursing home staff put residents at increased risk of harm;
  • Insufficient COVID-19 testing for residents and staff in the early stages of the pandemic put residents at increased risk of harm;
  • The current state reimbursement model for nursing homes gives a financial incentive to owners of for-profit nursing homes to transfer funds to related parties (ultimately increasing their own profit) instead of investing in higher levels of staffing and PPE;
  • Lack of nursing home compliance with the executive order requiring communication with family members caused avoidable pain and distress; and
  • Government guidance requiring the admission of COVID-19 patients into nursing homes may have put residents at increased risk of harm in some facilities and may have obscured the data available to assess that risk.

Undercounting of COVID-19 Deaths in Nursing Homes

Preliminary data obtained by OAG suggests that many nursing home residents died from COVID-19 in hospitals after being transferred from their nursing homes, which is not reflected in DOH’s published total nursing home death data. Preliminary data also reflects apparent underreporting to DOH by some nursing homes of resident deaths occurring in nursing homes. In fact, the OAG found that nursing home resident deaths appear to be undercounted by DOH by approximately 50 percent.

OAG asked 62 nursing homes (10 percent of the total facilities in New York) for information about on-site and in-hospital deaths from COVID-19. Using the data from these 62 nursing homes, OAG compared: (1) in-facility deaths reported to OAG compared to in-facility deaths publicized by DOH, and (2) total deaths reported to OAG compared to total deaths publicized by DOH.

In one example, a facility reported five confirmed and six presumed COVID-19 deaths at the facility as of August 3 to DOH. However, the facility reported to OAG a total of 27 COVID-19 deaths at the facility and 13 hospital deaths — a discrepancy of 29 deaths.

Lack of Compliance with Infection Control Policies

OAG received numerous complaints that some nursing homes failed to implement proper infection controls to prevent or mitigate the transmission of COVID-19 to vulnerable residents. Among those reports were allegations that several nursing homes around the state failed to plan and take proper infection control measures, including:

  • Failing to properly isolate residents who tested positive for COVID-19;
  • Failing to adequately screen or test employees for COVID-19;
  • Demanding that sick employees continue to work and care for residents or face retaliation or termination;
  • Failing to train employees in infection control protocols; and
  • Failing to obtain, fit, and train caregivers with PPE.

For instance, OAG received a complaint that at a for-profit nursing home located north of New York City, residents who tested positive for COVID-19 were intermingled with the general population for several months because the facility had not yet created a “COVID-19 only” unit. At another for-profit facility on Long Island, COVID-19 patients who were transferred to the facility after a hospital stay and were supposed to be placed in a separate COVID-19 unit in the nursing home were, in fact, scattered throughout the facility despite available beds in the COVID-19 unit. This situation was allegedly resolved only after someone at the facility learned of an impending DOH infection control visit scheduled for the next day, before which those residents were hurriedly transferred to the appropriate designated unit.

OAG received reports that nursing homes did not properly screen staff members before allowing them to enter the facility to work with residents. Among those reports, OAG received an allegation that a for-profit nursing home north of New York City failed to consistently conduct COVID-19 employee screening. It was reported that some staff avoided having their temperatures taken and answering a COVID-19 questionnaire at times when the screening station at the facility’s front entrance had no employees present to take that information or when staff entered the facility through a back entrance, avoiding the screening station altogether.

At yet another facility in Western New York, a nurse reported to OAG that immediately prior to the facility’s first DOH inspection in late April, a nurse supervisor had set up bins in front of the units with gowns and N95 masks to make it appear that the facility had an adequate supply of appropriate PPE for staff. The nurse alleged that the nurse supervisor came in to work unusually early the day of the first inspection and brought out all new PPE and collected all of the used gowns. Although the initial DOH survey conducted that day did not result in negative findings, DOH returned to the facility for follow-up inspections, issued the facility several citations, and ultimately placed the facility in “Immediate Jeopardy.”