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?

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.”