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The Nursing Home Scandal
New York City Mayor Bill DeBlasio is one of the most ghoulish politicians in America. This latest appearance discussing nursing homes is yet another example:
.@NYCMayor De Blasio on nursing homes: "A lot of these are for-profit organizations. I think there’s going to be a lot of questions about whether they put their residents first or whether they put profit first" pic.twitter.com/KfPZNAXH0d
— Tom Elliott (@tomselliott) May 6, 2020
Yesterday, New York State announced an additional, previously undisclosed 1,700 deaths in the state’s nursing homes. Writing for the New York Post Michael Goodwin explains,
Two weeks ago, Gov. Andrew Cuomo was first asked about his policy that forced nursing homes to admit patients infected with the coronavirus.
“That’s a good question, I don’t know,” the governor answered, turning to an aide.
On Tuesday, Cuomo was asked about a report from the Associated Press that his team had added more than 1,700 deaths to the count of those who died in nursing homes, bringing the total to at least 4,813.
“I don’t know the details, frankly,” the governor answered, turning to an aide.
…
The March 25 order that forced infected patients on them allows for no exceptions and has not been changed.
The killer fifth paragraph still reads: “No resident shall be denied re-admission or admission to the NH solely based on a confirmed or suspected diagnosis of COVID-19. NHs are prohibited from requiring a hospitalized resident who is determined medically stable to be tested for COVID-19 prior to admission or readmission.”
Owners and managers said Tuesday they are not aware of any loosening of the policy. They also say that hospitals still are referring infected patients to them on a near-daily basis and they are expected to take them if they have an empty bed.
To them, the March 25 order was a death sentence. Some facilities say they had no deaths or even positive patients before that date, but many of both since, including among staff members.
Recall, too, the experience of Donny Tuchman, CEO of Brooklyn’s Cobble Hill Health Center. On April 24, when his facility already had lost 55 patients, he showed reporters email exchanges with the Department of Health where he got no help when he asked for relief. Even his request to have some of the COVID-19 patients sent to the Javits Center or the Navy ship Comfort, both of which were well below capacity, was rejected.
As the Post front-page headline said the next day, “THEY KNEW,” meaning the state could no longer pretend it had no idea of the chaos it inflicted on nursing homes.
Cuomo, in response, has constructed an evolving litany of self-defenses, once coldly asserting it was “not our job” to help the homes get protective equipment for their staffs, even as other officials said the equipment was being provided. His office claimed the state policy mirrored federal policy, which, as the AP noted in its report, isn’t true. The feds never mandated that nursing homes be forced to accept COVID-19 patients.
The story in New Jersey is no different. While we were being told that every life is sacred, officials in both New York and New Jersey were moving nursing home patients out of hospitals to free up beds for the more important patients, and in the process, spreading the virus throughout the nursing home systems.
In California, experts were sounding the alarm on deaf ears,
Even as senior care centers have been particularly hard hit by the coronavirus — with patient and staff deaths accounting for nearly 40 percent of all COVID-19 deaths across California — the state is calling on assisted living facilities to house infected patients in exchange for money.
A letter from the state Department of Social Services sent to licensees of senior and adult care residential facilities on Friday urged them to temporarily take in patients who have tested positive for the virus — for up to $1,000 a day — to make room in hospitals for people who become critically ill and require acute care.
But health experts and advocates say the plan risks introducing the virus into facilities that have been spared or those already dealing with their own outbreaks.
The majority of deaths in this country have been in nursing homes, and public policy is being set on the total number of deaths, despite the fact that nursing homes were turned into death traps by public officials.
Will there be a reckoning? It doesn’t appear likely.
You're feeling pretty good about yourself these days, aren't you @NYGovCuomo ? pic.twitter.com/E82jNFYV6b
— Christopher C. Cuomo (@ChrisCuomo) May 6, 2020
Published in General
Hate to click “like” on this, given the content, but it’s a good post.
Reading this, one has to wonder (if one wasn’t wondering already) if we really want to trust the economy to people who demonstrate the stellar judgment described here. I think I’d rather the first 2,000 names in the Albany phone book got to decide for themselves how they want to run their lives, than that these public health geniuses were in charge.
People should read this story out of France to compare and contrast what might have happened if Cuomo and apparently the governor of New Jersey as well had acted differently.
It goes against everything I know to willingly send a patient with an infectious disease into a nursing home. A hospital administrator would be trying to keep it out, not bring it in. Goodness, daycare centers would know not to do this. It is the basis of our compulsory vaccination for kindergartners policies in Massachusetts.
I wonder if Governor Baker in Massachusetts did this too. Half of our 4,000 deaths have been in nursing homes.
No doubt Comrade DeBlasio thinks nursing homes should be run by the government. Why not have the organization that makes the regulations run them? I’d like for him to explain how going from private, for-profit businesses to public (government-run) ownership will eliminate waste, fraud, and abuse, and make them safer.
March 29 Massachusetts apparently tried to clear out some nursing homes so as to devote those facilities to covid-19 patients. At least someone knew to do that.
I can’t find out yet if Governor Baker issued the same order the governors of New York and New Jersey did.
People are asking questions in this state today too. As well they should.
God I detest these people.
Beverly Manor was a chain of nursing homes when I was still in medical practice. I believe it was then owned by the Mormon Church. They were pretty good, considering that a majority of the patent were on Medicaid, which did not pay well. Families would often deplete the assets of the elderly family member to make them eligible for Medicaid.
Warren Wilhem Jr is a communist and his opinions on profit are not to be considered.
Just looking around for more information about this sequence of events as they may have also played out in Massachusetts, it’s possible it wasn’t an outright attempt to murder the patients in the nursing homes.
It sounds like people did not know what to do with the elderly patients, and they made a stupid decision. In other words, it was stupid but perhaps not an attempt to murder the nursing home residents.
I read an interesting book called Five Days at Memorial about a hospital at the center of the Hurricane Katrina disaster. Every disaster planner across this country–most especially hospitals–should read this book.
People will be held accountable afterward. Poor preparedness planning is not an excuse for negligent homicide. The Memorial Hospital doctors were involved in long-running trials afterward.
The governors and others (I have a horrible feeling this includes Massachusetts as well) who placed covid-19 patients in nursing homes will have to answer for this. This country spends a lot of money on nursing home care. It’s something the country cares about.
It will take years to sort this out because it involves a lot of decisions along the way. What’s not said yet is if the governors said or meant that these nursing homes already had patients or staff who had tested positive, which is why they issued the order. If so, that would at least help the states make sense of these orders.
On further thought, I would mostly blame the nursing home administrators.
I have had hundreds of instances when I was responsible for kids, and the situation did not feel safe, I acted. I used to tell the kids, my own kids, and everyone else involved, “I am charged with protecting these kids. I answer to God. Not to anyone else.”
But I often came across people with bureaucratic attitudes who would tell me about policy or orders from above. I am not wired the way those people are.
This is one time when I hope there is an army of lawyers working on this. Lawsuits may be the only way to let the nursing home administrators know that they answer to a higher authority. There should be no “following-orders” Nuremberg defense for them.
Young healthy kids can’t go to school but we put people we know are contagious among the most vulnerable. And since NY did it, NJ’s governor just said “ditto” as he has with everything related to Covid so far. Starting to think Cuomo is our governor too.
My daughter is a nurse (manager, not direct care) in a local (Oregon) hospital. As the panic was ramping up, she told me that the hospital was having problems because, when patients from nursing homes were well enough to be discharged, the homes wouldn’t take them back. The hospital had to keep them during the time when there was increasing concern about capacity. Since that time the state made arrangements with a couple of facilities to receive recovering patients from hospitals. It seems that Oregon did at least one thing right.
It’s brilliant! You reduce the number of COVID nursing home deaths by removing the elderly from nursing homes!
If Oregon could get it right you know it was a low bar and anyone should have been able to figure out that sending patients back to nursing homes from hospitals with active Wuhan flu cases was a bad idea. I thought one of the main points of the lockdown was to protect the most vunerable.
In Massachusetts what used to be strictly “nursing homes”–glorified hospices, really–have over the years come to be convalescent homes. As hospitals have had to discharge their critical care patients to a stepped-down care facility, the nursing homes have been utilized for that purpose.
So, yes, it did make sense to move the patients around. Some of the convalescent facilities are well equipped and well staffed and could handle patients in need of a high level of nursing care. Move the non-covid-19 patients out, and move the recovering covid-19 patients in. I can understand doing that. In fact, we are opening new facilities and repurposing existing ones for covid-19 patients going forward.
That said, I’ve been assuming until I read these stories about Cuomo that Massachusetts nursing home deaths were due to infections brought in by the staff or visitors. Of course, the source will be next to impossible to sort out. Going forward to contact tracing in Massachusetts, we will be able, I hope, to avoid that happening again.
But I hope the nursing home deaths in Massachusetts were not the result of our governor’s intentionally putting covid-19 patients into nursing homes that didn’t have other covid-19 cases. But if it does turn out to have been the policy here in my state, I hope there is hell to pay. I truly do. That is negligent homicide to me. I respect our governor, Charlie Baker, who is a Republican who enjoys a 65 percent popularity rating in our state. If he did this too, my heart will break.
There has to be a postmortem type of accountability for the nursing-home deaths in Massachusetts. Let the chips fall where they may.
No, that would be an attempt to reshuffle, so non-COVID versus all COVID residents. The Feds recommended this for hospitals early on, simplifying protective measures as there would be no non-COVID patients to protect in a facility with COVID in the air system and on workers gear.
Or, as I suggested, panic plus a will to power.
So where were Doctors Fauci and Birx in all this? Quick to scold beach goers, talked about protecting nursing homes, yet not a peep here?
#14 MarciN
I’m similarly hoping that something like this Andrew Cuomo/Howard Zucker atrocity wasn’t slipped by Charlie Baker here in the Bay State — especially given that Baker came into the governor’s role with a CEO stint in health insurance.
(Aside: Baker’s probably likable enough personally but a RINO all the same — for example, together with the MA congressional delegation, he’s been attempting to screw MA fishermen in favor of the chimera of the proposed Vineyard Wind project.)
Apropos of health insurance, is it possible that the health insurers (and/or life insurers that have/had LTC books of business) have — unbeknownst to us — set some kinds of “step-down” thresholds in their policies (Long-Term Care policies or similar), and that these have contributed to shunting elderly Wuhan Virus patients from hospital beds back into nursing homes and/or ALFs much too soon?
In other words, if a given elderly patient were in the direst of straits with Wuhan Virus in the ICU, then were to recover *just* enough so that, for example, their changes in symptoms were to trigger the applicability of new ICD-10 codes, might that in turn trigger an alert from the insurer telling the hospital that the insurer henceforth would be ratcheting down its reimbursement rates — or even voiding reimbursements completely for all days going forward in which the patient remains in an ICU bed “unnecessarily”?
(Indeed, maybe such a scenario might be happening or have happened not only in MA and involving private health insurers, but perhaps also in New York State it might also have been a driver behind the policy Zucker imposed — and in particular if there are/were any CMS/Medicare reimbursement threshold drop-downs of the kind I’m conjecturing — then they too might have been a driver as well.)
As an aside, would NYS Health Commissioner Howard Zucker possibly be closely related to CNN’s Jeff Zucker?…
(I’m [Ashkenazi] Jewish so I’m fully aware that our family names can frequently fail to be indicative of anything particularly meaningful — but sometimes one never knows…)
Bethany Mandel is trying to kill my family send tweet
DRGs are the mechanism. The payment is based on diagnosis, not condition.