Controversial Decisions by Governors in NY, NJ, and PA Criticized as Factors in High Level of COVID-19 Nursing Home Deaths

The governors of New York, New Jersey, and Pennsylvania are under fire for controversial nursing home policy decisions that critics say fueled coronavirus deaths in those facilities.

On March 25, New York Gov. Andrew Cuomo (D) ordered nursing homes to accept patients who tested positive for COVID-19, as the New York Post reported:

An executive at the unnamed Queens nursing home says that the facility was coronavirus-free until Gov. Andrew Cuomo forced facilities in the state to accept coronavirus patients on March 25.

In Pennsylvania, the Bucks County Courier Times reported:

On March 29, as Pennsylvania, New York and other states began ordering nursing homes to admit medically stable residents infected with the coronavirus, national trade groups warned it could unnecessarily cost more lives.

The health directives put “frail and older adults who reside in nursing homes at risk” and would “result in more people going to the hospital and more deaths,” the American Health Care Association and affiliates said at the time.

A month later, it appears government officials should have heeded the dire call to pursue different pandemic emergency plans.

Then on April 6, New Jersey Gov. Phil Murphy followed Cuomo’s lead and ordered New Jersey nursing homes to accept patients who tested positive for COVID-19, as NorthJersey.com reported:

New Jersey nursing homes cannot bar coronavirus patients from being admitted into their facilities, a new state policy designed to make room at hospitals already stressed from a growing surge of critically ill patients.

Though not all 50 states are currently providing complete data, a huge percentage of the 83,231 COVID-19 deaths in the United States, as of 5 p.m. eastern on Tuesday, May 12, were among residents of nursing homes and long-term care facilities.

The Henry J. Kaiser Foundation has assembled nursing home/long-term care facility COVID-19 mortality data from the 33 states that report that data, and calculates that, as of May 7, nursing home and long term care facility residents accounted for 38 percent of the COVID-19 deaths in those states. The percentage of coronavirus deaths from nursing homes appears to be increasing as the pandemic drags on.

Table 1 below shows a summary of the ten states with the highest number of nursing home/long-term care facility COVID-19 deaths, as of May 7.

Table 1
Number of Nursing Home COVID-19 Deaths
Highest Ten States, as of May 7, 2020
(Source: Henry J. Kaiser Family Foundation)
State Deaths
New York 5,215
New Jersey 4,556
Massachusetts 2,653
Pennsylvania 2,355
Connecticut 1,249
Illinois 1,082
California 946
Maryland 804
Louisiana 738
Georgia 633
33  State Total 24,974

(States not reporting COVID-19 deaths in long term care facilities in the Kaiser Family Foundation report as of May 7, 2020 include Alabama, Alaska, Arizona, Hawaii, Idaho, Iowa, Kansas, Michigan, Minnesota, Missouri, Montana, New Mexico, North Dakota, South Dakota, Vermont, Wisconsin, and Wyoming. )

In New York, where Gov. Andrew Cuomo’s political star was rising nationally as recently as last month, the shocking revelations of his decisions to force nursing homes to take in patients who tested positive for COVID-19 appear to not only have burst that political bubble for Cuomo, but more ominously they appear to be the driving force in the surge of nursing home COVID-19 deaths, as the New York Post reported on April 23.

On Sunday, Gov. Cuomo reversed that controversial order, as NY1 reported:

Governor Cuomo is effectively reversing a much-criticized policy directive that was sending seniors treated for COVID-19 back into nursing homes.

A March 25th order from the state Department of Health required all nursing homes to readmit seniors who left to be treated for coronavirus at a hospital..

Critics said that policy led to more than 5,000 deaths in nursing homes, which are regulated by the state.

In New Jersey, Gov. Phil Murphy’s handling of nursing homes has come under fire for additional decisions by some who say the long term care facility regulatory control bill he signed last year was too “watered-down” to address what become the coronavirus pandemic, as Politico reported on Monday:

Almost a year after a 2018 adenovirus outbreak killed 11 children at a long-term care facility in northern New Jersey, Gov. Phil Murphy signed legislation requiring every such facility in the state to develop outbreak response plans to prevent future tragedies. . .

Six sources with direct knowledge of the bill’s drafting in 2019 say the state Health Department — worried about its limited resources — objected to a requirement that all of the plans be submitted for state vetting. Lawmakers reworked the legislation to limit the mandate to less than two dozen sites.

Now, 11 months after the bill was sent to Murphy’s desk, nearly 4,900 deaths have been linked to coronavirus cases at 500-plus facilities across New Jersey — more than half of all the fatalities in the state and one of the worst outbreaks in the nation.

In Pennsylvania, Morning Call reported Gov. Tom Wolf has been criticized for inattention to nursing homes:

The escalating tragedy in Pennsylvania nursing and personal care homes, which have more than two-thirds of the state’s coronavirus deaths, has prompted lawmakers to point fingers at the Wolf administration.

“There is no excuse for what is going on, OK?” said Chester County state Sen. Andrew Dinniman, who like Gov. Tom Wolf is a Democrat. “The Department of Health has failed our nursing homes.”

Dinniman’s comments came Wednesday. On Thursday, state Sen. Judy Ward and other Republican senators said the administration failed to pay enough attention to nursing homes and their highly vulnerable residents when the virus first arrived in the U.S.

The percentage of coronavirus deaths from residents of nursing homes varies by state, ranging from 19 percent in Nevada to 81 percent in Minnesota. In Massachusetts it is 60 percent.

On March 25 Worldometers reported there were 775 COVID-19 deaths in the United States. New York State had the most COVID-19 deaths of any state in the country, 271, or 35 percent of the country’s total at the time.

Rounding out the top ten states for reported number of COVID-19 deaths on March 25 were Washington with 123, California with 51, Louisiana with 46, New Jersey with 44, Georgia with 38, Michigan with 24, Florida with 20, Illinois with 16, and three states were tied for the tenth spot with 12 deaths each: Connecticut, Texas, and Indiana.

As of 5 p.m. eastern time on Tuesday May 12 there are 83,231 COVID-19 deaths in the United States. New York State still has the most COVID-19 deaths of any state in the country, with 27,166, or 32 percent of the country’s total. Georgia, Washington, Texas, and Indiana are no longer in the top ten states for COVID-19 deaths, but Pennsylvania and Massachusetts now are, as Table 2 below indicates:

Table 2
Ten States With Most COVID-19 Deaths
 As of May 12, 2020
(Source: Worldometers)
State Deaths
New York 27,166
New Jersey 9,532
Massachusetts 5,141
Michigan 4,674
Pennsylvania 3,917
Illinois 3,601
Connectict 3,041
California 2,847
Louisiana 2,347
Florida 1,782
Total US 83,231

New York, New Jersey, and Pennsylvania are not the only states where governors have come under criticism for nursing home decisions that backfired, but they are the highest profile due to the high number of total COVID-19 deaths and the high number of COVID-19 deaths among nursing home residents.

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