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Blair Horner: Is NY Doing Enough To Regulate Health Care?

The Cuomo Administration has been taking a beating in the media over its months-long refusal to disclose public information to reporters and watchdog groups about COVID-19 deaths in nursing homes and other similar non-hospital settings.  The Legislature, a co-equal branch of government, had also been stonewalled by the Cuomo Administration.  Republicans have called for the governor to be impeached and for a special session to be called to address the Administration’s failures.  Democrats have threatened to subpoena Administration officials and to hold public hearings on the issue.

This week’s public hearing on the governor’s proposed health budget is likely to produce significant fireworks as the Health Commissioner will face lawmakers for the first time since the Attorney General’s January report was released documenting 50 percent more nursing home deaths from COVID than had been reported by the Cuomo Administration.

While it is important for the legislative branch to get to the bottom of Administration’s apparent effort to sit on evidence of what may have been a tragic failure in COVID policy, an important additional issue should be explored as well.

In addition to identifying the previously undisclosed nursing home deaths, the Attorney General’s report found that nursing homes that scored poorly in federal reports on quality of care had the highest fatalities.  According to the AG, “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.”

Of course, if the federal reporting is accurate, it would not be surprising that the nursing homes with the lowest scores – and therefore the poorest quality of care – would be the ones that had the worst performance in protecting residents from COVID. 

But if the feds had been reporting that performance, why hadn’t state regulators acted prior to the pandemic?  Why did it take COVID and the Attorney General’s report to bring it into the public spotlight?

Advocates for seniors and others in care facilities were well aware of this information and had long been complaining about poor quality of care.  As one advocate for nursing home residents commented, “There’s a lot of neglect in nursing homes in the best of times and these are not the best of times.”.  But those concerns, apparently, had been ignored by state health officials.  As a result, nursing homes residents and their loved ones suffered.

Where was the Cuomo Administration’s Health Department?  The governor has been in office for over a decade, yet it appears that too little was done to react to the federal government’s reports.

Struggles with infections – not just those from COVID – are a problem statewide.  This is deeply troubling in places designed to tend to those sick and frail.  New York State hospitals tend to perform worse than the national average when it comes to infections. 

Moreover, the federal government also reports on hospitals’ quality of patient care in the same way as it does for nursing homes.  A recent review of that federal data found that New York State’s hospitals, on average, tend to perform worst in the nation.

The Attorney General’s report stated that nursing homes with the lowest scores put their residents at the highest risk of contracting COVID.  It’s fair to assume that those residents are at risk of other illnesses as well.

The same logic should apply to the performance of New York’s hospitals.  If they too perform poorly, are patients at risk of substandard care?

This raises the biggest question: Where are the regulators?  The federal government has been reporting quality failures, yet the New York Health Department appears to have not adequately responded to the concerns – certainly in the case of nursing homes as reported by the Attorney General.  Is that true for hospitals as well?

Since a huge chunk of the state’s annual budget goes to health care, this week’s budget hearing is the right time to ask whether New Yorkers are getting quality oversight and healthcare services for their tax dollars.  When the Health Commissioner faces lawmakers at the hearing, he should not only be forced to explain the Cuomo Administration’s failures to be open and accountable with respect to COVID regulations for nursing homes, but he also should detail what the Department has done to respond to years of federal reports on the poor quality of care in nursing homes and hospitals.  The answer to that question is a matter of life and death.

Blair Horner is executive director of the New York Public Interest Research Group.

The views expressed by commentators are solely those of the authors.They do not necessarily reflect the views of this station or its management.

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