State Comptroller audit finds NY health department understated the number of COVID nursing home deaths
Two years after the COVID-19 pandemic upended everyday life in New York, a new report finds the state Department of Health was unprepared to respond to disease outbreaks in nursing homes – and undercounted the number of COVID-19 deaths there. New York State Comptroller Tom DiNapoli, a Democrat, released the audit Tuesday night, saying a “persistent lack of funding for public health over the last decade forced DOH to operate without critical information systems and staff” that could have identified and limited the spread of COVID in nursing homes.
DiNapoli’s report also finds the Department of Health didn’t provide accurate COVID-19 death counts to the public and “became entangled in the undercounting of those deaths” as then-Governor Andrew Cuomo took control of information provided to the public.
The audit also finds the Department of Health understated the number of nursing home deaths from COVID by 4,100, and by more than 50 percent at some points during the pandemic. The DOH was unable to explain the discrepancies, according to DiNapoli.
DiNapoli also finds the Department of Health was slow to respond to a federal directive to survey nursing homes for infection control problems during the pandemic. And he says the department didn’t adequately use the data it collects to detect emerging infectious diseases or shape disease control policies.
DiNapoli recommends the Executive Chamber improve internal control, cooperation with state oversight inquiries, external reporting and communication. It is now run by Governor Kathy Hochul — who replaced Cuomo, a fellow Democrat, in August when he resigned over a raft of scandals including his handling of the pandemic.
The Department of Health agreed with some of the recommendations but took exception to parts of the audit.
State Attorney General Letitia James, also a Democrat, said in a statement that DiNapoli “affirms many of the findings that we uncovered last year about the state’s response to COVID, most notably that DOH and the former governor undercounted the number of deaths in nursing homes by as much as 50 percent.”
Cuomo has denied undercounting the COVID deaths and said his administration was following federal guidance. He says investigations into the matter were politically motivated.
DiNapoli spoke with WAMC Wednesday:
We call it like we see with our audits. And keep in mind, the audits are done by auditors, right? Auditors are civil service people, they are hired through a merit system. They are not political people, I don't know if they're Republicans or Democrats, you can't tell the auditors what to do. They do it. We had an audit underway on nursing homes; we've done nurse nursing home wards in the past, not related to the pandemic, and we found deficiencies in oversight. So we had started an audit on nursing homes, particularly looking at infection control, but in the context of COVID, it really, I think, was appropriate for us to take a deeper dive specific to what was happening with how COVID was handling. And certainly hearing the concerns from so many of the families who lost loved ones to really look at the question of not only infection control and prevention, but also reporting of numbers and accuracy of data.
So this report went on for a number of months. And, you know, what we put out confirmed, I think, what a lot of folks already knew, and certainly what our great Attorney General Tish James had reported, is that there was an underreporting of nursing home deaths. What I think is troubling in the audit is that it was clear that while there was inaccuracies in the reporting at the at the early end, they did figure it out. But that information, the accurate information, still didn't get out to the public. And so that really, you know, spoke to the reality that beyond the Department of Health, those at the executive level, say in the governor's office, gotta call it as it is, in terms of the public communication of numbers, were not giving the accurate numbers. And yet, the folks of the Department of Health, you know, they knew the reality, but that information didn't get out to the public. So that's just a confirmation of what I think a lot of folks know, which is that data was manipulated to make New York look better than it was.
By the governor at the time, Andrew Cuomo.
Have you heard from Cuomo since you've put this material out?
No, no, no, but I haven't heard from him in a long time either way. But the other piece of the audit, not to lose sight of this, is to really look at ways in which Department Health moving forward, we hope we're past COVID, but who knows what the next public health emergency will be? How are we investing in public health. And the audit really speaks to what has been an under investment, the need for there to be greater workforce training, particularly at the nursing home level, the need to collect accurate data, the need to have the right data systems. We did comparisons with how other states handle this and manage this, and New York's not doing as well. And that's going to mean more resources, more sense of pride. Not just being more honest and direct. But also part of the problem was they didn't have the handle on the information they should have had, because we had in inadequate data systems data collection, inadequate contact with the nursing homes in the field. And again, some of that is resource driven, training driven. But we better do a better job of investing in our public health system, Biden's proposed more money in this area. I hope, if we can't do it on our own in New York, let's hope the feds help us out.