4,500 patients sent to homes

Critics say N.Y. directive for senior facilities fueled outbreak

NEW YORK — More than 4,500 recovering coronavirus patients were sent to New York’s already vulnerable nursing homes under a state directive that was scrapped amid criticisms it was accelerating the nation’s deadliest outbreaks, according to a count by The Associated Press.

AP compiled its own tally to find out how many COVID-19 patients were discharged from hospitals to nursing homes under the March 25 directive after New York’s Health Department declined to release its internal survey conducted two weeks ago. It said it is still verifying data that was incomplete.

Whatever the full number, nursing home administrators, residents’ advocates and relatives say it has added up to a big problem for facilities that even Gov. Andrew Cuomo — the main supporter of the policy — called “the optimum feeding ground for this virus.”

“It was the single dumbest decision anyone could make if they wanted to kill people,” Daniel Arbeeny said of the directive, which prompted him to pull his 88-yearold father out of a Brooklyn nursing home where more than 50 people have died. His father later died of COVID-19 at home.

“This isn’t rocket science,” Arbeeny said. “We knew the most vulnerable — the elderly and compromised — are in nursing homes and rehab centers.”

Cuomo still defends move

Cuomo, a Democrat, on May 10 reversed the directive, which had been intended to help free up hospital beds for the sickest patients as cases surged.

But he continued to defend it this past week, saying that he didn’t believe it contributed to the more than 5,800 nursing and adult care facility deaths in New York — more than in any other state — and that homes should have spoken up if it was a problem. “Any nursing home could just say, ‘I can’t handle a COVID person in my facility,’ ” he said, although the March 25 order didn’t specify how homes could refuse.

Over a month later, on April 29, the Health Department clarified that homes should not take any new residents if they were unable to meet their needs, including a checklist of standards for coronavirus care and prevention.

In the meantime, some nursing homes felt obligated and overwhelmed.

‘Clear and present danger’

The state order “put staff and residents at great risk,” nursing home CEO Stuart Almer said. “We can’t draw a straight line from bringing in someone positive to someone catching the disease, but we’re talking about elderly, fragile and vulnerable residents.”

The Society for Post-Acute and Long-Term Care Medicine had warned from the beginning that Cuomo’s order admitting infected patients posed a “clear and present danger” to nursing home residents. Now, Jeffrey N. Nichols, who serves on the executive committee of the group, said “the effect of that order was to contribute to 5,000 deaths.”

Cuomo has deflected criticism over the nursing home directive by saying it stemmed from Trump administration guidance.

Still, few states went as far as New York and neighboring New Jersey, which has the second-most care home deaths, in discharging hospitalized coronavirus patients to nursing homes. California followed suit but loosened its requirement after criticism.

Some states went in the opposite direction. Louisiana barred hospitals for 30 days from sending coronavirus patients to nursing homes with some exceptions.

New York’s Health Department told the AP on May 8 that it was not tracking how many recovering COVID-19 patients were taken into nursing homes under the order. But it was at that moment surveying administrators of the state’s over 1,150 nursing homes and long-term care facilities on that question.

Those survey results have yet to be released. But regardless, the Health Department said, the survey had no bearing on Cuomo’s announcement May 10 that “we’re just not going to send a person who is positive to a nursing home after a hospital visit.”

Andrew Cuomo