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Eyes and ears usually trained on New York’s nursing homes and adult care facilities have been nearly locked out as the coronavirus has claimed the lives of more than 3,500 residents statewide.
Almost entirely out of the picture are nursing home inspectors, employed by the state Department of Health and coordinated by the federal government, who are responsible for ensuring that the facilities comply with federal health and safety requirements.
“Nursing facilities are essentially free of public scrutiny right now, at a time when scrutiny is more important than ever,” said Susan Dooha, executive director of the Center for Independence of the Disabled in New York.
At his Thursday coronavirus briefing, Gov. Andew Cuomo announced that the state health department and Attorney General Letitia James will begin a joint investigation of nursing homes. Facilities that are not following federal and state requirements, including on infection control, “can be subjected to a fine or they can lose their license,” he said.
Asked by THE CITY about nursing home inspections until now, Cuomo said: “They do it on an ongoing basis.”
Dooha’s organization oversees the New York City long term care ombudsman office — a consumer advocate for residents of nursing and adult care homes funded by the state and federal government.
In normal times, federal law guarantees ombudsmen round-the-clock access to residents. Now, they can only investigate complaints by telephone, which can be a challenge for residents with cognitive or physical disabilities.
“We are especially worried because of the lack of coronavirus testing, short staffing and poor infection control history,” said Dooha.
Families of residents have been unable to visit loved ones for weeks, under restrictions barring them from facilities to minimize chances of outsiders bringing in the virus, except in “end of life situations.”
On March 4, the federal Centers for Medicare and Medicaid Services ordered state nursing home inspectors to suspend routine inspections and focus on COVID. It directed states to check on facilities that have a track record of dangerous infection control violations, and to prioritize infection control, allegations of abuse or neglect, and complaints of conditions that may cause serious harm or death.
But so far, no top-priority, special infection control inspections have occurred at nursing homes in New York State, let alone New York City, the epicenter of the coronavirus pandemic in the United States.
Of the 69 infection control inspections conducted in nine states from March 27 through April 3, only 19 found infection control violations and all but three were classified as posing no harm to residents, said Toby Edelman, a senior policy attorney at the Center for Medicare Advocacy, who reviewed the findings.
“Inspectors made some effort to go to facilities in COVID epicenters, so it seems odd that none were in New York,” she said.
CMS and the New York State Department of Health, which employs the inspectors under an agreement with CMS, declined to respond to requests for information about inspections.
Mass Fatalities
As of April 21, 3,505 nursing home and adult care home residents have died as result of the coronavirus in New York State, according to state Department of Health data. Those include 2,120 in New York City.
The state has also released a more limited list of 1,286 fatalities as so far reported by individual nursing homes. At five of those in New York City, between 12% and 18% of residents died from the virus, measured by the homes’ average occupancy in February.
Among those is Sapphire Center for Rehabilitation and Nursing in Flushing, Queens, which reported 26 residents dead.
Assemblymember Ron Kim (D-Queens) said the Department of Health sent inspectors there last week, but only after he took to social media to demand an investigation.
An official with New York City’s nursing home ombudsman program says more inspections are needed at homes with multiple COVID fatalities.
“The facilities that have the highest number of reported deaths should be prioritized for inspections to give families answers as to whether they followed the appropriate guidance to control the virus,” said Deirdre Garrett-Scott, director of New York City region for the state long term care program.
Gov. Cuomo agrees, saying Thursday, “That is going to be one of the criteria for the investigation that the Department of Health and the Attorney General are undertaking.”
The state ombudsman office is aware of only one infection control inspection in New York City, at Brooklyn’s Crown Heights Center for Rehabilitation and Nursing on April 4, she said.
“We are still getting complaints from family members throughout the five boroughs,” said Garrett-Scott. ”Families are clueless – they are not getting information, not only about how many cases or deaths but they’re not getting regular reports about how their loved ones are doing.”
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