Mass deaths in New York nursing homes

As federal and state governments begin advancing plans to “reopen the economy” and force workers to “get back to work,” the COVID-19 pandemic continues to disproportionately reap the lives of New York’s most vulnerable, with the unfortunate residents of the state’s nursing homes being especially at risk.

Over the past two weeks, numerous scandals have exposed management coverups of chronic understaffing, acute shortages of personal protective equipment (PPE) and other vital supplies and the grisly storage of corpses in “makeshift morgues” at nursing homes. Across the US, over 10,000 people have now been confirmed to have died from COVID-19 in nursing homes.

Recently released New York state data reveals that at least 3,505 residents of nursing homes and assisted living facilities have died from confirmed or suspected COVID-19 illness, almost 23 percent of the state’s official death toll of 15,302.

Even these numbers, however, are greatly deflated. A recent New York Times study showed that at least 4,000 people had died from COVID-19 and gone unreported in New York City, which would make for a staggering 298 percent increase in the city’s death toll between March 11 and April 18 to at least 17,200.

Democratic Governor Andrew Cuomo did not issue an executive order requiring nursing homes to report the deaths until last Friday, a half-hearted attempt at reversing policies that have undercounted deaths and exacerbated suffering for the elderly and the health care workers caring for them. Nursing home operators in New York are still only required to report those who perish within their facility and not at hospitals, and only if the total is above five residents “for privacy purposes.” Moreover, with a very limited ability to test, many deaths from COVID-19 will not be reported as such. Even this move came only after a continued public outcry from relatives who have been kept in the dark for weeks and public protests by nursing home workers.

In one particularly ghastly incident, it was revealed that at a nursing home in East New York in Brooklyn, management had left 10 corpses in a room with residents. The windows were open, and the air conditioner was on. The scandal became public after workers at the home held a demonstration to bring attention to the horrific situation.

The numbers that have since been released, while still underrepresenting the real death toll, are staggering. A state report lists several facilities that have reported fatalities of over 40 victims in Brooklyn, Queens, the Bronx and Staten Island. At Bensonhurst Center for Rehabilitation and Healthcare in Brooklyn, 34 people have died, 17 percent of the residents. In another facility, 55 have died. Ten facilities reported 30 or more deaths.

Even as testing has remained extremely limited, eight percent of the city’s 40,000 nursing home residents had tested positive by April 15. Virtually every single facility in New York City has confirmed positive cases. Manhattan nursing homes had an infection rate of 123 per 1,000, 60 percent higher than the rest of the city. Queens, which has seen over 4,000 deaths of COVID-19 in total, more than any other borough, has also been leading in the fatality rate among nursing home residents with 53 deaths per 1,000.

At the Ozanam Hall nursing home in Bayside Queens, where over 50 residents have died of COVID-19, staff complained about the lack of PPE to THE CITY, a news website. They reported that they were forced to place asymptomatic patients with others who had been known to have had the virus. One nurse’s aide complained of trying to deliver care to the residents under dangerous conditions, stating, “We are not comfortable, but they still have to get care. We try and protect ourselves as best we can.”

Workers complained about being understaffed to the point that they have to regularly work double shifts or risk being fired. They also spoke of the despair they felt upon witnessing residents for whom they have cared and known a long time suddenly perish. Nursing home staff have also been heavily affected by the spread of the virus. Over 40 employees were out sick last week at this facility alone with COVID-19 symptoms. There have been reports of nursing home staff being forced to work while sick, a phenomenon also widely reported by hospital workers in New York.

Despite Cuomo’s order, many nursing homes still are not reporting their data. A nurse at Workmen’s Circle MultiCare Center in the Bronx, which is not listed in the official data, told THE CITY last week that in one unit of 12 patients, six had died over the previous week. She was overseeing a total of 45 patients per shift, and about one quarter of them were showing symptoms of COVID-19. She said, “It’s very stressful. When they’re sick, it’s very hard to know, who do you go to first? How closely can you actually monitor those people?”

A nurse supervisor at that facility also recently died from COVID-19. Another nurse said, “It’s very upsetting. Sometimes I go home after a shift, and I just cry because it’s so sad.”

A similar situation reigns at other facilities that are not reporting numbers of infections and deaths among either patients or staff. Hebrew Home in Riverdale, one of the largest nursing homes in the state, saw at least 17 staff members fall ill and 45 residents die between mid-March and April 7. It is still unclear how many of these deaths were related to COVID-19.

Doctors at hospitals report receiving completely neglected patients from nursing homes. One doctor told THE CITY that they had received one patient with very elevated sodium levels, suggesting she had not had anything to drink in days. “It’s the folks coming from nursing homes—these signs of basic neglect that are so deeply unsettling and heart-wrenching. I suspect what’s happening is that these nursing homes are probably overwhelmed.”

Based on a New York state Department of Health directive from March 25, nursing homes must readmit confirmed yet stable COVID-19 patients after their discharge from hospitals, all but ensuring the quick spread of the highly communicable disease among the residents.

As has been the case internationally, the policies by the state have first contributed to the spread of the virus and were then aimed at covering up the extent of the deaths in the facilities. Up until Cuomo’s recent executive order, nursing homes have only been asked to share information regarding COVID-19 infection in their facilities with relatives, who under the given circumstances, have been conflicted about whether or not to remove their family member from the facilities.

That and other policies, such as the prevention of all visitation by relatives, has resulted in a complete absence of transparency and a situation where the profit-motivated management of these facilities has been allowed to cover up the true extent of the death toll for weeks.

The situation has been further compounded by industrywide poor standards of care and the absence of minimum staffing requirements. Inspections conducted by the Centers for Medicare & Medicaid this year revealed that one in three nursing homes in the US did not follow proper hand-washing guidelines and did not properly use PPE. These horrifying conditions are the direct result of the subordination of nursing home care to private profit and decades of ongoing cuts to social programs like Medicaid. In New York, $126 million were slashed from Medicaid payments to nursing homes this year alone, with another $496 million projected cuts in the years ahead.