AG report finds NY nursing homes with low staffing had most deaths
New York nursing homes with the lowest staffing levels had more residents die from coronavirus, an investigation by state Attorney General Letitia James found.
The AG’s office matched hospital staffing ratings of nursing facilities issued by the federal Centers for Medicare & Medicaid Services with the state Health Department’s daily reports of nursing home COVID-19 deaths.
The same bombshell report released Thursday also claimed Gov. Andrew Cuomo’s administration publicly undercounted the COVID-19 death toll of nursing home residents by 50 percent.
“Nursing home residents died at a higher rate — deaths per average population of residents — in facilities that entered the COVID-19 pandemic with low CMS Staffing ratings. This data reflects that facilities with the highest CMS Staffing ratings had much lower death rates,” the report said.
CMS grades facilities from 1 to 5 — with 1 being the worst rating and 5 the best.
The report revealed that a stunning 343 of the 589 New York facilities — 55 percent — received poor staffing ratings of level 1 or 2. These nursing homes accounted for 65 percent of all the COVID-19 deaths through Nov. 16 — 4,401.
The death rate was 7.1 percent per 100 residents in the 77 nursing homes with the lowest 1 rating for staffing, accounting for 975 COVID-19 resident deaths.
There were 266 facilities rated level 2 for staffing, with a 6.92 percent COVID-19 death rate. These nursing homes reported a total of 3,426 deaths.
Eight facilities that had no rating accounted for 600 deaths, with a sky-high 9.67 percent death rate.
By comparison, the death rate was 4.94 percent for the 31 facilities receiving the highest rating for staffing, level 5. These nursing homes reported only 97 deaths.
“Nursing homes with CMS 1-Star or 2-Star Staffing ratings represented an outsized number of deaths, as compared to nursing homes with higher CMS Staffing ratings,” the report said.
The analysis said a resident anywhere in New York was likely to face roughly half the risk of death from COVID-19 if cared for in a 5-star facility.
The report noted that of the state’s 401 for-profit facilities, over two-thirds — a total of 280 — entered the COVID-19 pandemic with low staff ratings and over half of COVID resident deaths occurred at the facilities.
“Also concerning has been the recent trend observed by OAG of for-profit owners buying not-for-profit nursing homes in transactions that result in more for-profit facilities,” James said.
Nursing home watchdogs have long complained about inadequate staffing at nursing homes and the lack of state Health Department enforcement to address the issue — a problem exposed during the pandemic.
“Study after study has shown that nursing home staffing is perhaps the most critical indicator of the quality of care furnished to residents. The better, expert studies on COVID-19 have shown that this is particularly true during the pandemic,” said Richard Mollot, executive director of the Long Term Community Care Coalition.
“Unfortunately, New York’s nursing homes are among the lowest staffed in the country. This is due to lack of enforcement of baseline staffing standards and, as the Attorney General noted, the nursing home industry’s business model of understaffing to increase profits.”
Mollot said about 75 percent of nursing homes fail to provide sufficient staff to meet residents’ basic clinical needs.
“DOH’s failure to clearly provide information on this most important indicator of care to the public is a profound disservice to New York seniors and their families,” Mollot said.
The state health department defended its oversight of staffing levels at nursing homes.
“State law is clear: nursing homes must refuse a patient if they cannot properly care for them, and that includes having enough staff. That’s why staffing levels – among many other issues that relate to patient care – have been and continue to be a central focus of our 2,200+ nursing home safety inspections, which have led to nearly 200 citations and over $1 million in fines,” said health department spokesman Gary Holmes.
The AG’s report, he said, acknowledged that the department set up emergency contracts and staffing portals for volunteers that helped several nursing homes address staffing problems.
“We will continue to support facilities that ask for help and take action against those who operate unsafely. Bottom line: even during a global pandemic, there’s no excuse for nursing homes to let staffing levels drop to unsafe levels, and we are reviewing the report’s recommendations for further actions that may be appropriate,” Holmes said.