‘Perfect storm’ in nursing homes
shows need for stronger oversight
COURIER LIFE, MAY 15-21, 2020 29
OP-ED
BY JUSTIN BRANNAN AND
MARK TREYGER
While the entire
state has been focused
on ensuring our hospital
system could handle
the COVID-19 crisis, a
perfect storm has been
quietly brewing inside
a different facility altogether:
our city’s nursing
homes.
Throughout the past
two months, our offi ces
have heard that many
nursing homes — which
are full of the population
most vulnerable to
this specifi c virus — are
direly understaffed, severely
lacking in PPE,
and massively underprepared
for a viral outbreak.
The situation is
bleak, and it exposes
both a massive weakness
in how our city cares for
the elderly, and an unfathomable
slowness on
the part of the state to
rein in this crisis.
We started getting
calls in mid-March that
worried us.
First came reports
of nursing homes refusing
to share information
with residents about the
presence of positive cases
in the facility. We would
hear that entire sections
of the nursing homes
had been cordoned off,
that ambulance trips to
hospitals were increasing,
but that the residents
still had not been
told whether there were
positive cases. Families,
feeling panicked and
wanting to have the information
they need to
make decisions about
the care of their loved
ones, would call the facility
repeatedly, but the
facility would refuse to
give answers. Indeed,
even when our offi ces
would attempt to contact
these nursing homes, we
as elected offi cials would
be ignored by administration
and staff.
Then the more diffi -
cult calls started coming
in. Reports of residents
who the nursing home
had transferred to the
hospital, but the emergency
contacts had never
been notifi ed. Residents
who were informed that
their loved one had been
showing symptoms only
after they had passed
away. Family members
who were informed of
a resident’s death and
then immediately told to
pack up their loved one’s
belongings within fi ve
hours to make room for a
new patient.
And the number of
calls from nursing home
administration to our
offi ces, asking for help?
Zero.
Nursing homes fall
under the jurisdiction of
the state, not the city. The
state is responsible for
ensuring that the homes
are following protocol,
and the state is charged
with the duty of investigating
any misconduct
by the nursing home. As
city offi cials, we have
been watching the crisis
unfold and trying to
sound the alarm with
the state, while frantically
trying to outfi t our
nursing homes with PPE
— one of the few things
we have the power to do,
here. But the problem is,
it took entirely too long
for the state to step in
in this case, and their
actions have been halfmeasures
at best.
Indeed, Gov. Andrew
Cuomo issued an executive
order on April 15 —
a full MONTH after our
offi ce started getting
calls from family members
— requiring them
to disclose new positive
cases and COVID-related
deaths to residents and
family members. The
data now made public
has exposed the scale of
this crisis: nearly 2,000
people have died in New
York City nursing homes
as of May 1.
However, that data
should have led to decisive
and swift action
to immediately address
the problem, but the
messaging and efforts
by the state have been
mixed and confusing at
best. Cuomo has since
focused his efforts on
ensuring that nursing
homes do not turn away
potential patients due
to testing positive for
COVID-19, but that is
the exact opposite of the
action we should be taking.
With 25 percent of
all reported statewide
deaths occurring in
nursing homes, facilities
that are unequipped to
handle this crisis should
not be taking any new
patients whatsoever,
and the state should be
involved in transferring
existing residents who
wish to leave to other,
safer facilities — hospitals,
for instance, or
off-site facilities like the
Javits Center.
Immediately after
Cuomo issued his executive
order, our offi ces
sent a letter to city and
state health offi cials requesting
how they plan
to address the lack of
safety protections at
nursing and rehabilitation
centers. It became
apparent to us that we
cannot rely on private
nursing homes to operate
on an honor system
and self-report to the
state whether or not they
can accurately communicate
their needs and
defi ciencies as well as
coronavirus infections
and death rates.
As Cuomo himself
pointed out, every resident
is a source of income
for the nursing
home. When the residents
are removed by
the state, they lose out on
that income. This could
explain the silence and
the refusal to admit
an inability to properly
manage the care of
nursing home residents
— especially given that
many nursing home
executives take home
a salary approaching
seven fi gures.
The state needs to
take a proactive role in
monitoring and enforcing
protocols for detection,
containment,
treatment, and reporting
— starting yesterday.
We know that the
staff in these facilities
are overworked, underpaid,
and merely following
the less than
suffi cient protocol that
had been put in place
to respond to this virus.
However, there is
no excuse for the lack
of transparency and accountability
we are seeing
from nursing home
administration right
now. We need to expect
more from the administration
and leadership
of these facilities, and
absent that leadership,
we need to enact stronger
and more aggressive
government oversight
moving forward.
The deaths and numbers
of positive coronavirus
cases are already
distressing. If the state
does not act soon, we
fear we will look back
on these few months
and realize that nursing
homes were ground
zero of the COVID-19
pandemic, and that we
could have prevented
this from happening
from day one.
Mark Treyger and
Justin Brannan and both
New York City Councilmen
who represent parts
of southern Brooklyn.
Firemen don personal protective equipment as they enter the Cobble Hill Health Center nursing home, one of the worst hit
residences by the pandemic in Kings County. REUTERS/Lucas Jackson