EDITORIAL: Independent probe needed into nursing home devastation

Two thoughts occur upon reading the New York State Department of Health's report on the deaths of nursing home residents from Covid-19:

--Given the numbers, its conclusion is plausible: that factors other than an unfortunate state policy were responsible for most of the deaths within those facilities.

--The report will nonetheless and necessarily be seen as a political document. The Department of Health reports to Gov. Andrew M. Cuomo, who instituted the policy requiring hospitals to discharge Covid-positive residents back to their nursing homes if they could care for themselves.

It's well established that governments can't credibly investigate themselves, so even if the report is accurate, it lacks the arms-length impartiality that would lend it broad credibility.

Unfortunately, that approach encourages a political response -- which State Senate Minority Leader Rob Ortt of North Tonawanda was only too happy to provide. None of it helps with what is more urgent: ensuring that New York clearly understands what happened and devises a plan that will better deal with a second wave of infections, considered by some to be all but inevitable.

The report, issued on Monday, concluded that nursing home deaths were driven more by nursing home staff and visitors than by the state's policy, which was instituted in part to ensure that urgently needed hospital beds would remain available for other Covid-19 patients. In that regard, it's fair to say that, if the policy was mistaken, its reasoning was at least defensible and that the decision was made under high pressure and in the dark.

Federal figures lend some credence to the Health Department's conclusions. New York State had the nation's highest number of infections as the crisis took hold in March and April, but its rate of nursing home infections and deaths is more restrained.

According to data from the Centers for Medicare and Medicaid Services, New York's nursing home infections per 1,000 residents was the 14th highest in the country as of June 21. That was better than all adjoining states except Vermont.

Deaths per 1,000 residents were similar: New York suffered the nation's 10th highest rate but, again, Vermont was the only adjoining state with a better record.

Does that mean that sending residents back to nursing homes made no difference? That's unlikely, given that Cuomo eventually reversed the policy. What it does mean is that the state should welcome an independent review that would give New Yorkers a more reliable evaluation.

Most likely, a joint Senate and Assembly committee would conduct such a review and while both chambers are, like the executive branch, in control of Democrats, it is an independent body. Its Republicans would presumably have a role in which they could explore issues they believe to be important.

Until then, what is important is to understand that both Cuomo and Ortt are pitching from political mounds. Cuomo contends that the report makes clear that the policy didn't significantly influence deaths in nursing homes, but by its nature, it can't do that. It's too closely tied to him.

Ortt, meanwhile, goes over the top, claiming without evidence that "Cuomo's phony whitewashed report" amounts to a "cover-up." But Ortt's hyperbole is no more reliable than the Health Department report, and probably less so, since the report at least relies on actual numbers.

The consequence is that New Yorkers are left with no truly reliable sense of what went wrong in the state's nursing homes -- and what could go wrong in the future, if the pandemic once again overruns New York.

Fortunately, the Legislature is interested not just in the subject of Cuomo's policy, but a range of relevant questions.

"There are a lot of other issues relating to nursing homes and Covid-19, including staffing levels, adequacy of Health Department quality and safety enforcement and adequacy of funding," said Assemblyman Richard Gottfried of Manhattan, the chairman of the Assembly's health committee. "Those issues were serious long before Covid-19, which has made the problems even worse. That's why we plan to hold legislative hearings."

That sounds like someone who is serious. Given that nursing home deaths were a national problem, and not one invented in New York, we'll wait for the results of those hearings before drawing any conclusions.

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