New York state Comptroller Tom DiNapoli released a report Wednesday criticizing the state’s progress in addressing pandemic-related issues in nursing homes.
It is in response to an initial audit in March 2022 that found the state was unprepared to respond to infectious disease outbreaks in these facilities.
The comptroller's office said their initial audit made four recommendations for the state, and of them only one was fully implemented. The governor’s office and the state Department of Health say that doesn’t tell the whole story.
“This what we call a follow-up audit,” DiNapoli said of the report. “Because of the importance of the topic, we went back in to see to what extent those earlier recommendations were followed through on.”
DiNapoli said the audit found that when it comes to resolving New York’s pandemic-related nursing home issues, the state still has work to do.
“We still feel that more needs to be done to make sure that data is being collected, that the data is accurate, particularly with regard to outbreaks and infection, and at the nursing home level that there is more guidance to make sure they are responding and reporting,” he said.
In the audit, DiNapoli criticizes the state’s efforts to implement the recommendations made:
- The DOH should evaluate and request resources as necessary to adequately address public health emergencies: That was implemented.
- It said the DOH should expand its use of infection control data to identify patterns and find ways to improve infection control: That was partially implemented.
- The DOH should improve controls over additions and deletions from the Centers for Medicaid & Medicare database: That was not implemented
- Finally, it recommended the DOH find ways to Help facilities better understand Outbreak Reporting: That was not implemented
“We still see limitations in the use of the existing reporting methods that are available,” he said.
Additionally, DiNapoli recommended that the the governor assess and document the adequacy of the internal control environment at the DOH and the executive chamber and take steps to fix it. He said that has been partially implemented.
On Wednesday, Gov. Kathy Hochul addressed the audit, stressing that her administration is making up for a decade of disinvestment while taking steps to address issues related to the pandemic.
“The agency charged with overseeing our nursing homes was basically starved to death,” she said. “I’ve had to bring in more leadership, infuse more money, try to attract more people to do this, so I agree with them that there have been problems in the past, but we are laser focused on fixing them.”
She also stressed that the state has learned from the mistakes made during the pandemic, citing her efforts to end a hiring freeze in the department that she says made it difficult to recruit top talent.
“A lot of lessons were learned the hard way,” she said. “We won't make those mistakes. Mistakes that were made in the past will not be made again.”
The Department of Health reiterated the governor’s statements while emphasizing that the report doesn’t paint the full picture, omitting some efforts to improve data systems that have been made and taking issue with what it calls the report’s implications about whether or not the course of the pandemic could have been altered using different systems.
“The New York State Department of Health was on the front lines of a global pandemic, gathering data with new and repurposed systems, and working quickly to share that information to both inform the public and guide the public health response,” the department told Spectrum News 1. “Further, upon taking office, Governor Hochul immediately took steps to expand the data in our COVID press releases to include both CDC fatalities and our state death data gathered from our Health Electronic Response Data System. We appreciate the Comptroller’s recommendations, including other actions to strengthen data tools and processes that are completed, underway, or being addressed by the Department. The lessons learned from the COVID pandemic continue to inform us, as we remain well-prepared for any new COVID outbreaks or future pandemics.”
“They need to be laser-focused on it,” DiNapoli said in response.
He said he acknowledges that work is being done but emphasizes that his office feels those impacted by the crisis deserve more from the state.
“To the governor’s credit, it’s different tone in the executive chamber in terms of transparency,” he said. “There’s a new team at the Department of Health, but there is still questions from the depths of the COVID emergency, we know those who lost loved ones still haven’t gotten a clear answer."
Meanwhile, the state Health Facilities Association praised the report's efforts to right the wrongs of the past, while stressing their belief that the current administration is working to undo issues that it says were years in the making.
“In his audit report examining the Department of Health's use, collection, and reporting of infection control data to determine if their efforts were sufficient to make informed decisions and promote strong infection prevention and control policies, Comptroller DiNapoli found that New York's persistent underinvestment in public health over the last decade may have limited the Department’s ability to prepare and respond to the COVID pandemic in the most effective way,” said President & CEO Stephen Hanse. "Nowhere is this more true than with the prior administration's disinvestment in nursing homes. For over 15 years, the prior administration cut Medicaid funding to nursing homes, jeopardizing the health and well being of the State's most vulnerable residents. In fact, New York was the only state in the nation to cut Medicaid to nursing homes in the middle of the pandemic. The Hochul administration is reversing the failed policies of the prior administration and is actively working in partnership with the Legislature, providers, and labor to reinvest in nursing homes and protect the health and well being of New York's seniors."