As the Cuomo administration takes heat for withholding data on coronavirus in nursing homes, it’s worth noting that the federal government’s reporting is also flawed and incomplete.

Since mid-May, the Centers for Disease Control and Prevention (CDC) has required homes to submit detailed weekly reports on coronavirus, including counts of infection deaths among both residents and staff, as well as information on testing and access to masks and other infection-control equipment.


This is an installment in a special series of #NYCoronavirus chronicles by Empire Center analysts, focused on New York’s state and local policy response to the coronavirus pandemic.


However, the CDC made it optional for homes to retrospectively report what happened in March, April and early May – which is when New York’s pandemic was at its worst.

Most facilities appear to have chosen against providing the retrospective data, with the result that CDC’s total count of deaths in New York as of Aug. 23 was just 4,610, about 2,000 less than the state Health Department’s flawed official tally.

Worse, the CDC does not clearly identify which homes did the optional reporting, making valid comparisons among facilities, regions and states difficult if not impossible.

The state’s count has been deservedly faulted for leaving out thousands of nursing home residents who died after being transferred to hospitals, something done by few if any other states. This significantly understates the impact on nursing home residents and their loved ones, and skews New York’s statistics in relation to the rest of the country.

The CDC more logically counts the coronavirus-related deaths of all residents, regardless of where they were in their final hours. The CDC also presents the data in spreadsheet form, dated by week, whereas the state posts an undated PDF file that’s awkward to work with.

The advantages of the CDC’s methodology are largely negated by its incomplete and inconsistent reporting from March to early May, which was the critical period of the pandemic in New York and other Northeast states.

In spite of those flaws, the CDC data set does raise questions about the accuracy of New York’s reporting.

For the weeks after May 24 – when the CDC mandated reporting for all homes – the agency recorded 956 coronavirus deaths as of Aug. 23, the most recent date available. That number is almost 50 percent higher than the state Health Department’s total for the same period, which was 646. That implies that roughly one out of three residents were transferred to hospitals before dying, and therefore not reflected in DOH’s count.

Assuming that ratio applies to the nursing home fatalities throughout the pandemic, the state’s full toll would be approximately 9,600, or 3,100 higher than the official count.

For certain homes, the CDC data show higher death tolls than the state – suggesting that these facilities opted for retrospective reporting back to the beginning of the pandemic, and not just since mid-May.

The widest disparity is seen at the Upper East Side Nursing and Rehabilitation Center in Manhattan, where the state count through Aug. 12 was 14 deaths but the federal count through July 26 was 95 (see table). Of the 25 highest tolls in the CDC data, nine were more than double the number reported by the state.

If the CDC were to mandate full reporting from all homes, it seems likely that more such discrepancies would emerge.

The Health Department has been requiring homes to report the coronavirus deaths of all residents, both within and outside their facilities, through its Health Emergency Response Data System, or HERDS. To date, however, the agency has held back the count of hospital deaths, omitting it even from its own report on the pandemic in nursing homes.

At legislative hearings last month, Commissioner Howard Zucker told lawmakers who pressed him on the issue that he wanted to verify the accuracy of the numbers before releasing them.

The department has also postponed the Empire Center’s request for the data through the Freedom of Information Law, questionably claiming that it needed more time to conduct a “diligent search” for the information.

The result is that a major public health disaster affecting New York’s nursing home residents is not being accurately documented by either of the agencies responsible for protecting them – because state officials are refusing to share the true numbers, and federal officials haven’t yet asked for them.

 

About the Author

Bill Hammond

As the Empire Center’s senior fellow for health policy, Bill Hammond tracks fast-moving developments in New York’s massive health care industry, with a focus on how decisions made in Albany and Washington affect the well-being of patients, providers, taxpayers and the state’s economy.

Read more by Bill Hammond

You may also like

Answers needed on Governor Hochul’s health-care budget

The health-care agenda laid out by Governor Hochul in her budget proposal this week leaves a lot of questions unanswered. Here are a few of them. Read More

Putting Governor Hochul’s $10 billion health-care ‘investment’ in context

In her State of the State address this week, Governor Hochul prominently called for a $10 billion "multi-year investment" in the state's health care system, including $4 billion earmarked for wages and bonuses, with a goal Read More

Hochul faces a test on health insurance costs

With judicious use of her veto pen this month, Governor Hochul could draw a line against spiraling health expenses for consumers and taxpayers. Several health insurance-related bill Read More

The Health Department takes a big step toward COVID transparency

The state Health Department released a flurry of 20 COVID-related data sets this week, taking its biggest step yet toward full transparency about the state's pandemic response. Read More

When COVID-19 struck, a lot of the state’s pandemic stockpile was out of date

Much of the material in the state's pandemic stockpile had passed its expiration date when the coronavirus crisis struck in March 2020, according to newly released Health Department records. Read More

Sluggish in September: NY job growth still trails U.S.

New York's employment recovery slowed to a near halt in the crucial month of September, falling further behind the national growth rate in the 18th full month since the pandemic hit in March 2020, according to and federal monthly job reports. Read More

The Health Department’s response to a FOIL request for nursing home data triggers 2020 déjà vu

Despite Governor Hochul's promise of transparency, the Health Department keeps responding to requests for COVID data with tactics from the Cuomo administration Read More

Hochul’s Emergency Order Imposes Insurer Restrictions Sought by Hospital Group

Buried in Governor Hochul's emergency order on health-care staffing is a temporary bar against insurance companies challenging claims submitted by hospitals–and an influential hospital association is taking credit. Read More

Subscribe

Sign up to receive updates about Empire Center research, news and events in your email.

CONTACT INFORMATION

Empire Center for Public Policy
30 South Pearl St.
Suite 1210
Albany, NY 12207

Phone: 518-434-3100

General Inquiries: Info@EmpireCenter.org

Press Inquiries: Press@EmpireCenter.org

About

The Empire Center is an independent, non-partisan, non-profit think tank located in Albany, New York. Our mission is to make New York a better place to live and work by promoting public policy reforms grounded in free-market principles, personal responsibility, and the ideals of effective and accountable government.

Empire Center Logo Enjoying our work? Sign up for email alerts on our latest news and research.
Together, we can make New York a better place to live and work!