Former Governor Andrew Cuomo and his political critics have something in common: They’re both trying to drag Minnesota Governor Tim Walz into Cuomo’s nursing home scandal.
Cuomo’s attempt to hide behind Walz, like so many of his other defenses on this issue, is based on bunk.
On Monday, Cuomo agreed to appear before the House Select Subcommittee on the Coronavirus Pandemic, which has been investigating his administration’s much-debated March 2020 directive compelling nursing homes to admit Covid-infected patients.
In a defiant statement on the upcoming hearing, set for Sept. 10, Cuomo repeated his claim that a dozen other states had issued the same policy as New York’s – and pointedly included a quote from Walz defending Minnesota’s version: “This was federal guidance. This was what everyone was doing.”
Cuomo’s implied message for fellow Democrats: An attack on Cuomo is also an attack on the party’s nominee for vice president.
The analogy has also been used to denigrate Walz, with one commentator asserting that Walz had implemented “the exact same policy” as Cuomo on nursing homes, which the commentator said was “disqualifying.”
In fact, Walz’s nursing home guidance differed from Cuomo’s in critical ways.
First, Minnesota’s four-page guidance document, issued April 8, 2020, was permissive rather than prescriptive. It allowed transfers of infected patients from hospitals to nursing homes but did not require them.
Second, Minnesota’s guidance included caveats and restrictions. It specified that homes receiving such patients should be “equipped to provide appropriate care and ensure the safety of vulnerable adults” already in the facilities. It encouraged hospital discharge planners to prioritize facilities that were solely dedicated to Covid-positive patients, or that had established isolated Covid wings with separate staff.
Third, Minnesota’s guidance said patients could be transferred without being tested, but did not forbid homes from waiting on test results.
Fourth, it referenced other guidance documents from the CDC, the Centers for Medicare & Medicaid Services (CMS), the Minnesota Department of Health and a professional organization for nursing home operations – and provided links to each.
By contrast, New York’s directive of March 25, 2020 used prescriptive language, saying “all [nursing homes] must comply with the expedited receipt of residents returning from hospitals” (emphasis added).
Its key paragraph, which was underlined, said, “No resident shall be denied re-admission or admission to the [nursing home] solely based on a confirmed or suspected diagnosis of COVID-19.” It added that requiring a patient to be tested before admission was “prohibited.”
The one-page document included no caveats about the nursing homes’ readiness to handle infected patients or specifics about the precautions they should take. It made no explicit reference to the safety of other residents.
Finally, it did not cite the CDC or CMS, but instead linked to a page of guidance from the state Health Department.
Walz later faced criticism for not doing more to restrict Covid-infected transfers to nursing homes – by steering them away from facilities with poor quality ratings and high fatality rates.
New York, by contrast, effectively mandated more than 9,000 transfers into nursing homes – regardless of quality ratings and mortality rates – for more than six weeks before the policy ended on May 10.
Because the order came from state officials exercising emergency powers in a crisis, some industry officials reasonably believed that it was meant to override all other rules and regulations
Cuomo and his aides would later contend that nursing homes were always obliged to follow federal guidance and to turn away patients they couldn’t safely handle. But they sent that message only after the policy had been in place for weeks. They also cited a regulation that Cuomo had suspended by executive order earlier in March.
In an earlier response to the House subcommittee’s investigation, Cuomo said the state had followed CDC and CMS policies issued on March 4, 9, 13 and 23, 2020. But all of those versions of federal guidance called for allowing transfers rather than mandating them. They also emphasized that nursing homes must be able to follow “transmission-based precautions” – i.e., infection control – before accepting any such patients:
A nursing home can accept a resident diagnosed with COVID-19 and still under Transmission-Based Precautions for COVID-19 as long as the facility can follow CDC guidance for Transmission-Based Precautions. If a nursing home cannot, it must wait until these precautions are discontinued.
New York’s directive included no such language.
In short, Walz can accurately say that his state followed the federal guidance, while Cuomo cannot.
In another falsehood, Cuomo’s Monday statement asserted that New York “had a lower nursing home death rate pro rata than all but 11 states.”
His basis for that claim is a 2022 paper in the Journal of Health Economics, which in turn cites data gathered by CMS.
As the study itself acknowledges, CMS did not begin collecting its data until mid-May 2020 and made it optional for homes to report deaths retroactively.
As a result, CMS is missing thousands of deaths from the worst phase of New York’s first wave. It counts fewer than 6,000 Covid deaths in New York nursing homes during 2020, which is barely half the 11,400 tallied by the state Health Department.
The CMS dataset is worthless for comparing nursing home death rates among states, especially in 2020 – which is something Cuomo ought to know.
More comprehensive figures indicate that New York’s nursing home death rate was higher than average – but not by much, because Covid-positive transfers were one of many ways that the virus found its way into the facilities.
Cuomo’s continued resort to false arguments and bad data fits his pattern on this issue.
From the beginning, Cuomo has chosen to deflect, deny and deceive rather than acknowledge wrongdoing or error. He waged an 11-month campaign to hide the complete death toll in nursing homes, releasing the data only after a court ordered him to do so.
That strategy helped win him an impeachment investigation, his resignation as governor and, now, what’s likely to be a public dressing-down in Congress.
Where will it take him next?