From Cuomo Spokesman Rich Azzopardi:
This report clearly states what we have said since the beginning, the state ‘provided appropriate guidance that was consistent with universal best practices in congregate care and accurately reflected the best understanding of the scientific community at the time they were issued.’ It also plainly states that our data collection standards regarding where a person passed away were not only well established but also state law and took both reports from the Attorney General and the State Comptroller to task for issuing reports on nursing homes COVID policies that “were routinely devoid of input from appropriate State subject matter experts and frequently contained inflammatory language that stoked public fears. This examination is a sharp contrast with the partisan farce that is the Congressional COVID subcommittee and while we don’t agree with all their conclusions, the facts presented are indisputable. However, dumping it on a Friday in the middle of summer tells me that those who commissioned the report didn't want anyone to actually read it.
Overall take away of nursing home policies during COVID:
"While NYS policies with a direct impact on skilled nursing and congregate care facilities were frequently rushed and uncoordinated, they ultimately provided appropriate guidance that was consistent with universal best practices in congregate care and accurately reflected the best understanding of the scientific community at the time they were issued. COVID-19 highlighted many preexisting discrepancies in the level of care available at NYS nursing homes." (page 56)
"NYS issued 480 policies and directives associated with the health and human services sector. Of these, 106 policies or directives were related to skilled nursing facilities, rehabilitation facilities,congregate care and long- term care facilities...this analysis found that they were issued in good faith based on the information that was available at the time the policy decisions were made." (p59)
On March 25 DOH admission guidance:
"The State is required by virtue of the applicable federal standards to have planning and processes in place to execute medical surge strategies to preserve the capacity to provide life-saving clinical care. It is also obligated to ensure that people are not discriminated against due to their health conditions. The policy to admit or return COVID-19 patients to nursing homes following hospital admission was an attempt to accomplish both standard public health disaster practices." (p66)
"Like other strategies put into place to manage the medical surge, the State relied on the standards of infection control and public health disaster management to preserve the acute care capacity of the health system... The admission and re-admission to nursing homes strategy could only be as effective as the successful application of standard infection control practices in the receiving nursing homes. These standards have long been required by state and federal law, and by state and federal guidance specific to COVID-19, and include actions like universal precautions, appropriate use of PPE, physical distancing, isolation, quarantine, surveillance, and testing." (p59–60)
On Reporting and the Comptroller/ AG Reports:
“For example, reports from the Office of the Attorney General and the Office of the Comptroller attempted to provide actionable and accurate real time assessment of the situations in nursing homes. However these documents were routinely devoid of input from appropriate State subject matter experts and frequently contained inflammatory language that stoked public fears.’" (p58)
"Interviewed representatives from the NYSDOH and other NYS agencies that provided congregate care were quick to point out the adherence to state law for reporting as the primary cause for the variance in attribution of deaths related to nursing homes. They also noted that they were not consulted by the Comptroller’s office for their input or perspective before issuing the report." (p63)
"Failing to anticipate the potential for raising public concern, the State then failed to effectively and broadly communicate specifically why the reporting varied over time and generally why public health data changes were not made when better data was obtained or poor data could have been replaced. The State’s antiquated technology and data systems did not help it avoid those issues.
"Furthermore, accusations flew when the Comptroller’s audit was released. The appearance was of a badly fractured state government, which does not help instill confidence. The Office of the State Comptroller is not required to consult with the agencies it is auditing. Had it done so, it may have been able to present some mitigating information in its report to help the public understand potential root causes for nursing home deaths. It may also have preserved some trust between itself and other agencies. All these degradations of trust, between constituent facilities and the State, among state agencies, between agencies and the Executive Chamber, and between the State and the public, can be understood as self-inflicted wounds." (p67)