Hearing Wrap Up: “Must-Admit” COVID-19 Nursing Home Mandates were Deadly for Elderly Americans, State Officials Responsible
WASHINGTON — The Select Subcommittee on the Coronavirus Pandemic held a hearing titled “’Like Fire Through Dry Grass’: Nursing Home Mortality & COVID-19 Policies” to gather facts about pandemic-era, nursing home policy decisions — specifically in New York, New Jersey, and Pennsylvania — that led to the deaths of tens of thousands of Americans. Select Subcommittee members from affected states detailed the effect of disastrous COVID-19 nursing home policies on their elderly populations and detailed how state officials prioritized personal political gain over the health of elderly Americans. Witnesses testified that it was known from the early data and science that COVID-19 would be lethal in elderly care facilities. Witnesses also shared their personal stories of loss, grief, and neglect due to former Governor Andrew Cuomo’s mandates. Members on the Select Subcommittee also discussed the blatant disregard for CDC and CMS guidance by state officials, demanded accountability for those involved in the intentional cover-up of nursing home deaths and recognized the voices of families affected by this tragedy. The Select Subcommittee is committed to furthering its investigation into these deadly policy decisions as it continues its after-action review of the COVID-19 pandemic.
Key Takeaways
Forcing nursing homes and long-term care facilities to admit positive COVID-19 patients was a catastrophic decision that had deadly consequences.
Representative Ami Bera, M.D. (D-Ca.), former Chief Medical Officer of Sacramento County, blasted state officials for issuing must-admit orders that put elderly Americans in harm’s way: “For the life of me, I can’t understand why anyone would take a COVID positive patient and put them in a nursing home where, you know, that’s medical malpractice in my mind, and that is a decision I can’t understand…I’m not a lawyer. It’s not necessarily about criminal liability, etc., but if we don’t actually know the truth, we can’t actually help you find closure.”
Dr. David Grabowski, the Democrat witness, and a Professor of Health Care Policy at Harvard Medical School, described the increased risk faced by elderly individuals during the COVID-19 pandemic: “COVID has completely devastated nursing homes in the US. After accounting for the gap in federal data at the start of the pandemic, there have been over 1.6 million COVID cases among nursing home residents leading to roughly 176,000 COVID-related fatalities. For comparative purposes, this is equivalent to 12% of all residents living in a nursing home at the start of the pandemic. There were many additional pandemic-related deaths among nursing home residents due to gaps in medical care and increased morbidity.”
Former Governor Cuomo, along with his counterparts in New Jersey and Pennsylvania, engaged in a cover-up to hide the true, nursing-home mortality rates from the public and shift political blame.
Mr. Bill Hammond, Senior Fellow for Health Policy at the Empire Center — a New York based think-tank that revealed critical nursing-home death data — testified that former Governor Cuomo covered-up his failed policy mistakes through a series of manipulative events: “Once it became the subject of some criticism and controversy, they compounded their original mistake by engaging in a cover up. They pulled the directive off the web, so that it wasn’t available for the public to read. They misstated how it would work. They misstated how it had worked. They misstated how it related to federal policy…Also, they said that this really was optional. It sounded imperative, but it was actually optional because of a regulation the state had that said nursing homes should never accept a patient that they can’t handle. It turns out that the governor had suspended that exact regulation seven days before he issued the order. Finally, and maybe worst of all in this cover up, they understated the number of deaths. When they finally came clean with the full data, which was in response to a lawsuit brought by my organization, the number was closer to 15,000, which is 6,000 more than they had previously acknowledged.”
Affected families and victims deserve answers and accountability. The Select Subcommittee will continue to investigate the failures of state officials and work to bring transparency to all Americans.
Ms. Janice Dean recounted the tragic loss of two close family members due to former Governor Cuomo’s deadly COVID-19 nursing-home policies: “Sean got a call in the late morning at the end of March 2020 and was told that his dad was not doing well. He had a fever. His breathing was labored. Three hours later, he was dead. Sean had to break the news on the phone to his mom in lockdown that her husband died. It was the hardest thing he’s ever had to do. My husband saw his mom once in early April after that to bring her some flowers. He could not pass the front desk. He saw her in the lobby for only 1 to 2 minutes, standing ten feet away with a mask on. He told her he loved her, and she started to cry before he left. He would never see her again.
“A few days later, Dee’s health went downhill. She was moved to the hospital, tested immediately and diagnosed with COVID-19. The last time Sean spoke to his mother, she told him her throat was raw. She had trouble breathing. Despite her ill health, her final words were to ask him to buy Easter presents for her grandkids and to please write her name on the card. A nurse called us the next day to tell us she was in and out of consciousness. The next day she died. Our grief and our confusion turned to anger in the days and weeks afterward, when we learned how elder care homes were turned into death traps.”
Ms. Vivian Zayas, daughter of Ana Martinez who lost her life after she was sent to an in-patient rehab facility in a nursing home following routine knee surgery, explained the devastating loss of her healthy mother because of the must-admit nursing home orders: “My mother, Anna Martinez, a physically, mentally, and emotionally strong woman in her seventies developed arthritis. It was aggressive and hampered her quality-of-life. Following doctor’s orders, in our due diligence, she underwent knee replacement surgery. Her first surgery. She was scared, but she was reassured that it was routine, and she would quickly recover after some physical therapy. After the surgery, we were full of expectation that we would see our mother in her kitchen again, cooking her amazing dishes. Our mother was in the midst of recovery at home, post-surgery when she developed a cyst. After treatment at a local hospital, she was sent to a nearby nursing home rehab facility to receive in-patient physical therapy. It was expected that she would gain strength and return home soon. A minor wound led my mom down a path into a nursing home from which she would never return.
“Our daily visits to the nursing home came to an abrupt end in March of 2020 when the facility called to notify us that all visitation would be suspended for approximately two weeks. We never saw our beautiful mother again. She was dead shortly after, gasping for air, alone, confused, and scared without her daughters, who were her translators and caregivers. She could not tell us anything was wrong or that she was exposed to COVID-19 because she was also kept in the dark. Like many other families, nursing homes kept them in the dark as well, never telling us that they were admitting COVID positive patients at the insistence of Governor Cuomo.”
Member Highlights
Select Subcommittee on the Coronavirus Pandemic Chairman Brad Wenstrup, D.P.M. (R-Ohio), discussed former Governor Cuomo’s blatant disregard for COVID-19 nursing home victims and their families.
Dr. Wenstrup: “You’ve been a fierce advocate, obviously, since the beginning on this issue. How has your governor, Governor Cuomo, treated you?”
Ms. Dean: “Well attacks, belittlement. I believe one of his aides said, well, Janice Dean, she’s not a reliable source on anything except the weather — even though I had two close family members die in separate eldercare facilities. I’m aware of, I haven’t seen them, of texts that were exchanged between Andrew Cuomo’s brother and the administration calling me interesting names that I don’t want to repeat today. But there was no sympathy. There was never a gesture of a phone call. No condolence cards. I don’t think he really met with any families. He just decided to write a book talking about how great a leader he was.”
Rep. Debbie Lesko (R-Ariz.) compared New York’s failed COVID-19 nursing home policies, particularly the “must-admit” order, to Arizona’s nursing home policies that followed CDC and CMS guidance.
Rep. Lesko: “I, quite frankly, lay the deaths of the thousands of people who died from COVID-19 in New York and other states that required nursing homes to take in COVID-19 infected people, at the feet of the state officials who decided that mandate. To show the significance in the difference between what state officials’ policies did, let me compare the differences between New York and Arizona, where I live. Arizona has lots, LOTS of senior citizens, lots of long-term care facilities. So according to the Atlantic’s COVID tracking project, New York had 14,450 deaths across 698 long-term care facilities. That is 21 deaths per facility. Conversely, in Arizona, which has a very large senior population, there were 2,505 COVID deaths across 1000 long-term care facilities. That’s 2.5 deaths per facility. So, you compare 21 deaths per facility in New York to 2.5 COVID deaths per facility in Arizona. So that’s not a federal problem. That’s a state problem. And so we have to ask why? Well, unlike New York, New Jersey and Pennsylvania, Arizona never, NEVER required nursing homes to admit COVID-19 patients. That’s the difference. That’s the problem. And somebody better be held accountable because this pisses me off.”
Rep. Nicole Malliotakis (R-N.Y.) revealed a report issued by New York Attorney General Letitia James which proved that former Governor Cuomo’s Administration undercounted the total number of nursing home deaths by as much as 50%.
Rep. Malliotakis: “It wasn’t until the Attorney General accused Cuomo and his cohorts of underreporting, and the Empire Center — which we thank Mr. Hammond for being here today — we need a court order releasing the complete data. So my first question, Mr. Hammond, your organization did a tremendous public service fighting to obtain this information and complete, the complete data. How was the information manipulated based on your assessment?”
Mr. Hammond: “So starting in April, the state was releasing counts not just of how many people had died generally, but also a separate number for nursing homes. And then a few weeks later, they modified how they were releasing that to take out the cohort of residents who had died after a transfer to a hospital. So, when they got sick, they got sick enough that they needed hospital care, they were probably put in an ambulance, taken to a hospital, and then they died in the hospital and the state stopped, including those people. It had data on how many of those people there were, but it backed them out of its daily reports.”
Rep. Malliotakis: “And why would they do this, in your opinion?”
Mr. Hammond: “I believe they were trying to make the situation in nursing homes look less bad than it was because it was embarrassing to them.”
Rep. Malliotakis: “And because they did not comply with the CDC guidance and CMS guidance.”
Mr. Hammond: “Yeah, they were probably aware, because of the order that had been issued, that they were going to be blamed for how bad things got.”
Rep. John Joyce, M.D. (R-Pa.), slammed Pennsylvania state officials for following in New York’s footsteps and issuing must-admit nursing home orders, while simultaneously shielding their own family members from these harmful policy decisions.
Dr. Joyce: “CMS Administrator Seema Verma said that ‘under no circumstances should a hospital discharge a patient to a nursing home that is not prepared to take care of those patient’s needs.’ Yet only three days later, the Pennsylvania Department of Health issued guidance mandating that nursing homes accept patients even after they had tested positive for COVID-19. Must-admit nursing home orders willfully and deliberately disregarded CDC and CMS guidance. Now, Admiral Rachel Levine, then Pennsylvania’s Secretary of Health, moved her own mother out of a personal care home as patients with COVID-19 were being moved in — a decision that ultimately led to more infections and more deaths among our state’s seniors. While shielding her own family, which was a luxury that was not afforded to many Pennsylvanians, these disastrous public health policies led to an insurmountable amount of pain and grieving for families who lost loved ones. My office received calls from constituents who were refused the chance to visit dying spouses, parents, and grandparents, yet this committee has been stonewalled by requests for more information regarding these must admit orders. It’s time to have accountability. It’s time to have accountability for failures and cover-ups that led to thousands of needless deaths. Dr. Grabowski, given the guidance issued at that time in March of 2020 by CMS, was there a good rationale for the must-accept orders issued in Pennsylvania and in other states?”
Dr. Grabowski: “That policy was a mistake.
Dr. Joyce: “I agree. It was an incredibly lethal mistake that was made.”
Rep. Rich McCormick, M.D. (R-Ga.), detailed his experience with COVID-19 illness and death as an Emergency Room doctor during the height of the pandemic
Dr. McCormick: “Let me tell you, I also witnessed as an E.R. doctor, I watched families struggle with this. Once we were no longer able to allow families into the E.R., I watched people die by themselves. I held the hands of people who were dying and looked in their eyes and told them I was going to do my very best, but knew there is very little I could do because we didn’t know what to do. I watched and prayed with people knowing that the outcome was going to be very poor and knowing we were doing some things very wrong over time. And realizing, as it continued, I became very aware that the government was the biggest problem of all. They didn’t help this pandemic. They got in the way of the conversation. They interjected themselves between the professionals and the patients. They kept families apart. They didn’t let people even die with dignity or with any choice in their own health care. Let me ask you this. This is my take home. Why do we keep on turning back to the government to solve the problems that the government created? That’s what I get out of this.”
