New York Gov. Andrew Cuomo’s top advisers successfully pushed state health officials to strip a public report of data showing that more nursing-home residents had died of Covid-19 than the administration had acknowledged, according to people with knowledge of the report’s production.
The July report, which examined the factors that led to the spread of the virus in nursing homes, focused only on residents who died inside long-term-care facilities, leaving out those who had died in hospitals after becoming sick in nursing homes. As a result, the report said 6,432 nursing-home residents had died—a significant undercount of the death toll attributed to the state’s most vulnerable population, the people said. The initial version of the report said nearly 10,000 nursing-home residents had died in New York by July last year, one of the people said.
Get a coronavirus briefing six days a week, and a weekly Health newsletter once the crisis abates: Sign up here.
The changes Mr. Cuomo’s aides and health officials made to the nursing-home report, which haven’t been previously disclosed, reveal that the state possessed a fuller accounting of out-of-facility nursing-home deaths as early as the summer. The Health Department resisted calls by state and federal lawmakers, media outlets and others to release the data for another eight months.
State officials now say more than 15,000 residents of nursing homes and other long-term-care facilities were confirmed or presumed to have died from Covid-19 since March of last year—counting both those who died in long-term-care facilities and those who died later in hospitals. That figure is about 50% higher than earlier official death tolls.
Mr. Cuomo now faces mounting political pressure over both his administration’s handling of the pandemic in nursing homes and accusations that he sexually harassed two former staffers. Republicans and some Democrats have called for the governor to resign from office or be impeached.
Mr. Cuomo has rejected calls for his resignation and apologized for his behavior. Regarding nursing home deaths, Mr. Cuomo has said his administration followed federal guidance and acted to preserve hospital capacity.
Federal prosecutors in Brooklyn asked the Cuomo administration in February for information about nursing-home deaths, The Wall Street Journal has reported. Federal prosecutors expressed interest in the July report, people familiar with the matter said.
In response to questions from the Journal, administration officials said Thursday that Mr. Cuomo’s advisers advocated against including data on out-of-facility deaths because they had concerns about its accuracy.
“The out-of-facility data was omitted after DOH could not confirm it had been adequately verified,” Beth Garvey, a special counsel and senior adviser to Mr. Cuomo, said in a statement.
One official familiar with the back-and-forth between the Health Department and Mr. Cuomo’s advisers said state Health Commissioner Howard Zucker agreed the out-of-facility data shouldn’t be included in the report.
“[The Department of Health] was comfortable with the final report and believes fully in its conclusion that the primary driver that introduced Covid into the nursing homes was brought in by staff,” said Gary Holmes, a spokesman for the Health Department.
The Health Department updated the report on Feb. 11 to include out-of-facility deaths of nursing-home residents, saying its conclusions remained unchanged by the new data.
State lawmakers from both parties have said the out-of-facility death data was critical for them to evaluate nursing-home policies that could prevent future fatalities. They said the Cuomo administration’s decision to delay its release constitutes a coverup of data the governor knew would be damaging to his political stature.
Melissa DeRosa, Mr. Cuomo’s top aide, explained the delay to state lawmakers during a Feb. 10 meeting. She said that the state sidelined a legislative request for the data because of a U.S. Department of Justice inquiry. Ms. DeRosa said the state was concerned the information would be politicized by the administration of former President Donald Trump, according to a transcript.
The Justice Department, through its Civil Rights Division, began requesting information about nursing-home deaths from New York and other Democratic-leaning states in August.
The initial July report was the product of a Health Department study of the factors that contributed to the death toll in nursing homes. The agency undertook the study in response to complaints from state lawmakers and people who lost loved ones that a March 25 Health Department directive fostered the spread of the virus among members of the state’s most vulnerable population.
That directive said that no nursing home could refuse to readmit residents or admit new residents from hospitals solely because of a Covid-19 diagnosis.
The July report concluded that nursing homes were already rife with the virus by the time of the March 25 policy and attributed the spread to staff who brought it with them to work.
Several of Mr. Cuomo’s top advisers—who were members of his Covid-19 task force—reviewed and requested changes to the report, the Journal previously reported.
They included Ms. DeRosa; Dr. Zucker; Jim Malatras, a longtime adviser who was named chancellor of New York’s public college system in August; and Linda Lacewell, the superintendent of the New York State Department of Financial Services.
The lead author of the report was Eleanor Adams, who until August worked out of the Health Department’s Metropolitan Area Regional Office in a unit that focuses on infection control in healthcare facilities, one of the people said. Dr. Adams has since become a senior adviser to Dr. Zucker.
The initial version of the report submitted to Mr. Cuomo’s team for review included both data on deaths of nursing-home residents in hospitals and deaths of residents inside nursing homes, people familiar with the report’s production said.
While health department officials agreed to remove that data, they resisted Cuomo aides’ requests to alter the report to play down the role of the March 25 directive in the spread of the virus, some of the people said.
The report as published concluded that the directive was “not a significant factor in nursing home fatalities.”
“Covid task force officials did not request that the report conclude the March 25 order played no role,” Ms. Garvey said in a statement. “Task force members, knowing the report needed to withstand rigorous public scrutiny were very cautious to not overstate the statistical analysis presented in the report. Overall, ensuring public confidence in the conclusion was the ultimate goal of DOH and the Covid task force in issuing the report.”
The March 25 order came as hospitals were rushing to make space for an expected surge of coronavirus patients.
Nursing-home operators, learning of the policy only after it was issued, immediately objected, saying it would introduce the virus into their facilities. A national group representing nursing-home health providers said at the time that the March 25 directive was “not in the least consistent with patient safety principles.”
Covid-19 in Nursing Homes
A New York State Health Department spokeswoman Jill Montag said in August that the decision to issue the directive was “made on the merits by the public-health experts at DOH and following [Centers for Medicare and Medicaid Services] and [Centers for Disease Control and Prevention] guidelines.” Health Department officials didn’t provide an updated statement when asked on Thursday.
CMS and CDC guidance at the time said nursing homes could accept residents who had been diagnosed with Covid-19 if they could follow necessary precautions to prevent transmission.
The Cuomo administration rescinded the directive in May.
The July report said that the number of nursing-home residents who died of Covid-19 was low relative to other northeastern states when measured as a percentage of overall population. But the other states counted nursing-homes residents who died in hospitals, as well as those who died inside nursing homes.
In January, a report by the New York Attorney General said the state had undercounted nursing-home deaths and said the governor’s directive may have spread the disease.
—Lisa Schwartz and Corinne Ramey contributed to this article.
Copyright ©2020 Dow Jones & Company, Inc. All Rights Reserved. 87990cbe856818d5eddac44c7b1cdeb8