Ambulance crews are parked outside Andover Subacute and Rehabilitation Center in Andover, N.J., on Thursday April 16, 2020. Police responding to an anonymous tip found more than a dozen bodies Sunday and Monday at the nursing home in northwestern New Jersey, according to news reports. The ownership has since changed hands and the facilities renamed Limecrest Subacute and Rehabilitation Center and Woodland Behavioral and Nursing Center. (AP Photo/Ted Shaffrey) APAP
What the Pandemic Revealed About This Country’s Nursing Home Owners – New Jersey
Those who are willing to speak out are punished for their efforts. Attorneys have been disbarred for whistleblowing, called something else, as they attempt to uncover the inhumanity. Newspaper journalists have been and continue to be admonished or sued for shedding light on the hardcore truths about the industry. Public media wars have been waged on politicians trying to right an entirely skewed collective moral compass. It is an “open secret” in politics, we are told.
There is a sheer and inexplicable cognitive dissonance of those who do not question this industry, its finances, its treatment of the elderly. For years we, along with our collective and small group of journalists, bloggers and activists have tried to scatter the puzzle pieces for anyone who might be willing to put them together.
The savagery coupled with the profit is really not rocket science to figure out.
It took a pandemic to show just how blurred the lines of that which is deemed acceptable in a humane society really are. The black and white of right and wrong were crossed a very long time ago. Perhaps a New Jersey law is a step in the right direction. Likely not. Until owners who have records of abusing the system are put permanently out of commission, no law will draw an impassable line. It is all just a distraction.
Nursing home operators must reveal more information about their finances and their ownership and also pass a review evaluating their track record on safety and quality before state regulators will allow properties to be sold, under a new law Gov. Phil Murphy signed late Wednesday.
Manatt concluded the industry was unprepared for the pandemic, in part because one-third of all facilities had been cited for infection control violations previously and staffing shortages were endemic.
The consultant also took issue with the Health Department for not aggressively monitoring the 370 nursing homes in the state, 74% of which are owned by for-profit companies that change hands often. Manatt recommended the state adopt a stricter system of reviewing operators’ finances before they are permitted to buy new facilities.
The law, A4477, requires nursing home operators to report the names, addresses and the organizational chart for the companies who intend to buy a facility, any lease or management agreements, a list of all facilities the buyer has owned in the last five years and financial audits from the last three years. The health department will use the information to identify facilities which may be in financial distress, according to the law. Applications for ownership transfers must be posted on the DOH’s website.
HYDE PARK, NY – Senator Sue Serino released the following in response to comments made today by the Governor at a Buffalo event in relation to COVID-19 deaths in New York’s nursing homes:
“The Governor can rewrite history all he wants, but the truth is the only people who played politics when it came to hiding the number of nursing home deaths in New York State are the members of his Administration who have now been caught doing so for months.
I first called for a full investigation into the state’s overall handling of the COVID crisis in nursing homes on May 7, 2020—at a time when the Governor’s approval rating was through the roof—and most would argue it was actually politically unpopular to criticize anything his Administration was doing at the time. I did so because it was the right thing to do. Families who were losing loved ones deserved answers. Having access to the real number of deaths could have provided a more accurate picture of the pandemic’s impact, which could have helped us improve the state’s response and maybe even saved lives.
Time and again, the Governor clearly put politics—and profit—over the residents of these facilities. It’s not right, and we will not stop pushing for truthful answers and real accountability.”
When asked today why his Administration hid the accurate number of nursing home deaths for so long, the Governor claimed the issue was simply politicized. He continued to argue that withholding the data was about ‘accuracy.’
Senator Serino countered that point saying, “If they were so concerned about ‘accuracy,’ then they would have withheld all the numbers until they were properly audited. Instead, they were okay with publicly releasing a blatant undercount that fit the Administration’s own political narrative. An undercount the Governor publicly bragged about repeatedly. The hypocrisy is stunning. New Yorkers—especially these vulnerable residents and their loved ones—deserve so much better.”
Senator Serino is the Ranking Member of the Senate’s Aging Committee.
Senator O’Mara shares his weekly perspective on issues facing New York State government.Every available action needs to be taken to compel the governor and his inner circle to tell the truth and be held accountable. New Yorkers, in particular families who lost loved ones in nursing homes due to Cuomo’s fateful order, deserve nothing less.
Senator O’Mara offers his weekly perspective on many of the key challenges and issues facing the Legislature, as well as on legislative actions, local initiatives, state programs and policies, and more. Stop back every Monday for Senator O’Mara’s latest column…
Here was the lead paragraph in a National Review article late last week following Governor Andrew Cuomo’s May 5th news conference: “New York governor Andrew Cuomo defended an executive order that may have exacerbated coronavirus outbreaks in state nursing homes as ‘smart’ from a ‘medical point of view.’”
Smart?
After all these months, when how Governor Cuomo and his inner circle addressed the COVID-19 pandemic in nursing homes has been defined by cover-ups, stonewalling, lies, and the like, and keeping in mind that the Cuomo administration is under federal investigation for its actions, the governor calls it “smart.”
Trust me, there’s another side to that story.
Recall that Governor Cuomo issued a March 25, 2020 directive requiring New York State nursing homes to accept COVID-positive patients from hospitals into the homes. Last year’s March 25th directive would end up sending more than 9,000 COVID-positive patients into hundreds of nursing homes statewide, according to reporting from the Associated Press earlier this year, and likely contributed to thousands of deaths. Over 6,000 of those were new admissions to nursing homes, not readmissions as the Cuomo administration has tried to lead the public to believe.
Here’s how “smart” that action was considered at the time by many of the nation’s leading long-term care professionals.
The day after Governor Cuomo’s March 25 directive to nursing homes, on March 26, 2020, a prominent, national group of long-term care professionals denounced the directive and warned against it.
Specifically, the prominent, national medical professionals group American Medical Directors Association (AMDA)-The Society for Post-Acute Care and Long-Term Care (PALTC) Medicine released a statement that the Cuomo order was “over-reaching, not consistent with science…and beyond all, not in the least consistent with patient safety principles.” The group’s statement went on, “Rather than bullying nursing facilities and medical providers to make unsafe decisions, the State of New York would be wise to direct its energies at ensuring adequate personal protective equipment is available to all healthcare providers…developing a long-neglected healthcare workforce, and identifying and standing up alternative care sites.”
Three days later, on March 29, AMDA-PALTC was joined in another statement by the American Health Care Association (AHCA) and the National Center for Assisted Living (NCAL). The groups stated, “As organizations dedicated to preserving the safety of patients and residents in post-acute and long-term care settings including assisted living, we strongly object to this policy directive and approach…This is a short-term and short-sighted solution that will only add to the surge in COVID-19 patients…We understand the need for public health and elected officials to weigh the risks and benefits of their decisions…However, a blanket order for every nursing home in the state to accept all admissions from hospitals is not sound policy.” [Both statements can be viewed in full on the AMDA-PALTC website: paltc.org]
Despite these dire warnings from the medical community directly involved in the care of our state’s elderly nursing home residents this directive was left in place for more than 30 days, until May 10, 2020. During this period, in excess of 9,000 COVID-positive hospital patients were sent from hospitals into New York’s nursing homes. Over 6,000 of these patients were not in a nursing home prior to entering the hospital.
During a joint Senate-Assembly hearing on the nursing homes crisis on August 3, 2020, I directly asked Health Commissioner Howard Zucker if he had received and read the March 26 and March 29 statements. He denied knowledge of them.
I didn’t believe Commissioner Zucker on that day and I still don’t believe it. It is simply not credible that New York’s top health official would not have been informed on statements from leading medical professionals expressing their alarm at one of New York State’s key directives and its potential and alarming risk to the elderly and these residential facilities overall.
And I don’t believe that Governor Cuomo’s policy was “smart.”
If Governor Cuomo and his top lieutenants had heeded the warning from the experts on the front lines of nursing home care in America, thousands of nursing home residents would have at least been better protected. Many lives could have been saved.
The question is no longer whether the Cuomo administration’s handling of the nursing homes tragedy was smart.
Instead, in my view and the view of many others, the question remains unanswered about why Governor Cuomo and his inner circle ignored the warnings from public health experts that their March 25 mandate to nursing homes to accept COVID-positive patients was over-reaching, and not consistent with science or patient safety principles.
It is just one of many unanswered questions that still demand to be pursued regarding the Cuomo administration’s nursing homes cover-up.
Governor Cuomo has tried to conceal the truth on the devastation of this crisis in our nursing homes and in other places, and it has caused great harm. Reports keep forcefully exposing the lies, cover-ups, and crimes.
Every available action needs to be taken to compel the governor and his inner circle to tell the truth and be held accountable. New Yorkers, in particular families who lost loved ones in nursing homes due to Cuomo’s fateful order, deserve nothing less.
When a change in ownership within some of the largest players in the nursing home industry is described in the news as a “blockbuster move”; and when an earnings call to investors raises the specter of “even further upside potential” without any mention of superior care, quality of life, increased standards, greater accountability and better medicine, it is not nursing care. It is a different animal altogether, the savage world of publicly traded horse-trading.
It is worth noting here, that some of the parties cited in the article below are owners and operators of some of the worst rated nursing and rehabilitation facilities throughout the United States. Thus, shareholders to whom this article was addressed, are to some extent investing in substandard care. That’s just one part of the human tragedy. Another part of the human tragedy, cited in an earlier article below, tacitly admits that one methodology for adding shareholder value is manipulating the more lucrative sides of benefits from acute care patients “who also come with more lucrative Medicare and private insurance coverage than the typical long-term nursing home resident on Medicaid.” Statements like that should upend the comfort of Medicare and private insurance carriers.
The number of nursing home residents who died in the pandemic has been a particularly sensitive question for the Cuomo administration. Credit…Pool photo by Shannon Stapleton
Published 5.4.21 9:28am
Dear Reader:
Perhaps the punishment for cruelty to the elderly in nursing care should be lying in the same nursing home bed forced to wallow in excrement and urine. Were we to be a legislators, this would be the top of our bucket list. Alas, should the punishment not fit the crime? And yet, those with the courage to speak out are inevitably doomed.
Most of New York’s nursing homes or those owned throughout the United States by New York nursing home conglomerates, are a special brand of hell to the elderly living in them; and their owners and managers deserve accountability. Many are understaffed or staffed by undertrained employees. In most care is substandard, if there is care at all. In many the food is unpalatable or barely edible, but it is inexpensive. In all but a select few, elderly patients can spend hours sitting in their own excrement, thirsty for a drink, exposed to Covid-19 and other pathogens. There is no accountability. Where laws exist there is no oversight. It is a vicious cycle.
In some, the owners use the open spaces for parties and celebrations – a show of wealth and so-called hospitality. After all, a nursing home is a hospitality business. Even during Covid-19, at the worst of the outbreaks, we received reports of massive gatherings in the halls of some of these homes, catered by top kosher caterers, but not open to the patients and their families.
In all but a select few, money flows like water; and the only beneficiaries are the owners and operators, their investors and the politicians who benefit from political contributions. Name the horror and you will likely find it in New York’s nursing homes. Sadly, so many of the nursing homes are owned by different combinations of the same uber-wealthy individuals who have already sold their souls for money. Their attorneys shut their eyes, look the other way. It is really not an attorney’s job to judge. And the billing is glorious to those attorneys for whom these are their top clients. If one is without a conscience, a sense of morality, and is already adept at skirting laws, falsifying records and documents, paying off or discrediting those who get in their way – will new laws do anything but pay lipservice?
Factor in the guardians, many of whom are complete savages, and we have a lethal mix. Many of the patients are sent to nursing home hell by self-serving guardians who likely get hefty kickbacks – a “quid pro quo” of sorts. Most of New York’s nursing homes are for profit. Their ownership structure can be a moving target, crafted to avoid accountability. Many are financed by hedge funds, hedge fund owners and investment managers; or are publicly traded in various portfolios in the stock exchanges of the United States, Israel, the Canadian Stock Exchange and so many others. It is business, after all. Are we talking about human life? Irrelevant really. We are talking about money.
Guardianship is an extraordinary racket, a well-oiled machine which includes (but is not limited to) social workers, judges, politicians, guardians, medical staff, nursing staff, attorneys, the judiciary and the list goes on and on and on. It is a vicious cycle with little hope of breaking. We have been told it is an “open secret” in government and those who attack the system inevitably doom themselves to a loss of livelihood, reputation, financial well-being and even family safety. The people involved in this racket are like a close-knit family “the Gansa Mishpucha” for whom money leads, whatever conscious there is or may have been was set aside long ago.
The multitude of people involved are not morally bankrupt, as that implies there was something there to bankrupt in the first instance. That is a stretch. The elderly in many of the nations nursing homes are nothing more than financially lucrative chattel; lives of meaningless vulnerable people whose daily existence generates cash. It is a godless business.
New York’s nursing homes and their owners are some of the worst. And then there’s the governor, Andrew Cuomo and his aides who were complicit in setting in motion further devastation as Covid-19 ravaged the elderly. So what did they do? They created immunity – and another loophole to escape accountability. We have coined that immunity the “Granny Killer Immunity Provisions”. Cuomo’s political existence has depended, in large part, upon a significant donor pool that exists within the nursing home industry. He is the quintessential beneficiary of political largesse.
Creating laws that would protect our morally challenged nursing home owners was all part of the movement of money. Until Covid-19 put the brakes on that, at least temporarily it just kept going. The Granny Killer Immunity Provisions immunized nursing home owners, operators and managers and hospitals. Those provisions have been overturned but their creation should be a warning to anyone in this fight. If the power of the nursing home industry can have sway over Governor Cuomo, it will happen again.
There is an effort (see below) to place restrictions on nursing homes. We again pose this: restrictions mean nothing if there is no one there to enforce. Our government is a part of the problem. Enforcement will not happen and the crimes against humanity – our elderly and most vulnerable – will continue. Do we not owe them more lest we all be savages?
While Gov. Andrew Cuomo was securing a reported $4 million deal to write a book on his pandemic “leadership,” he and his staff were busy suppressing the truth about New York’s nursing-home deaths in the wake of the March 25 order that forced homes to admit COVID-contagious patients. And it now turns out the coverup was even worse than we’d thought.
On top of blocking health officials from telling the truth, senior staffers also quashed a scientific paper that reported the true fatality total, The New York Times reported.
A June 18 e-mail from top aide Melissa DeRosa to health officials shows Team Cuomo was “anxious” about a pending Department of Health report on nursing-home coronavirus fatalities and out to downplay the idea that the March 25 mandate had proved deadly.
The Cuomoites were publicly citing a nursing-home death toll of about 6,000 by ignoring home residents who’d died while hospitalized. The draft report shared the full count of over 9,700, noting that the homes accounted for “approximately 35 percent” of all NY coronavirus deaths. But DeRosa — who at the same time was intimately involved in the gov’s book-deal negotiations — and other staff got all that edited out. The final report said the homes only yielded 21 percent of the state’s virus death total, making it seem below, rather than above, the US average.
The feud between Ron Kim and Andrew Cuomo is not over yet.
Assemblyman Ron Kim and Governor Andrew Cuomo had a very raw, very public falling out this past February that essentially catapulted the nursing home scandal—in which Cuomo is accused of hiding the number of fatalities from COVID-19 within New York State nursing homes—into the media spotlight. Kim became a household name overnight after the local politician alleged Cuomo threatened to ruin his career. Now, Kim is calling upon the Attorney General to join the fight.
Kim gathered with Voices for Seniors members in Foley Square on Monday afternoon. In the shadow of the Thurgood Marshall United States Courthouse, the assemblyman stood ahead of those who had lost elderly loved ones to the deadly virus calling out the Governor for what he says are “Some of the worst and deadly policies that this country has ever witnessed.”
“For ten months Andrew Cuomo only listened to the worst operators, the lobbyists, to put forward policies that were not only deadly but were irresponsible and criminal. So, we are here once again calling for full accountability for Andrew Cuomo’s unilateral decision-making around nursing homes, in particular, we are asking for the Attorney General and every other investigator who has now opened up investigations into Andrew Cuomo to look into him and his allies, and his administration committing fraud,” Kim said.
While Attorney General Letitia James is reportedly already conducting an investigation into the slew of sexual misconduct allegations levied at the head of state, this demand for action asks James to look into a cover-up of deaths within nursing homes. Kim also cited the importance of this proposed investigation to the families of the deceased who formed Voices for Seniors, a group that looks to improve the lives of the elderly through advocacy. Members of the organization clutched photographs of perished family members and signs dubbing the Governor a “super spreader,” blaming Cuomo for the deaths of their loved ones.
As part of its recent budget, New York State has enacted a new law that significantly impacts nursing home operators in New York. Effective January 1, 2022, the new Section 2828 of the Public Health Law requires, among other things, that:
Not less than 70% of nursing home revenues shall be spent on direct resident care costs;
40% of the nursing home revenues must be spent on staff who work directly with patients (so-called resident-facing staff, as that term is defined in Section 2828), which is included in amounts spent on direct resident care costs; and
Nursing home profits are limited to not more than 5%, and profits in excess of this threshold shall be turned over to the [sic]
Pursuant to the legislation, the Department of Health shall promulgate regulations in accordance with the new [sic]
Direct resident care is defined to include non-revenue support services (e.g., maintenance and patient food service), ancillary services (e.g., laboratory and pharmacy services), and program services directly serving patients.
Direct resident care is defined to include non-revenue support services (e.g., maintenance and patient food service), ancillary services (e.g., laboratory and pharmacy services), and program services directly serving patients. Expenses that are specifically excluded as not related to patient care include, without limitation, administrative costs (other than nurse administration), capital costs, debt service, taxes (other than sales taxes or payroll taxes), capital depreciation, rent and leases, and fiscal services. Specifically excepted from the new law are nursing homes that provide certain specialized services, including, for example, behavioral intervention and neurodegenerative services.
Aides to the New York governor, Andrew M. Cuomo, repeatedly prevented state health officials from releasing the number of nursing home deaths in the pandemic.
Mr. Cuomo’s most senior aides engaged in a sustained effort to prevent the state’s own health officials, including the commissioner, Howard Zucker, from releasing the true death toll to the public or sharing it with state lawmakers, these interviews and documents showed.
A scientific paper, which incorporated the data, was never published. An audit of the numbers by a top Cuomo aide was finished months before it became publicly known. Two letters, drafted by the Health Department and meant for state legislators, were never sent.
And they came as the governor’s approach to nursing homes was receiving intensifying scrutiny from critics and Republicans, including former President Donald J. Trump, whose administration made a public show of requesting nursing home death data from four states with Democratic governors, including New York.
The number of nursing home residents who died in the pandemic has been a particularly sensitive question for the Cuomo administration.
The number of nursing home residents who died in the pandemic has been a particularly sensitive question for the Cuomo administration.
Gov Cuomo signs bill repealing legal immunity granted to New York nursing homes during pandemic as he faces probe into hundreds of excess deaths at care facilities
Effective immediately, nursing homes and other healthcare facilities can be held civilly and criminally liable for treatment of individuals with COVID-19
The bill was sponsored and championed by Cuomo critics including Sen. Alessandra Biaggi
However, Cuomo himself has faced calls to resign amid probes into whether the state mishandled nursing home deaths related to the pandemic
The Cuomo administration has faced accusations that the state miscounted hundreds of nursing home deaths as hospital deaths
Lawmakers had already rolled back some of the protections that had been granted to healthcare workers last year
Queens assemblyman and advocates rally for nursing homes investigation and immunity repeal
“Every time we get close to the truth, it seems like the governor is untouchable. How many more scandals? How many more women? How many more nursing home-related lies and frauds need to be exposed before we can hold him accountable?” Kim said during a virtual rally with advocates on Thursday, April 1.
This week, Arizona legislators will vote on bill 1377, which would shield nursing homes from civil liability for negligence while providing services during the Covid-19 pandemic.
At least 32 states have already passed laws or issued executive orders during the pandemic making it harder for nursing home residents or their families to take the companies that run these facilities to court. The new Arizona bill would protect any health care institution assumed to be acting in “good faith” except in cases of “willful misconduct” or “gross negligence.”
The provision of such broad immunity is particularly problematic for nursing homes in light of growing evidence indicating that during the pandemic, nursing home residents have suffered considerable harms from neglect and prolonged isolation, in addition to the risk of Covid-19 itself.
In a report published last week, Human Rights Watch documented serious concerns over possible neglect in nursing homes across the United States during the pandemic’s first year, when staffing was low and family members were often not allowed in facilities. Residents, family members, and staff reported extreme weight loss, dehydration, and infected bedsores, which in some cases may have contributed to death. In many cases, residents’ hygiene appeared to have been neglected as well, with family members reporting residents were left in soiled incontinence pads for hours at a time and their hair and fingernails grew long and dirty. Many nursing home residents, deprived of daily social contact because of restrictions on visitors and activities, declined physically and emotionally.
The academic evidence echoes our findings: just last week, an article published in the Journal of the American Medical Directors Association (JAMDA) found that in Connecticut nursing homes, depression, substantial weight loss, and incontinence increased among residents in the four months after visitor restrictions went into place.
Human Rights Watch, to continue reading click here.
We have contended from the outset that the oversight agencies are ineffective, corrupt, complicit in or facilitators of abuse, neglect and exploitation. Full Stop. We have contended that many of the players within the elder-care guardianship and nursing home context are inextricably intertwined in wrongdoing, most with incestuous relationships with the oversight agencies. We have posited that there is no such thing as reporting if it is left to the good will of those entrusted with the care of the elderly. We maintain that too many people are making too much money for the nonsense legislation to have any substance.
Oversight agencies must be held accountable for their failures. Elder abuse MUST be accompanied by criminal penalties, whether to the guardians, the owners and operators, the magnates, the investors, the employees or the judges and politicians that allow the abuse to continue unchecked. Elder abuse MUST be deemed unacceptable. Full stop. Elders MUST have the power to decide their own destinies. Elders MUST be believed until their statements are proven unbelievable, if that is possible. An Elder’s human dignity MUST be respected before all else and not entrusted in the care of those who lack humanity and conscience.
New Jersey’s four-part legislation pays lipservice to intent but does none of that. It assumes unicorns and rainbows with respect to an industry which is no different that legalized human trafficking. When you build a beautiful house on a flawed foundation the house is doomed. So too is the fluff and nonsense legislation in New Jersey.
Assembly Panel Advances Murphy & Vainieri Huttle Bill Package to Combat Abuse, Neglect & Exploitation of Seniors and Vulnerable Adults
Measures to Modernize Conservatorships & Guardianships; Address Financial Abuse; and Strengthen Protections for Vulnerable Adults
(TRENTON) – The Assembly Aging and Senior Services Committee on Monday approved a package of four bills sponsored by Assembly Democrats Carol Murphy and Valerie Vainieri Huttle to protect elderly or vulnerable adults from facing abuse, neglect or exploitation.
About one in ten Americans over age 60 have experienced some form of elder abuse, including physical or emotional abuse or financial exploitation. Mental or physical impairments may make them more vulnerable to abuse, and many cases go unreported.
People with disabilities are also at a higher risk of abuse, neglect or exploitation. About 30 percent of individuals with disabilities who need assistance with daily care, maintaining their health and safety, and accessing their communities have experienced some form of mistreatment.
“As we age, many of us will need a support system to help manage our health, finances, transportation and other aspects of life. This is especially true for seniors with dementia or other cognitive impairments” said Murphy (D-Burlington). “Sadly, too often the person trusted with an elderly person’s care ends up taking advantage of them. We must ensure the people caring for our most vulnerable have their best interests at heart, and everyone knows how recognize and report elder abuse.”
“Every person deserves to age with dignity,” said Vainieri Huttle (D-Bergen). “We may face illness, disability or physical decline, but we should never face abuse. By strengthening protections for older adults and our most vulnerable, we are helping to keep our elderly loved ones safe and safeguard our own futures.”
Two bills in the package would modernize existing laws regarding conservatorship and guardianship in New Jersey. The first measure (A-4615) would require proposed conservatees or someone already under conservatorship to have counsel throughout the course of all court proceedings. The court would be required to appoint a counsel if they were ever unrepresented. The counsel would personally interview the conservatee or proposed conservatee within 72 hours before each scheduled hearing focused on conservatorship.
Counsel must also be provided to individuals under guardianships, or wards, as part of the second bill (A-4618).
LOSTMESSIAH 