On Sunday, I wept with relatives of those who perished from COVID in New York nursing homes.
Five years after former Gov. Andrew Cuomo’s notorious directive of March 25, 2020, the pain I experienced as a nursing-home physician taking care of sick and dying COVID patients is still raw.
Like those families, I become furious every time I hear Cuomo claim he was simply following federal guidelines when he sent scores of infectious COVID patients from hospitals into nursing homes — and that therefore, all objections to his order are politically motivated.
I know he’s wrong. I helped sound the alarm as soon as he issued it.
As Cuomo campaigns to become New York City’s next mayor, he’s blaming his order on guidelines from the federal Centers for Medicare & Medicaid Services that were meant to help nursing homes manage individual patients suspected of having COVID.
The guidance said that staff should use gowns, gloves, masks and face shields when giving care, and should not mix new patients admitted from hospitals with pre-existing residents. That was it.
But Cuomo’s Health Department, which regulates the homes, twisted those guidelines: Instead, Albany ordered the mass transfer of infected COVID patients from hospitals into nursing homes as an officially sanctioned response to the pandemic — something CMS never said.
Specifically, the department said nursing homes “must” accept any patient that was medically stable, and could not deny admission “solely based on a confirmed or suspected diagnosis of COVID-19.”
The state Health Department’s “must comply” order bullied homes into admitting thousands of contagious patients from hospitals — not only patients that the homes had previously transferred out for acute care, but many others unfamiliar to them.
In truth, the March 25 memo actually violated the CDC standards for responding to a respiratory pandemic.
These rules explicitly said that the role of nursing homes during a pandemic surge situation is to take in uninfected patients from hospitals — those recovering from surgery or a stroke, for example — so the hospitals could manage contagious patients.
Nursing homes were supposed to remain “clean,” under the CDC’s recommendations, never the recipients of the infected.
That’s why Cuomo’s refusal to accept blame for his nursing-home COVID debacle so enrages us.
His claim that his nursing-home directive followed CDC and CMS standards is an insulting attempt to veil his failure to prepare and execute a pandemic hospital plan.
And while Cuomo says only his political enemies object to the March 25 order, the reality is that nursing-home doctors like me, stunned by its recklessness, were the first to call him out — on March 26.
That’s when the national organization of nursing-home medical directors issued a statement calling New York’s policy “over-reaching, not consistent with science . . . and beyond all, not in the least consistent with patient safety principles.”
Cuomo’s directive continues to cause pain and suffering to this day — not only for the grieving family members of those who perished, but also for heroic nursing-home staffers now reliving those terrible days.
Front-line nursing-home caregivers witnessed death on a scale matched only on the battlefield or in a mass-casualty event.
Unlike our counterparts in the hospitals, however, nursing-home staffers often had long-standing, close relationships with the residents they watched die, causing wounds that are still unhealed.
The pandemic took a dreadful physical toll on us, too.
By the end of 2020 more than 1,250 nursing-home staffers perished from COVID-19 nationwide, mainly certified nursing assistants — a shocking statistic that remains barely acknowledged, because the fatal illness they contracted on the job is not tallied by the Labor Department.
Working as a nursing-home CNA back then was the most hazardous occupation in America. So many deaths in any other sector would have sparked a huge outcry and demands for reform.
Yet barely a whisper was heard as these devoted professionals quietly continued to care for their residents, adding to the trauma of those who remain.
This milestone five-year anniversary gives us a chance to transform these painful experiences into opportunities to grow and heal.
While most of society has moved on from the pandemic, nursing homes are still experiencing COVID outbreaks which, while not as severe as in 2020, constantly derail their ability to function. Their staffs have been depleted, and their morale is waning.
Let’s recognize their courage and compassion as they continue their vocation of care for the elderly.
And New Yorkers, as you choose your next mayor, scrutinize this episode carefully.
Andrew Cuomo’s order — and all the excuse-making and finger-pointing that has followed — demonstrates the former governor’s lack of preparedness, judgment, honesty, integrity and empathy.
Elaine Healy, MD, is a practicing geriatrician and board-certified nursing home medical director.