Cuomo Takes Aim at For-Profit Nursing Homes, Hints at Reforms for 2021

New York Gov. Andrew Cuomo’s handling of the COVID-19 crisis in nursing homes continues to make headlines amid accusations of a deliberate cover-up, but the embattled executive this week promised to explore reforms targeted at for-profit facility owners.

“I have long believed that there is a tension in a for-profit nursing home, because those institutions are trying to make money,” Cuomo said during a press conference this week, according to a local news report.

The governor signaled an interest in implementing for-profit nursing home reforms — particularly a mandate to re-invest income into facility operations — as part of the state’s next budget, due April 1, TV station WIVB reported.

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“Everything becomes one or the other,” Cuomo said. “Do you want to have more staff or do you want to make more profit? Do you want to buy more PPE and stockpile more PPE, or do you want to make more profit? Do you want to buy new equipment, new beds, new sheets, new furniture, invest in the facility, or do you want to make more profit?”

Stephen Hanse, president and CEO of the New York State Health Facilities Association, told the outlet that Cuomo’s targeting of for-profit nursing homes reflected a “false narrative” and called on state officials to beef up Medicaid rates for institutional care.

Cuomo — a Democrat who rose to national media prominence during the pandemic, frequently portrayed as a straight-talking counterpoint to former President Trump — has been under a steady barrage for his administration’s handling of COVID-19 deaths in nursing homes. Critics in particular have focused on a heavily condemned March 2020 directive requiring facilities to accept coronavirus patients from hospitals, as well as a general lack of transparency around case and death counts.

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The controversy boiled over again last week after a New York Post report indicated that the Cuomo administration deliberately stalled efforts to release more detailed data about infections and deaths in Empire State nursing homes.

That news followed a January probe from the state’s attorney general that took aim at both the state’s nursing home sector and the governor’s oversight, finding that nursing home COVID deaths may have been undercounted by as much as 50%.

“Already-low staffing levels decreased even further, to especially dangerous levels in some homes, even as the need for care increased due to the need to comply with COVID-19 infection control protocols and the loss of assistance from family visitors,” New York AG Letitia James’s office observed in its final report. “OAG’s preliminary investigations reflect many examples where for-profit nursing homes’ pre-pandemic low staffing model simply snapped under the stress of the pandemic.”

New York could emerge as a representative test case for nursing home reform efforts across the country, as both Democrats and Republicans call for Cuomo and the industry to be held accountable for the waves of illness and death during the pandemic.

State lawmaker Richard Gottfried told New York 1 that he’ll soon introduce a bill requiring owners to meet stricter staffing ratios and reinvest profits in their buildings.

“Melissa DeRosa, the governor’s chief of staff, said quite candidly that a lot of nursing homes have been getting away with a lot for a long time,” Gottfried told the outlet. “I think anyone familiar with the nursing home industry who was being straightforward, would have said that and would have been saying that for years and years.”

Hanse pointed to the gap between nursing homes’ average per-day costs of $266 and average Medicaid reimbursements of $211.

 “I would argue that people pay their babysitters more to care for their children then the state pays for nursing home care for our most vulnerable in our communities,” Hanse said, according to NY1.