The New York State Attorney General’s Office report released Thursday, which found the state Department of Health may have underreported nursing home COVID-19 deaths by 50%, makes plenty of mentions about Western New York nursing homes’ struggle to provide personal protective equipment and follow infection protocols during the pandemic.
The wide-ranging, 76-page report does not identify nursing homes by name and only provides regional location, profit status and star rating by the federal Centers for Medicare and Medicaid. All of the Western New York nursing homes spotlighted in the report are for-profit facilities and rated two stars or fewer, meaning below average.
The report found that insufficient PPE put residents at increased risk of harm, and it specifically mentions several Western New York facilities as not providing adequate PPE.
An aide at a local one-star nursing home told the AG’s office she had to wear the same gown everyday during the first weeks of the pandemic, before she eventually resorted to wearing a sleeping gown.
At a local two-star nursing home, a licensed nurse practitioner was allegedly forced to resign after questioning inadequate PPE policies and refusing to work under those conditions. Another LPN at the facility said there were not enough surgical masks to change between COVID-positive and COVID-negative residents, so staff were told to make masks last as many days as possible.
Some local nursing homes took steps to hide their lack of PPE from the state Department of Health, according to the report. A registered nurse at a one-star nursing home reported her supervisor came in “unusually early” the morning of a state inspection in April and set up bins with gowns and N95 masks, to make it appear that the facility had adequate PPE.
This inspection did not result in any negative findings, but the state later returned to the facility and placed it in “immediate jeopardy,” meaning a deficiency has “caused or is likely to cause serious injury, harm, impairment or death to the residents.”
The report also shows some Western New York nursing homes failed to follow basic protocols.
Two local facilities continued to hold communal dining despite the Centers for Disease Control and Prevention advising against it, according to the report. One of the facilities didn’t stop communal dining until its first resident went to the hospital with COVID in late March. At the other facility, a nurse manager said she tried to stop communal dining, but ownership overruled her.
A funeral director reported that a local one-star nursing home failed to take his temperature or ask him to fill out a health questionnaire when he entered the facility to pick up a deceased resident in mid-April. He also said he observed used gloves strewn on the floor.
The report, which found that nursing homes with low-rated staffing levels had higher COVID mortality rates, documented several instances of short staffing at Western New York nursing homes.
A certified nursing assistant at a local one-star facility reported that, for a few hours one day in late March, there was only one CNA in the entire building for 120 residents. Another employee there alleged that staffing levels were so low that CNAs, rather than nurses licensed to do so, were giving medications to residents.
Just one of Western New York’s 70 total nursing homes had a five-star rating for staffing levels as of August, while 29 had a two-star rating or lower.
The state Department of Health last year came out against a bill that would set minimum staffing levels in nursing homes, arguing there is not enough money or nurses to meet the threshold.
While the AG’s Office report found some nursing homes across the state stopped admitting new residents due to staffing shortages, some short-staffed local nursing homes continued to do so.
A one-star facility continued to take in new residents in late April despite 14 residents and staff testing positive and five residents dying of COVID. A two-star facility stopped accepting new residents for at least a week in late April, but only after more than half of its residents (33 of 59) tested positive and it did not have more kits to test the others.
The report also found that nursing homes across the state did a poor job of communicating with families during the pandemic, despite executive orders mandating they inform families within 24 hours of a positive case or death at the facility.
The AG’s Office opened a hotline in April to take complaints about poor communication. Fifty-six of the 653 complaints submitted through August were regarding Western New York nursing homes.
The AG’s Office is now conducting investigations into more than 20 nursing homes statewide whose alleged conduct it says presented “particular concern.” It is not immediately clear how many of those homes are in Western New York.