Nursing homes helped bring down Cuomo. How has Hochul handled them?
When former Gov. Andrew Cuomo would defend his controversial order that sent thousands of COVID-19 hospital patients into nursing homes, he often made the argument that nursing home residents were destined to fall victim to the disease.
“Older people, vulnerable people are going to die from this virus,” he said during one May 2020 press briefing. “That is going to happen despite whatever you do.”
To Lindsay Heckler, a Buffalo attorney representing nursing home residents, it was indicative of what she felt was the Cuomo administration's “ageism.”
“‘You're in a nursing home. Too bad,’” she said of the Cuomo administration's stance on nursing home residents. “And that's part of the larger concern that we have that just because you are older, you have varying care needs, does not mean you're not part of society.”
And so Heckler feels Gov. Kathy Hochul has been a welcome change.
“She views everyone in the state, young and old, as deserving of living life with independence and dignity,” Heckler said.
That’s the general viewpoint of many nursing home stakeholders, who WBFO asked to grade Hochul’s handling of the industry as she marks six months in office Thursday.
They gave her mostly positive reviews for exploring new solutions to the long-term care crisis while being transparent and working collaboratively, but at the same time acknowledged that Cuomo set a low bar with his controversial hospital order, undercounting of deaths and handicapping of the Medicaid system that funds most of the nursing home industry, before resigning in light of sexual harassment allegations in August.
Hochul, who succeeded Cuomo after serving as his lieutenant governor, has perhaps been applauded the most for her pledge to reinvest in industry. Her 2023 budget proposal restores a Cuomo-era 1.5% cut in Medicaid reimbursements to health care facilities, while providing an additional 1%.
It also outlines a $10 billion plan to grow the state’s health care workforce with wage increases and retention bonuses, something that could be crucial for a nursing home industry that has lost 13% of its workforce since the pandemic began.
The proposals have made nursing home owners happy. Stephen Hanse, president of the New York State Health Facilities Association, a nursing home lobbying group, said Cuomo’s Medicaid spending caps hurt his industry in the years leading up to the pandemic.
“When you have that policy of disinvestment year after year, it's going to come back and hurt you and ultimately hurt the residents in nursing homes,” he said. “So the Hochul administration is really making a proactive initiative to reverse those disinvestment policies.”
Another nursing home lobbying group leader and former state assemblymember, Michael Balboni, said Hochul’s relationship with the industry couldn’t be more different than Cuomo’s.
“This is a dialogue, as opposed to a dictatorship, and I like it very much,” said Balboni, executive director of the Greater New York Health Care Facilities Association. “This is a governor who has signaled her willingness to work with the industry, and we are very, very happy about that.”
But some worry Hochul might be too willing to work with the industry.
Hochul has twice delayed New York’s safe staffing and profit caps laws, two nursing home reforms that were supposed to take effect Jan. 1 and have been heavily opposed by the nursing homes industry.
The governor has cited a shortage of health care workers as the reason for the delays, but Richard Mollot, executive director of the Long Term Care Community Coalition, a New York-city based group that advocates for better nursing home care, called them “really troubling” all the same.
Mollot had hoped Hochul would beef up the state Department of Health’s regulation of nursing homes, which he felt had been too lax under Cuomo.
“We have given nursing home owners a free ride for a very long time, and we were hoping to see that change,” he said. “We still hope to see that change under this governor, but it really worries me.”
And others feel Hochul still hasn’t done enough about Cuomo’s handling of nursing homes.
Cuomo's March 25, 2020 order mandated nursing to accept recovering COVID patients from hospitals amid bed capacity concerns during the early weeks of the pandemic. A state Attorney General’s Office report last year concluded the order may have contributed to the state’s nursing home death toll.
Hochul apologized to family members of nursing home residents who died of COVID during a private meeting in October, and said she was open to their requests for a compensation fund and memorial.
But during a confirmation hearing last month, Hochul’s pick for state health commissioner, Dr. Mary Bassett, said she has no plans to look into the March 25 order.
“I wasn’t here and I decided I’m not going to take the time to unravel the previous situation,” Bassett told lawmakers.
State Sen. Patrick Gallivan, a Republican and ranking member of the Senate Health Committee, said Bassett’s comments “flew in the face” of Hochul’s promises for transparency.
“The governor could very easily tell the health commissioner, ‘You have to look at this and we have to make sure that something like that doesn't happen again,’” he said.
State Senate Republicans have since introduced legislation that would force Bassett and the health department to audit Cuomo’s March 25 order, and examine what impact it had on New York’s over 15,000 nursing home COVID deaths. It remains unclear whether it would have enough Democratic support.
Industry watchers also feel more light needs to be shed on the March 25 order.
Bill Hammond is a senior fellow for health policy at the Empire Center, a fiscally conservative think tank. He successfully sued the Cuomo administrationunder the Freedom of Information Law to reveal the number of nursing home residents who died of COVID after being taken to hospitals.
He said although Hochul has been more transparent with COVID data, even acknowledging some 12,000 more COVID deaths on her first day in office than Cuomo did, she has left the Cuomo administration’s tampered report defending the March 25 order on the health department website without fully correcting it; it was revised earlier this month.
He called it a “dereliction” to not try to learn from the order.
“I think it's a mistake in terms of policy because there are a lot of unanswered questions, and I think it's a mistake politically because it now sort of links her up with some of the worst things that happened during the Cuomo [administration],” he said. “It makes it look like she's not covering it up exactly, but sort of sitting on what happened and just not curious about clearing it up.”
Hochul spokesperson Hazel Crampton-Hays said in an email that the governor has worked everyday since taking office to “deliver accountability, restore trust in government, and protect vulnerable New Yorkers.”
Crampton-Hays added that Hochul will continue to do so by working with advocates and lawmakers during the ongoing legislative session.