Low Nursing Home Staffing Levels Contributed COVID-19 Deaths: AG Report

According to a damning new report by the New York Attorney General, nursing home understaffing problems played a crucial and tragic role in the high number of COVID-19 deaths at facilities throughout the state over the last year.

The report (PDF) was released by New York Attorney General Letitia James on January 28, listing a number of failures by nursing homes and state regulators which contributed to the COVID-19 deaths in those facilities since last March. While the state’s Department of Health lists more than 6,000 COVID-19 related deaths among nursing home residents in the state, the report indicates that number may be more than 50% higher.

One of the chief factors pointed out in the report is that facilities with lower pre-pandemic staffing ratings had a higher number of fatalities linked to the pandemic than facilities with sufficient staffing. In addition, the report found residents’ risks were increased by a lack of compliance with infection control procedures, and New York state government guidance which required admission of COVID-19 patients into nursing homes.

“As the pandemic and our investigations continue, it is imperative that we understand why the residents of nursing homes in New York unnecessarily suffered at such an alarming rate,” Attorney General James stated in a press release. “While we cannot bring back the individuals we lost to this crisis, this report seeks to offer transparency that the public deserves and to spur increased action to protect our most vulnerable residents.”

James’ report listed a number of recommendations to address the problem. It calls for ensuring accurate reporting of COVID-19 deaths at nursing homes across the state. It also calls for total enforcement of state laws requiring nursing homes to provide adequate care and treatment at times of emergencies, preventing nursing homes from pressuring employees to work when infected with COVID-19, and ensuring nursing homes provide adequate staffing care for residents’ needs.

In addition, it calls for more transparency in how nursing homes are operated, including their financial relationships, and ensuring that staff are adequately trained in infection control protocols. James also wants the state to support manufacturing of personal protective equipment and to ensure adequate testing is available, among other fixes.

“Pre-existing, insufficient staffing levels put residents and staff at increased risk of harm during the pandemic. As nursing home resident and staff COVID-19 infections rose during the initial wave of the pandemic, staffing absences increased at many nursing homes,” James’ investigation indicates. “As a result, 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.”

With more than 1.3 million residents in over 15,000 Medicare and Medicaid-certified nursing homes throughout the United States, significant attention has been placed on nursing home COVID-19 cases, which have typically hit facilities hardest that have a history of neglect and staffing problems.

The U.S. Centers for Disease Control and Prevention published a study in September, highlighting a link between COVID-19 and nursing home quality of care, indicating facilities which scored better in federal ratings have been less likely to experience severe outbreaks at their facilities. Attorney General James’ investigation into 20 nursing homes in New York resulted in similar conclusions.