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New York’s nursing home mistake

All in all, most people we hear from seem to think the New York state government has done a pretty good job in managing the coronavirus pandemic, but of course, some mistakes were inevitable. Any of us would’ve made some, too, if we had been in charge.

One of those mistakes was when, on March 25, the state Department of Health ordered nursing homes to accept COVID-19 patients.

Granted — and there are several “granted”s here — the state was trying to free up more than 100,000 hospital beds for COVID-19 patients, which, in 20/20 hindsight, turned out to be an overestimate. (Thank God we didn’t need so many.) The goal was to transfer stable COVID patients out of hospitals to make room for new ones.

Still, there were other places to send patients, such as the HMS Comfort hospital ship and numerous empty hotels. And everyone knew that older people with other health issues are the most vulnerable to this disease. That, of course, means nursing homes should have been the one place COVID-19 patients were kept farthest from.

It’s why nursing homes were among the first institutions in New York to take this seriously and lock down, especially after a rash of deaths at a nursing home in Kings County, Washington.

And then suddenly, the state ordered COVID patients to be sent to those homes directly. The virus quickly spread to others in the homes, which is a big factor in why nursing homes account for more than than 3,500 of New York’s 15,000-plus COVID deaths so far.

“The very nature of long-term care is a high-touch environment where social distancing is not an option in providing care,” said Stephen Hanse, president and CEO of the New York State Health Facilities Association and the New York State Center for Assisted Living. “Staff are hands-on helping residents with bathing, dressing, eating and other personal daily needs.

“This treacherous virus spreads through nursing homes like fire through dry grass, and the state’s March 25th policy served to unnecessarily fan the flames of this fire.”

Gov. Andrew Cuomo has defended the decision in recent days, saying if any nursing home was not able to safely handle COVID patients, it should have said so, and the patients been transferred elsewhere. He hinted that they accepted the extra patients because they needed the money.

It is true that the state requires nursing homes to be equipped to handle the number of residents they have, and it has also been true for a long time — widely reported, including in this newspaper — that nursing homes rarely have enough staff to handle the number of residents they have. That is a complicated but serious problem that should’ve been addressed long ago. The state health department knew all about it.

Yes, nursing homes absolutely share the responsibility here. They were capable of not accepting COVID patients. The state mandate, wrong as it may have been, only applied if they were accepting new residents. All they had to do was stop all new admissions during the outbreak, as Adirondack Health did at Mercy Living Center in Tupper Lake.

Thank you, Mercy. We wish the Elderwood company that runs the nursing home in Lake Placid would do the same.

Maybe there was confusion about what the state required. Maybe nursing homes were trying to do that part and not be shamed for shunning the sick, as upstate hospitals were when they balked at sending their ventilators downstate.

To echo Hanse’s “dry grass” metaphor, fighting the pandemic is kind of like fighting a fast-moving wildfire, and even top health care leaders have to trust the governor’s leadership as he directs them here and there on the fly, as strategically as possible. We’re not sure the state fanned the flames, as Hanse said, but it may have cut a fire break in the wrong way, fueling the flames instead of blocking them.

Sometimes you get away with mistakes. Sometimes you don’t, and the consequences can be brutal. It’s best not to condemn, because living with those consequences is punishment enough.

Again, most people agree that New York state has done a good job overall at handling a crisis like we’ve never seen before. And certainly our governor has been conscientious. Even when he seems too heavy handed, it’s obvious that he cares about New Yorkers’ well-being, and that’s the most important thing.

We are also grateful to all the local organizations and people who care for our elders here in the Adirondacks. We know everyone misses the in-person visits and shared meals and activities, but we will get through this — hopefully better than we got through past outbreaks such as tuberculosis, yellow fever and polio. Thanks for caring, and thanks for staying safe.

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