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Governor Cuomo: State Health Dept To Investigate Nursing Home Violations

April 23, 2020

From The Governor:

AMID ONGOING COVID-19 PANDEMIC, GOVERNOR CUOMO ANNOUNCES STATE HEALTH DEPARTMENT WILL PARTNER WITH ATTORNEY GENERAL JAMES TO INVESTIGATE NURSING HOME VIOLATIONS

Preliminary Phase I Results of Antibody Testing Study Show 13.9% of the Population Have COVID-19 Antibodies

Announces New Initiative to Ramp Up Testing in African-American and Latino Communities by Working with Places of Worship

Expanded COVID-19 Diagnostic Testing at NYCHA Facilities Begins Today

Announces $30 Million in Child Care Scholarships for Essential Workers and Supplies for Child Care Providers

Confirms 6,244 Additional Coronavirus Cases in New York State – Bringing Statewide Total to 263,460; New Cases in 44 Counties

Governor Cuomo: “Nursing homes are our top priority. They have been from day one. Remember how the nursing home system works. They are private facilities. They get paid to provide a service. They get regulated by the State government. There are certain rules and regulations that they must follow and we put in additional rules and regulations on nursing homes in the midst of this crisis. Staff must have appropriate PPE. They must have their temperatures checked before they come into the facility. There are no visitors who are coming into the facility which is a tremendous hardship but it’s necessary to protect public health. If they have a COVID-positive person in the facility that person has to be in quarantine. They have to have several staff for the COVID residents versus the non-COVID residents.”

Cuomo: “The State has very strict guidelines on privately run facilities. They get paid to take care of a resident. That resident, that patient must have a State-directed level of care. If they cannot provide that they can’t have the resident in their facility – period. Those are the rules.”

Cuomo: “We’re going to undertake an investigation of nursing homes now to make sure they’re following the rules. It’s going to be a joint Department of Health and Attorney General investigation, but those are the rules. They get paid to take care of a resident and they have to do it in accordance with State rules and if they don’t we will take appropriate action. The State Department of Health and the Attorney General are going to be commencing an investigation to make sure all of those policies are in place and being followed. If they’re not being followed, they can be subjected to a fine or they can lose their license. It’s that simple.”

Amid the ongoing COVID-19 pandemic, Governor Andrew M. Cuomo today announced the State Department of Health is partnering with Attorney General Letitia James to investigate nursing homes who violate Executive Orders requiring these facilities to communicate COVID-19 test results and deaths to residents’ families.

The Governor also announced a new directive requiring nursing homes to immediately report to DOH the actions they have taken to comply with all DOH and CDC laws, regulations, directives and guidance. DOH will inspect facilities that have not complied with these directives, including separation and isolation policies, staffing policies and inadequate personal protective equipment, and if DOH determines that the facilities failed to comply with the directives and guidance, DOH will immediately require the facility to submit an action plan. Facilities could be fined $10,000 per violation or potentially lose their operating license.

The Governor previously issued Executive Orders and the Health Department and CDC have issued guidance requiring nursing homes to provide personal protective equipment and temperature checks for staff; isolate COVID residents in quarantine; separate staff and transfer COVID residents within a facility to another long-term care facility or to another non-certified location; notify all residents and their family members within 24 hours if any resident tests positive for COVID or if any resident suffers a COVID related death; and readmit COVID positive residents only if they have the ability to provide adequate level of care under DOH and CDC guidelines.

Additionally, Governor Cuomo and Attorney General James announced New York State will increase staffing through the New York state professional staffing portal and expand training and technical assistance for nursing homes to use the professional staffing portal. The State will also continue to provide PPE to these facilities on an emergency basis, and families of nursing home residents who are concerned about the care they are getting can file complaints by calling 833-249-8499 or by visiting www.ag.ny.gov/nursinghomes.

Governor Cuomo also announced the preliminary results of phase one of the state’s antibody testing survey. The survey developed a baseline infection rate by testing 3,000 people at grocery stores and other box stores over two days in 19 counties and 40 localities across the state. The preliminary results show 13.9 percent of the population have COVID-19 antibodies and are now immune to the virus.

The Governor also announced a new initiative to ramp up testing in African-American and Latino communities by using churches and places of worship in those communities as a network or possible testing sites. The Governor will partner with Representative Hakeem Jeffries, Representative Yvette Clarke and Representative Nydia Velázquez on this initiative.

The Governor also announced expanded COVID-19 diagnostic testing for residents of public housing in New York City is beginning today. The Governor previously announced the new partnership with Ready Responders to ramp up testing at NYCHA facilities.

The Governor also announced that New York State will provide child care scholarships to essential workers. Essential workers include first responders such as health care providers, pharmaceutical staff, law enforcement, firefighters, food delivery workers, grocery store employees and others who are needed to respond to the COVID-19 pandemic. Child care costs will be covered with $30 million in federal CARES Act funding for essential staff whose income is less than 300 percent of the federal poverty level – or $78,600 for a family of four – and will be paid at market rate for each region statewide. Essential workers can use the funding to pay for their existing care arrangement. If an essential worker needs child care, they can contact their local child care resource and referral agency to find openings.

The Governor also announced the CARES funding will also be used to purchase supplies for child care providers statewide who remain open, including masks, gloves, diapers, baby wipes, baby formula and food. Child care resource and referral agencies will receive grants totaling approximately $600 per provider. Providers looking for supplies should contact their local child care resource and referral agency.

VIDEO of the Governor’s remarks is available on YouTube here and in TV quality (h.264, mp4) format here, with ASL interpretation available on YouTube here and in TV quality format here.

AUDIO of today’s remarks is available here.

PHOTOS will be available on the Governor’s Flickr page.

A rush transcript of the Governor’s remarks is available below:

Okay, good morning. Good to see all of you. We are going to go through some facts. I was talking to a reporter yesterday who said basically, you know, you give us grim facts, troubling facts. I don’t give grim facts. I don’t give happy facts. You know, facts are facts. And when we started this, I said the best thing I can do is to give people the truth and give people the facts, separate from an opinion, separate from my spin, separate from what I would like to believe, what I hope – just facts.

And the reason I do that is because everything we’re doing is basically voluntary, on behalf of people, right? State government, local government, federal government, can’t really, doesn’t have the power to enforce stay-at-home orders. If 19 million people said, I’m going out today, they would go out. But the belief was if they have the facts, if they understand the facts, they’ll act prudently in connection with the facts. Now, some of the facts have been disturbing. Some of the facts have been ugly. But those are the facts and that’s my job, is to present the facts as facts. If I have an editorial comment on the facts, I give it to you. But I want you to know, that’s my editorial comment, versus what data or science will say. Also, our Muslim brothers and sisters begin the observation of Ramadan this evening and we wish them all the best.

The hospitalization rate is down again, so that is good news. The overall, if you project the curve, everybody’s looking at curves nowadays. If you look at the curve, the curve continues to go down. And that’s also in the total hospitalization number, bounces up and down a little bit, but it’s clearly down. Number of intubations bounces a little bit, but it’s also clearly down. The number of new COVID cases walking in the door or being diagnosed is relatively flat. That is not great news. We would like to see that going down but it’s not going up either. Number of lives lost is still breathtakingly tragic – 438. That number is not coming down as fast as we would like to see that number come down.

And what we’re looking at this point is, okay, we’re on the downside of the curve, the numbers are trending down. Do they continue to trend down or do they pop back up? If they continue to trend down, how fast is the decline and how low will the decline go? In other words, if 1,300 people or about that number keep walking in the door, then you’re going to have a hospitalization rate proportionate with the number of people walking in the door. So we want to see the number of people walking in the door reduced, the number of new infections reduced, so we hit a low plateau, if you will. But we don’t know what that is and we don’t know when it is. And if you look at the number of incoming cases, it’s been remarkably flat for the past several days. So that’s the best indicator of how containment is working and how the close-down policies are working. And over the past few days, we’ve basically flattened at 1,300 new cases a day, which is not great. We would like to see those new cases reducing even more and we’d like to see them reducing faster.

You then have other long-term questions. Is there a second wave of the virus? We talk about the 1918 pandemic. It came in three waves. Is there a second wave? Does the virus mutate and come back? The federal officials are starting to talk about the fall and potential issues in the fall. They’re worried about the virus waning somewhat during the summer. Remember, there was talk, will it go away when the weather gets warm? No one is really saying it will go away when the weather gets warm in the summer. But there’s still a theory that the virus could slow during the summer but then come back in the fall. If it comes back in the fall, then it comes back with the normal flu season. That’s then problematic because you are then quote/unquote testing for the flu and you’re testing for covid on top of all the other tests you do. That could be a possible overwhelming of the testing system.

If people could have the flu or could have COVID in the fall and they don’t know which it is they could get nervous and start going into the health care system which could then bring back a capacity issue in the health care system. So that’s something we have to worry about and watch.

Nursing homes are our top priority. They have been from day one. Remember how the nursing home system works. They are private facilities. They get paid to provide a service. They get regulated by the State government. There are certain rules and regulations that they must follow and we put in additional rules and regulations on nursing homes in the midst of this crisis. Staff must have appropriate PPE. They must have their temperatures checked before they come into the facility. There are no visitors who are coming into the facility which is a tremendous hardship but it’s necessary to protect public health. If they have a COVID-positive person in the facility that person has to be in quarantine. They have to have several staff for the COVID residents versus the non-COVID residents.

If they can’t care for the person in the facility they have to transfer the person to another facility. The nursing home is responsible for providing appropriate care. If they cannot provide that care then they have to transfer the person to another facility. They have to notify residents and family members within 24 hours if any resident tests positive for COVID or if any resident suffers a COVID-related death. That is a regulation they have to follow and they have to readmit COVID-positive residents but only if they have the ability to provide the adequate level of care under Department of Health and CDC guidelines.

If they do not have the ability to provide the appropriate level of care then they have to transfer that patient or they call the Department of Health and the Department of Health will transfer that patient. But that is how the relationship works.

The State has very strict guidelines on privately run facilities. They get paid to take care of a resident. That resident, that patient must have a State-directed level of care. If they cannot provide that they can’t have the resident in their facility – period. Those are the rules.

We’re going to undertake an investigation of nursing homes now to make sure they’re following the rules. It’s going to be a joint Department of Health and Attorney General investigation, but those are the rules. They get paid to take care of a resident and they have to do it in accordance with State rules and if they don’t we will take appropriate action. The State Department of Health and the Attorney General are going to be commencing an investigation to make sure all of those policies are in place and being followed. If they’re not being followed, they can be subjected to a fine or they can lose their license. It’s that simple.

Testing is going to be a major operation that happens from now until the situation is over. It’s new, it’s technical, it’s complex, it’s a political football, but testing does a number of things for us. Number one, it reduces the spread of the virus by finding people who are positive, tracing their contacts and isolating them. That’s a function of testing.

Testing also – what they call anti-body testing – you test people to find out if they have the antibodies. Why? Because if they have the antibodies they can donate blood for convalescent plasma which is one of the therapeutic treatments. So you want to find people who had it so you can identify them to donate for convalescent plasma. The testing also can tell you the infection rate in the population, where it’s higher, where it’s lower, to inform you on a reopening strategy and then when you start reopening, you can watch that infection rate to see if it’s going up. If it’s going up, slow down on the reopening strategy. There are different forms of testing for different purposes. All of them are important. It was vital for any state, I believe, to first get a baseline study of where you are on the infection rate. All we know, to-date, is the hospitalization rate. How many people are coming into hospitals. That is all we have been tracking. That’s all we know.

From that, you had all sorts of anecdotal extrapolations on the hospitalization rate saying, I think the infection rate, I think the infection rate is that. I said, “I want to have the infection rate.” We have undertaken the largest, most comprehensive study of New York State to find out what is the infection rate. That, we started a few days ago. Sample size so far, 3,000 people statewide. Let’s find out what the infection rate is. We have preliminary data on phase one and this is going to be ongoing. We did about 3,000 tests. We’re going to continue this testing on a rolling basis. We’ll have a larger and larger sample, but I want to see snapshots of that is happening with that rate. Is it going up? It is flat? Is it going down? It can really give us data to make decisions.

We did 3,000 surveys in about 19 counties, 40 localities across the state. The surveys were collected at grocery stores, box stores, et cetera. That’s important. It means you’re testing people who, by definition, are out of the home and not at work. What does that mean? I don’t know, but that has to be a factor that’s taken into consideration. These are people who are out and about shopping. They were not people who are in their home. They are not people who are isolated. They are not people who are quarantined who could argue probably had a lower rate of infection because they wouldn’t come out of the house. These are people who were outside. These are people who were not at work so they’re probably not essential workers. So that has to be calibrated.

What we found so far is the statewide number is 13.9 percent tested positive for having the antibodies. What does that mean? It means these are people who were infected and developed the anti-bodies to fight the infection. So they were infected 3 weeks ago, 4 weeks ago, 5 weeks ago, 6 weeks ago, but they had the virus, they developed the antibodies and they are now quote, unquote recovered, 13.9 percent, just about 14 percent.

Breakdown male, female: Female 12 percent positive, males close to 16 percent, 15.9 percent positive. Regionally, Long Island at 16.7, New York City at 21.2, Westchester, Rockland 11.7 and rest of state, 3.6. This basically quantifies what we’ve been seeing anecdotally and what we have known, but it puts numbers to it. Rest of the state is basically upstate New York, 3.6. It’s been about 7-8 percent of the cases that we’ve had in the state. Westchester, Rockland we had an initial significant problem. Remember Westchester had the largest, hottest cluster in the country at one time. Eleven percent, so it’s literally somewhere in between. New York City 21, which again, supports what we knew anecdotally. Long Island, 16.7 so it’s not that far behind New York City and it is significantly worse than Westchester, Rockland. We’ve been talking about Westchester, Rockland and Nassau, Suffolk basically as one. But there is a variation with the Long Island numbers. By race, Asians about 11.7 percent, African-American, 22 percent, Latino, Hispanic, 22 percent, multi none other, 22 percent, white 9.1 percent. This reflects more the regional breakdown, African-American and Latinos are in this survey, disproportionately from New York City, and New York City is at 21 percent. So, the African-American number, Latino number is 22 percent. Upstate, whites, they’re talking about more upstate, which is 9, but it’s 3.6 in the survey. By age, nothing extraordinary here. We did not survey anyone under 18. So it starts with 18 years old. 18 to 24, 8 percent. 45 to 54, 16. 75 plus, 13.

But it’s a small percent of the total. Again, how many 75-year-olds were out shopping and about? That is the group that’s supposed to be isolating because they are the most vulnerable. 65 to 74 also. But that’s the distribution. Again, the sample was by definition, people who were outside the home, so we have to analyze that. What does that do to the numbers? But that is a factor that has to be taken into consideration. If the infection rate is 13.9 percent, then it changes the theories of what the death rate is if you get infected. 13 percent of the population is about 2.7 million people who have been infected. If you look at what we have now as a death total, which is 15,500, that would be about .5 percent death rate. But, two big caveats. First, it’s preliminary data, it’s only 3,000. Well, 3,000 is a significant data set, but, it’s still preliminary.

And, when we say there are 15,500 deaths, that number is going to go up. Those deaths are only hospitalization or nursing home deaths. That does not have what are called at-home deaths, right. This doesn’t include people who died in their home and were not in a hospital or a nursing home. We still have to compile all that data. And then the at-home deaths, you have to go back and try to find out what was the cause of death for those at-home deaths, and then add them to the number of deaths connected to COVID. It gets even more complicated because in California, they’re now finding deaths that go back to last December or January that they believe were COVID-related. And people didn’t even know about COVID at that time. So, if you then go back to December and January, and start to look at the number of deaths and check them for a COVID-related death, I don’t even know how you do that practically, you’ll see that total number of deaths go up.

But that 15,500 is not an accurate total number of deaths, in my opinion. Well, fact. It’s not an accurate total number of deaths because it does not count in-home deaths, at-home deaths. It’s not accurate because there will have been many other deaths that were never tested for COVID that should be attributed to that number. But, with those caveats, that’s what we see in this survey. It also supports the decision that we talked about to have a regional analysis and decision-making. Upstate New York is 3.6 percent. New York City is 21 percent. What you do in a place with 21 percent is not the same thing necessarily that you would do in a place with 3.6 percent. It’s just not. It’s the same theory that some states open now, and New York doesn’t. Because the facts should dictate the action. If the facts dictate the action – you have different facts, you have different action. So when we talk about a regional analysis on reopening, that’s exactly right because look at the facts in that area.

But there’s a second complicating factor, because there always is. What you do in a region still has to be coordinated because you have a pent up demand in the whole tristate area where one region opens up for business – you could see people come in, literally, from the tristate area and overwhelm that region. We try to rationalize with Connecticut and New Jersey because there have been facilities in Connecticut that were open and you have all sorts of New York license plates there. So, yes, regional analysis, but understand on that regional analysis that you still exist in a tristate area with millions of people who are looking for something to do to get out of the house and put the kids in the car and go. That has to be factored in because that is a significant factor.

We also have to do more to get testing in the African-American and Latino communities. We talked about health disparities. This state did not have the kind of disparities we’ve seen in other states, but I want to understand them and I want to address them. There are going to be a number of factors why you could have a higher percentage of positives in the African-American, Latino community. There were existing health disparities. There were existing comorbidities. Underlying illnesses, diabetes, et cetera. I also believe you have a greater percentage of the “essential workers” who are African-American and Latino. While everyone else or many other people had the opportunity to lockdown at home as terrible as that was, the essential workers had to get up every morning and go out and drive the bus and drive the train and deliver food and do all those essential services that allowed people to stay home.

Also, you have more people in the New York City area. More people getting on subways, getting on buses. More people dealing with that density. We know that’s where it communicates. But, New York City Housing Authority – we’re starting more testing today at New York City Housing Authority facilities. You talk about public housing. I was a HUD secretary. I worked in public housing all across this nation. That is some of the densest housing in the United States of America. People crammed into elevators, crammed through small lobbies, overcrowding in their apartment. So, public housing does pose a special issue and it should be addressed.

I also want to get more testing in African-American and Latino communities all through the New York City area, including Long Island after this. I want to work with Congressman Hakeem Jeffries and Congress member Yvette Clarke and Congress member Nydia Velazquez to help us work with the churches in those communities. The churches have volunteered, many of them, to be testing sites. One of the problems is finding a testing site, but many churches have said they would be willing to use their facilities for testing sites. As we ramp us the testing, I want to get it into the African-American, Latino community and using the churches as a network, I think, is going to be extraordinarily effective. But this is something New York should lead the way on – answering this question and addressing this issue.

Also, I want to speak to a point from our friends in Washington. Senator McConnell, who is the head of the Senate. You know, we’ve been talking about funding for state and local governments. It was not in the bill that the House is going to pass today. They said don’t worry, don’t worry, don’t worry the next bill. As soon as the Senate passed it, this current bill, Senator Mitch McConnell goes out and he says, “maybe the states should declare bankruptcy.” Okay? This is one of the really dumb ideas of all time. You know, I said to my colleagues in Washington, I would have insisted that state and local funding was in this current bill, because I don’t believe they want to fund state and local governments. Not to fund state and local governments is incredibly shortsighted. They want to fund small business, fund the airlines, I understand that. But state and local government funds police, and fire, and teachers, and schools. How do you not fund police, and fire, and teachers, and schools, in the midst of this crisis. Yes, airlines are important, yes small businesses are important, but so are police, and fire, and healthcare workers, who are the frontline workers. When you don’t fund the state then states can’t fund the services. It makes no sense to me.

It also makes no sense that the entire nation is dependent on what the governors do to reopen. We’ve established that it’s up this governor, it’s up to this governor, it’s up to this governor. But then you’re not going to fund the state government? You think I am going to do it alone? How do you think this is going to work? And then to suggest we’re concerned about the economy? States should declare bankruptcy? That’s how you’re going to bring this national economy back, by states declaring bankruptcy? You want to see that market fall through the cellar? Let New York state declare bankruptcy, let Michigan declare bankruptcy, let Illinois declare bankruptcy, California declare bankruptcy. You will see a collapse of this national economy. So, just dumb. Vicious is saying when Senator McConnell said, “This is a blue-state bail out.” What he’s saying is, if you look at the states that have coronavirus problems, they tend to be Democratic states. New York, California, Michigan, Illinois, they are Democratic states. So, if you fund states that are suffering from the coronavirus, the Democratic states, don’t help New York state because it is a Democratic state. How ugly a thought — I mean just think of what he’s saying. People died, 15,000 people died in New York, but they were predominantly Democrats, so why should we help them?

For crying out loud, if there was ever a time you’re going to put aside your pettiness and your partisanship and this political lens that you see the world through Democrat and Republican and we help Republicans, but we don’t help Democrats. That’s not who we are, it’s just not who we are as people. If there is ever a time for humanity and decency, now is the time. And if there was ever a time to stop your political obsessive political bias and anger, which is what its morphed into, just a political anger, now is the time and you want to politically divide this nation now? With all that’s going on? How irresponsible and how reckless. I am the governor of all New Yorkers, Democrat, Republican, independent, I don’t even care what your political party is, I represent you. We are all there to support each other. This is not the time or the place or the situation to start your divisive politics, it is just not.

That’s why look, our rule has been very simple from day one. There is no red and blue. There should have never been a red and blue when it comes to any important issue, but certainly not now. That’s not what this country is all about. It is not red and blue, it is red, white, and blue. When we talk about New York tough, we are all New York tough, Democrats and Republicans. We’re all smart, we’re all disciplined, and we’re all unified, and we’re all in this together and we understand that and that’s how we operate. We operate with love and we’re strong enough to say love. Say love is not a weakness. It is a strength and New Yorkers are that strong.


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