Vulnerable nursing home residents are being moved between facilities with little notice to families or elected officials, prompting concerns about the Cuomo administration's new strategy to create "COVID-only" establishments. While state officials say the policy is needed to keep hospital beds open for acute-care patients, critics told Gothamist/WNYC the lack of transparency fits a pattern, one that prioritizes nursing homes over patients and their families.

Advocates and elected officials pointed out that several facilities taking in COVID-positive patients discharged from hospitals have poor ratings, including one nursing home that has spent more than five years on a federal watch list for some of the worst nursing homes in the country.

“The public and I, as chair of the Assembly Health Committee, don’t really know anything about this,” said Assemblymember Richard Gottfried. “It’s troubling and it’s unfortunately a fairly common situation with the Cuomo administration.”

Earlier this year, after an investigation by Attorney General Letitia James and mounting pressure from lawmakers, top officials in the Cuomo administration admitted they obscured the data on nursing home deaths by not including the nearly 4,000 nursing home residents who died in hospitals. Gottfried said the latest lack of transparency about the COVID-only nursing homes suggested they haven’t changed their ways, adding that he does not have a problem with the program itself.

“They will tell us every day within hours precisely how many people they say got vaccinated yesterday. But a lot of information they refuse to give out or sometimes refuse to say they have.” Gottfried noted. “I don't think I've experienced this kind of wall-to-wall secrecy policy in a governor previously. And, you know, I've served with eight governors, so that's saying something.”

State officials told WNYC/Gothamist the move was needed to keep hospital beds open for acute-care patients. Originally, 19 nursing homes were designated COVID-only, with some facilities setting aside a wing or a unit and others an entire building. Because of a decline in COVID cases, health officials decreased the number to 13. As of March 10th, 36% of hospital beds were available in the state.

"Should rates of COVID prevalence rise, we are prepared to and will work to re-establish more COVID-only nursing homes as needed,” a Department of Health spokesman wrote in a statement. “Nursing homes are required under state and federal laws and regulations to accept only those residents for whom they can provide appropriate care."

Beyond poor communication about the new policy, critics told Gothamist/WNYC they were worried about residents who were moved haphazardly to low-rated facilities to make room for Covid patients who have the potential to bring in more funds because Medicaid reimburses homes at a higher rate for their care.

One resident of a long-term facility, who spoke on condition of anonymity for fear of retaliation, said he was given less than 24 hours warning before he was moved. He had lived at Beach Gardens Nursing and Rehab Center in Far Rockaway, Queens for 12 years.

“They told me to pack and that was it. The next day I was moved out,” the man told us, adding that at the new facility he was in he saw residents walking the halls without masks and crowded conditions. He said he was put in a room with three other people.

“I didn't come from one place to come to this place to get sick or get something,” he said. “I was scared. I was very, very scared.”

The man had moved from a four-star facility, as determined by the federal government, to a two-star facility, both run by the same owner. After complaining for several weeks and contacting the state health department, the man was transferred to a third facility, with a four-star rating, also owned by the same operator.

Beach Gardens didn’t respond to a request for comment. Last month staff from the facility protested the nursing home’s conversion to a COVID-only facility.

WNYC/Gothamist learned of this one man’s story because he works with an organization called the Center for Independence of the Disabled NY, which tracked him down after he was suddenly moved from his Far Rockaway home. Susan Dooha, executive director of CIDNY, said three other clients were transferred to make room for COVID patients—staff haven’t been able to locate two of them.

“Here we are in New York City in 2021 and it's possible to disappear people if they're older or if they have disabilities,” Dooha said. “With really no control whatsoever, no residents' rights, no ability to complain or appeal or say no, that's a really inhuman thing to do to someone.”

A spokesperson for the state health department declined to say what protections were in place to ensure residents were not transferred into facilities that were unsafe or inappropriate for them. They also wouldn’t say why facilities with poor ratings from the federal government would be suitable to care for COVID-19 patients.

“There are currently 13 various alternative facilities, with a significant number of beds suitable for COVID-positive nursing home patients,” they said in a statement. “These facilities, in coordination with local health systems and local governments, offered to voluntarily convert to COVID-only on a temporary basis. Each operator and facility was vetted against a backdrop of community need, quality and infection-control protocols, and operational ability.”

But it's been well documented that Cayuga Ridge Extended Care is a troubled nursing home with a long history of problems. According to an inspection report in June of 2019, it had 27 deficiencies. The average number of deficiencies in New York State is 5.2. In October, health officials found the nursing home failed to “provide and implement an infection prevention and control program.”

Cayuga did not return a phone call seeking comment; it’s unclear how many COVID patients are currently under its care.

Richard Mollot, an advocate for residents of long-term care facilities and director of the Long Term Care Community Coalition, said the Cuomo administration once again failed to consider the well-being of nursing home residents when implementing policy. He pointed to Cayuga, a one-star facility on a federal watch list as a stark example.

“There's really no oversight or planning to make sure that, again, that the facilities that are chosen are good and appropriate and meeting the minimum standards of care,” Mollot said. “And the same goes for the facilities to which people are being sent.”

Another facility on the state list with a low rating, the New Jewish Home, told Gothamist/WNYC that the federal rating system for nursing homes was problematic. The federal government gave the Manhattan facility an overall two-star rating, and only one star when it comes to health inspections.

Jeffrey Farber, director of The New Jewish Home, said the home has taken 174 COVID patients transferred from hospitals so far, and he defended the quality of care they’ve received

“We've had now seven infection-control focused prevention surveys by the Department of Health over these many months, and all of them have been perfectly fine, deficiency-free,” he said.

The non-profit nursing home on West 106th street isolated COVID patients in one of their three buildings. Farber said he had the room because many former residents died from COVID and no new residents arrived to replace them. He said the decision to take in COVID patients was not motivated by financial gain, although he acknowledged that the facility operated with a deficit, a financial reality that existed prior to the pandemic.

“So whether we'll end up better or not, I'm not really sure,” he said. “But it's certainly the right thing to do to take care of people.”

The facilities on the COVID-only list could receive a 50% percent increase in Medicaid reimbursement, something Gottfried said was reasonable as long as the extra money goes toward patient care. But he warned that nursing homes, particularly for-profit facilities, often spend a small fraction of their revenue on patients. Farber said the bump only kicks in after 100 days and by then most patients will have recovered and moved on.

Farber said he’s had to hire more staff, build a new entrance, and outfit workers with protective equipment to safely care for COVID patients. He said nursing homes have been unfairly blamed and scapegoated throughout the pandemic.

“It’s been a long, sort of demoralizing year in many ways,” he said. “I mean, this is a pandemic and we're on the front lines.”

Additional reporting from Afia Eama