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PolitiFact - New York’s nursing home policy was not fully in line with CDC

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Now is your chance to go on the record as supporting trusted, factual information by joining PolitiFact’s Truth Squad. Contributions or gifts to PolitiFact, which is part of the 501(c)(3) nonprofit Poynter Institute, are tax deductible.“Why did the state do that with COVID patients in nursing homes? It’s because the state followed President Trump’s CDC guidance.”New York Gov. Andrew Cuomo, facing criticism for how the state handled COVID-19 in nursing homes, has said his administration followed guidance from the U.S. Centers for Disease Control and Prevention.&nbsp;and Cuomo was asked on May 20 about calls for a federal probe into how the state handled nursing homes, and in particular,&nbsp;a March&nbsp;advisory&nbsp;that sent&nbsp;COVID-19 patients from hospitals to nursing homes.&nbsp;, but anyone who wants to ask, why did the state do that with COVID patients in nursing homes? It’s because the state followed President Trump’s CDC guidance," Cuomo said.&nbsp;Is Cuomo correct? We looked at federal guidance at the time of the state's , as well as other state Health Department actions at that time.&nbsp;CDC guidance&nbsp;Before the state Health Department sent its controversial March 25 advisory, which has since been withdrawn, the CDC released guidance for nursing homes.The CDC cited&nbsp;two "key factors" to consider when&nbsp;deciding whether to discharge a patient with COVID-19 to a long-term care facility, said Kristen Nordlund, a CDC spokesperson. First, is the patient medically ready for discharge to a long-term care facility?&nbsp;And second, is the selected long-term care facility able to safely care for a patient recovering from the virus by implementing all recommended infection control procedures? These directives were in place on or before&nbsp;, two days before the state issued its advisory.&nbsp;One week before the state's&nbsp;advisory was released, the CDC’s looked at a facility in Washington State. The report’s authors recommended that "in the context of rapidly escalating COVID-19 outbreaks in much of the United States, it is critical that long-term care facilities implement active measures to prevent introduction of COVID-19."&nbsp;The U.S. Centers for Medicare and Medicaid Services,&nbsp;the federal regulator of nursing homes known as CMS, also issued COVID-19 guidance.&nbsp;The top administrator at CMS,, pushed back on Cuomo’s claim that the state followed federal guidance. She&nbsp; a, which says&nbsp;that nursing homes should only accept those patients for which they can care.&nbsp;&nbsp;The CMS memo also states: "Per CDC, prompt detection, triage and isolation of potentially infectious residents are essential to prevent unnecessary exposures among residents, healthcare personnel, and visitors at the facility. Therefore, facilities should continue to be vigilant in identifying any possible infected individuals."&nbsp;It was a week after the Cuomo order, , that the CMS said new long-term care patients and residents "should be screened for COVID-19 through testing, if available."&nbsp;&nbsp;CMS guidance also states that if possible, nursing homes should dedicate a unit or wing exclusively to residents returning from the hospital, where they can remain for 14 days without symptoms.State order&nbsp;The state was clear about why it issued its to nursing home administrators, directors of nursing and hospital discharge planners: There was&nbsp;an "urgent need" to free up space in hospitals for seriously ill coronavirus patients.&nbsp;The advisory said all nursing homes "must comply with the expedited receipt of residents returning from hospitals to" nursing homes, and that hospitals must declare residents medically stable before they are sent back to the nursing homes.&nbsp;&nbsp;The next directive, where "NH" is "nursing home" (emphasis by the Department of Health): "No resident shall be denied re-admission or admission to the NH solely based on a confirmed or suspected diagnosis of COVID-19. NHs are prohibited from requiring a hospitalized resident who is determined medically stable to be tested for COVID-19 prior to admission or readmission."It also stated: "As always, standard precautions must be maintained, and environmental cleaning made a priority, during this public health emergency."In other communications in March, the state told nursing homes to infected residents in their rooms or to them in a dedicated unit, as well as to with CDC guidelines in preventing the spread of the disease.&nbsp;What Cuomo saysTo support Cuomo’s claim, the administration pointed us to longstanding and regulations that predate the pandemic, which require nursing homes to only accept patients for which they can care.&nbsp;"This is business in a nursing home: Take them if you can care for them," said state Department of Health spokesperson Gary Holmes.&nbsp;Holmes also pointed us to the&nbsp;, which states that when a resident who was diagnosed with COVID-19 is coming from a hospital, nursing homes "can accept" them, as long as the facility can follow CDC infection control measures.&nbsp;The CMS memo also states: "Nursing homes should admit any individuals that they would normally admit to their facility, including individuals from hospitals where a case of COVID-19 was/is present."Order’s impact&nbsp;Nursing homes to coronavirus patients&nbsp;following the March 25 order.&nbsp;&nbsp;The AMDA-Society for Post-Acute and Long-Term Care Medicine&nbsp;issued a on March 26 opposing the order: "We find the New York State Advisory to be over-reaching, not consistent with science, unenforceable, and beyond all, not in the least consistent with patient safety principles." A by that organization and others in long-term care&nbsp;three days later reinforced their objections: "a blanket order for every nursing home in the state to accept all admissions from hospitals is not sound policy."&nbsp;&nbsp;On April 9, the head of a Brooklyn&nbsp;nursing home asked state health officials if COVID-19 patients could be transfered to the Javits Center or the Navy hospital ship, and was denied permission, .&nbsp;&nbsp;In late April, when reporters questioned Cuomo about the directive that nursing homes accept coronavirus patients, Cuomo said that nursing homes should find other beds for these patients if they cannot care for them, or turn to the state to do so. He also said that the facilities " to the state’s policy.&nbsp;&nbsp;On , State Health Commissioner Dr. Howard Zucker&nbsp;said no nursing home had asked the state to take any patients it couldn’t handle.On April 29, after the state's policy had been&nbsp;under intense scrutiny, Zucker wrote a to nursing homes, telling them to alert the state if they have patients for which they cannot care.&nbsp;In recent weeks, three facilities have asked the state for help, Holmes said.&nbsp;The March 25 advisory has been from the state website, and the state’s directive to nursing homes is now much different. Cuomo on May 10, which states that hospitals "shall not discharge a patient to a nursing home, unless the nursing home operator or administrator has first certified that it is able to properly care for such a patient." The order also requires that a patient must be tested for COVID-19, and the test must be negative.&nbsp;Though the state's actions have been criticized, it’s what was&nbsp;the biggest source of infection in nursing homes, whether it was incoming residents, or health care workers and visitors unaware they had the virus.&nbsp;Our rulingThe CDC's guidance at the time of the March 25 state order was that COVID-19 patients who are medically stable can be discharged from a hospital to a nursing home, but only if the nursing home can implement all recommended infection control procedures.CMS, a&nbsp;federal agency that regulates nursing homes, issued similar guidance, and also said that preferably, coronoavirus&nbsp;patients should be cared for in a dedicated unit.&nbsp;Like CDC and CMS, the state Health Department said only those patients who are medically stable can be discharged, and&nbsp;also that nursing homes consider dedicated units, if possible. The Health Department prohibited nursing homes from requiring a COVID-19 test before admitting a resident, while&nbsp;CMS said new residents should be tested, but did not require it.&nbsp;The Cuomo administration points to state and federal regulations that predate the pandemic, which require facilities to accept only those patients they can care for. In addition,&nbsp;earlier state communications encouraged nursing homes to stay current with CDC guidance.But once the state issued its March 25 advisory, nursing home operators said that they felt they had no choice but to accept residents who were either known to be infected or suspected to be. That’s because the March 25 memo did not say anything about making sure that a nursing home can care for a patient before making an admission decision, and said they "must comply with the expedited receipt of residents." In the month following the memo, nursing homes&nbsp; from the order.&nbsp;We rate his statement Mostly False.&nbsp;&nbsp;Rev.com, May 20, 2020. Accessed May 21, 2020.&nbsp;USA Today, June 1, 2020. Accessed June 7, 2020.&nbsp;The Buffalo News, May 26, 2020. Accessed May 27, 2020.&nbsp;New York State Department of Health, March 25, 2020, via Skilled Nursing News. Accessed May 24, 2020.&nbsp;New York State Executive Order No. 202.30, May 10, 2020. Accessed May 24, 2020.&nbsp;Email interview, Kristen Nordlund, public affairs, U.S. Centers for Disease Control and Prevention, June 5, 2020.&nbsp;Twitter, , @SeemaCMS, May 21, 2020. Accessed May 22, 2020.&nbsp;Centers for Medicare and Medicaid Services, memo, March 13, 2020. Accessed May 22, 2020.&nbsp;&nbsp;Email, phone&nbsp;interviews, Gary Holmes, spokesperson, New York State Department of Health, May 21, 27, 2020.&nbsp;Centers for Disease Control and Prevention, "Discontinuation of Transmission-Based Precautions and Disposition of Patients with COVID-19 in Healthcare Settings (Interim Guidance)" on March 24, 2020, . Accessed May 27, 2020.&nbsp;Centers for Disease Control and Prevention, April 30, 2020. Accessed May 31, 2020.&nbsp;Email interview, Richard J. Mollot, executive director, Long Term Care Community Coalition, May 22, 2020.&nbsp;&nbsp;AMDA-The Society for Post-Acute and Long Term Care Medicine, March 26, 2020. Accessed May 25, 2020.&nbsp;AMDA-AHCA-NCAL Statement, March 29, 2020. Accessed May 25, 2020.Rev.com, transcript, April 23, 2020. Accessed May 30, 2020.&nbsp;&nbsp;Rev.com, transcript, April 22, 2020. Accessed May 25, 2020.&nbsp;ABC.com, May 22, 2020. Accessed May 25, 2020.&nbsp;Centers for Medicare and Medicaid Services, State Operations Manual, , Section §483.15(c) (1) (i), Revised Nov. 22, 2017. Accessed May 26, 2020.&nbsp;&nbsp;New York Codes, Rules, and Regulations: Volume C (Title 10), Chapter V, SubChapter A, Article 3, Part 415, Administrative, Title: Section 415.26 - , Admission Policies and Practices, June 2, 2010. Accessed May 26, 2020.&nbsp;Centers for Medicare and Medicaid Services, &nbsp;April 2, 2020. Accessed May 31, 2020.&nbsp;Centers for Disease Control and Prevention, March 18, 2020. Accessed May 26, 2020.The Associated Press, May 9, 2020. Accessed May 25, 2020.&nbsp;The Wall Street Journal, May 14, 2020. Accessed May 24, 2020.&nbsp;New York State Department of Health presentation, March 26, 2020. Accessed May 27, 2020.&nbsp;New York State Department of Health, March 13, 2020. Accessed May 27, 2020.&nbsp;The New York Times, March 31, 2020. Accessed May 27, 2020.&nbsp;New York State Department of Health , March 11, 2020. Accessed May 27, 2020.&nbsp;NBC News, April 25, 2020. Accessed May 27, 2020.&nbsp;Emailed statement, Christopher Laxton, executive director, AMDA-The Society for Post-Acute and Long-Term Care Medicine, May 29, 2020.&nbsp;In a world of wild talk and fake news, help us stand up for the facts.

Now is your chance to go on the record as supporting trusted, factual information by joining PolitiFact’s Truth Squad. Contributions or gifts to PolitiFact, which is part of the 501(c)(3) nonprofit Poynter Institute, are tax deductible.“Why did the state do that with COVID patients in nursing homes? It’s because the state followed President Trump’s CDC guidance.”New York Gov. Andrew Cuomo, facing criticism for how the state handled COVID-19 in nursing homes, has said his administration followed guidance from the U.S. Centers for Disease Control and Prevention.&nbsp;and Cuomo was asked on...

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PolitiFact - New York’s nursing home policy was not fully in line with CDC

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