So it came as no surprise that a total of 40,058 COVID-19 deaths had been recorded from the long-term care (LTC) residents of those states, accounting for 23 percent of the 174,474 COVID-19 deaths from LTC facilities across the United States.
Among the four states, New York had the most LTC residents who died from COVID-19 with 14,450, followed by Pennsylvania with 12,565, New Jersey with 7,969 and Michigan with 5,074. The numbers were derived from the COVID Tracking Project.
Overall, more than 500,000 Americans have died from coronavirus and one in every three was a nursing home resident. It was very clear that elders were vulnerable to the disease, but some politicians just couldn't see it.
New York Gov. Andrew Cuomo's policy requiring nursing homes to admit COVID-19 positive patients has been the most maligned. In January, New York State Attorney General Letitia James released a report that said the New York State Department of Health (NYDOH) had drastically under-reported COVID-19 deaths from nursing home residents. (Related: Will Andrew Cuomo be prosecuted for hiding data on nursing home coronavirus deaths?)
The NYDOH immediately corrected the number, but doubts lingered about the data's credibility.
A report released last month by the Empire Center for Public Policy concluded that Cuomo's policy had a direct impact on nursing home COVID-19 death rates.
The report titled "COVID-positive Admissions Were Correlated with Higher Death Rates in New York Nursing Homes" stated: "The admission of coronavirus-positive patients into New York nursing homes under March 25 guidance from the New York State Department of Health was associated with a statistically significant increase in resident deaths."
Cuomo's policy was in effect from March 25 to May 10 last year.
The report noted that there were 6,327 COVID-positive new admissions in nursing homes across the state between late March and early May and that they were associated with possibly more than a thousand resident deaths.
Pennsylvania Gov. Tom Wolf issued interim guidelines on March 18 last year, telling nursing homes to admit stable patients from hospitals.
The state provided more detailed guidelines on May 12, telling hospitals to test patients for COVID-19 before releasing them to a nursing home. But the guidelines stated that the nursing homes should admit the patients whether or not they tested positive for COVID-19.
Wolf had been investigated by the Pennsylvania House for his handling of long-term care facilities during the coronavirus pandemic.
New Jersey Gov. Phil Murphy, through the New Jersey Department of Health, required nursing homes to admit COVID-19 positive patients on March 31 last year, less than a week after its neighboring state of New York did the same.
Sen. Joe Pennacchio of New Jersey obtained copies of both guidelines and highlighted the similarities.
"Seems to me that New Jersey was taking directions from New York on its handling of COVID-19 patients in nursing homes," said Pennacchio.
Michigan Gov. Gretchen Whitmer issued an executive order requiring nursing homes to accept COVID-19 positive patients on April 15 last year.
"A long-term care facility must not prohibit admission or readmission of a resident based on COVID-19 testing requirements or results in a manner that is inconsistent with relevant guidance issued by the Department of Health and Human Services," the executive order stated.
During the Trump administration, the Department of Justice (DOJ) requested COVID-19 data from the governors of states that issued orders which may have resulted in the deaths of thousands of elderly nursing home residents.
The DOJ's Civil Rights Division evaluated whether to initiate investigations under the federal "Civil Rights of Institutionalized Persons Act" (CRIPA), which protects the civil rights of persons in state-run nursing homes, among others. The division wanted to determine if the state orders requiring admission of COVID-19 patients to nursing homes is responsible for the deaths of nursing home residents.
It wasn't clear if the DOJ under President Joe Biden would proceed with the investigation.
In Michigan, Macomb County Prosecutor Peter Lucido is establishing a protocol for the families of those who died in nursing homes from COVID-19 to file a criminal complaint against the state and Whitmer.
"If we find there's been willful neglect of office if we find there's been reckless endangerment of a person's life by bringing them in then we would move forward with charges against the governor," Lucido said. "Of course, we would. Nobody's above the law in this state.
Lucido started looking into the matter last year as a Michigan senator. He issued a statement in August last year that said more than 2,000 residents and 21 staff died in nursing homes, accounting for 32 percent of all COVID-19 deaths in the state.
"Why did my mom or why did my dad, brother, sister or aunt die? Was it because of the policy by bringing in COVID-infected patients that spread to my mom that killed my mother?" Lucido said. "This is not political, everyone. This is about people who passed away at the behest of a policy that was created by the governor."
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