Pennsylvania’s Nursing Home COVID-19 Scandal
(This article first appeared in the American Spectator.)
By Paul G. Kenor
Americans are well aware of the nursing home scandal in New York, where Gov. Andrew Cuomo allowed overflow COVID-19 patients to be sent to the worst possible place. Naturally, this had the effect of seeding outbreaks in New York nursing homes, many of which were subsequently ravaged. And when the angry Cuomo is asked about it, he does what he does best — he lashes out at whoever asks the question.
Well, it looks like New York may not be alone. The same thing might have happened next door in Pennsylvania, and perhaps worse. Pennsylvania has over 70,000 cases of COVID-19, with roughly 5,400 deaths. Of these fatalities, a staggering 70 percent (my last count) are in nursing homes. In some counties, the percentages are even higher.
The excessively high deaths in nursing homes are inflating the overall COVID-19 fatality rate in Pennsylvania, which currently stands as the nation’s fourth highest.
As a Pennsylvania resident, I’ve tracked the data daily. I noticed the disproportionate number of deaths in nursing homes weeks ago. In mid-April, I emailed with an attorney friend and an academic sociologist with a background in long-term care facilities and data analysis. What initially caught my attention was the suddenly high COVID-19 fatality rate in Allegheny County (the county for Pittsburgh). It had shot above 7 percent. This was alarming and strange. It didn’t make sense from data I was seeing on COVID-19 morbidity from the University of Pittsburgh Medical Center (UPMC) in particular. UPMC is one of the nation’s largest health-care providers and a cutting-edge research facility, which as early as April 1 held a press conference announcing the possibility that researchers there had a vaccine for COVID-19. UPMC’s overall handling of the virus (which I follow closely as a former UPMC researcher myself) was impressive and inspired confidence. UPMC facilities plainly did not have a COVID-19 fatality rate akin to what the Pennsylvania Department of Health was reporting for Allegheny and other counties.
So, where were the deaths coming from? The answer was clear when looking deeper into data at the website of the Pennsylvania Department of Health: nursing homes. When I examined the striking number of deaths in Allegheny County’s nursing homes and personal care facilities, separating those from the overall numbers, it made a big difference. The fatality rate for COVID-19 cases in Allegheny County outside of those facilities was actually barely 3 percent. And this was true for many counties statewide.
That possibility is getting major attention across the state. A devastating investigative piece was published in the Bucks County Courier Times (jointly done with reporters from USA Today), a county with a huge number of COVID-19 cases (the vast majority of Pennsylvania’s cases are in eastern counties close to New York and New Jersey). Titled, “States ordered nursing homes to take COVID-19 residents — Thousands Died,” it documents the disproportionate deaths in Pennsylvania nursing homes:
Coronavirus has spread like wildfire through many nursing homes across the Northeast, and state officials are scrambling to better protect those most vulnerable. Yet the death toll has been devastating.
On March 29, as Pennsylvania, New York and other states began ordering nursing homes to admit medically stable residents infected with the coronavirus, national trade groups warned it could unnecessarily cost more lives.
The health directives put “frail and older adults who reside in nursing homes at risk” and would “result in more people going to the hospital and more deaths,” the American Health Care Association and affiliates said at the time.
A month later, it appears government officials should have heeded the dire call to pursue different pandemic emergency plans.
Note what is alleged: On March 29, Pennsylvania joined New York and other northeastern states in “ordering nursing homes to admit medically stable residents infected with the coronavirus,” despite warnings from groups like the American Health Care Association that such “health directives” could “unnecessarily cost more lives.”
These intrepid government officials should have heeded something known as common sense. Who but a fool would move infected COVID-19 patients into nursing homes? What was option two, moving them into Walmarts?
The article continued, “The death toll is devastating, according to interviews with nursing-home officials, patients’ families, health-care advocates, government officials and from an examination of state records … across the Northeast.” And yet, among the plagued northeast, the infection rate in nursing homes is uniquely bad in Pennsylvania:
At least 3,043 people have died inside New York nursing homes due to COVID-19 complications, or about 17% of the state’s 18,015 deaths as of Wednesday.
In Pennsylvania, about 65% of coronavirus deaths [now closer to 70%] were nursing-home residents, and in counties in the hardest hit southeastern part of the state, long-term care residents account for as much as 80% of county deaths.
New Jersey had 3,200 residents of long-term care homes die due to complications from the virus, about 40% of the statewide total.
About 58% of the deaths in Delaware lived in nursing homes, and 46% of the fatalities in Maryland were at nursing homes.
Pennsylvania’s nursing home deaths are far higher than comparable states. As for how this came about, the report pointed directly to Pennsylvania Gov. Tom Wolf’s health secretary, Dr. Rachel Levine:
“This may include stable patients who have had the COVID-19 virus,” according to a copy of the guidelines.
Continued admissions was ordered “to alleviate the increasing burden in the acute care settings,” according to the directive.
Pennsylvanians who gasped when they heard that Andrew Cuomo had permitted such directives in New York recoiled in angered amazement when they heard it might have happened in their state, as well.
They were likewise aghast to hear that Dr. Levine removed her own 95-year-old mother from a nursing home. “My mother requested and my sister and I, as her children, complied to move her to another location during the COVID-19 outbreak,” Levine confirmed in a press conference.
Yes, you read that right.
So, who’s responsible? Who made these decisions? To what degree should Rachel Levine be blamed, or Tom Wolf? Are the reports accurate?
Certainly, hard questions need to be asked. And the politics of Wolf and Levine probably help explain why the liberal national media has gone easy on them. Cuomo-like, the partisan press will protect Wolf because he’s a staunch liberal Democrat. That’s likewise true for Levine. In fact, Levine is a liberal darling as the nation’s first (and arguably highest-ranking) transgendered public official. This has earned Levine nothing but love from liberal “journalists.”
There have been exceptions. A heated exchange took place between Levine and Marty Griffin, talk-show host on Pittsburgh’s KDKA-AM. Griffin during the interview referred to Levine as “sir,” which was no doubt an honest mistake, especially in an audio interview in which Levine, being biologically male, has a male-sounding voice. Griffin apologized profusely for it.
Griffin: How do you respond, doctor, to the conjecture that your response is jeopardizing the health and well-being of seniors by moving them into nursing facilities even if they’re no longer COVID positive, sir?
Levine: So please don’t misgender me.
Griffin: I’m so sorry.
Levine: It’s really insulting.
Griffin: I apologize. It’s not malicious. I apologize. I’m so sorry.
Liberals went bananas. Pittsburgh’s Mayor Bill Peduto responded with a hissy fit, boycotting his appearance not on Griffin’s show but another KDKA show. Like Tom Wolf, Peduto is a cultural radical. For LGBTQ Pride Month, his activist city officials imposed their sexual beliefs on police, forcing Steel City cops to adorn their vehicles with giant rainbow decals, despite objections by the police union.
Unfortunately, this cultural-ideological element became the dominant takeaway from the Griffin–Levine discussion. The exchange occurred precisely amid Griffin questioning Levine on nursing homes, thus allowing Levine’s liberal defenders an opportunity to shake their rainbow flags rather than focus on the far more important transgression at hand — namely, not a matter of “misgendering” but of misdirecting COVID-19 patients. The issue shouldn’t be a politically incorrect faux pas in liberal la-la land, but an apparent major mistake that literally could have killed people.
Quite ridiculously, the Griffin–Levine exchange received far more attention because of Levine’s gender. But some have kept their eye on the ball.
One influential statewide source who has called out Levine is Lowman Henry, chairman and CEO of the Harrisburg-based Lincoln Institute. In a piece titled, “It’s Time for Rachel Levine to Resign,” Henry said of the nursing home deaths, “that horrific death rate can be attributed in large measure to the Pennsylvania Department of Health’s policies requiring COVID-19 positive patients to be housed in such facilities. Officials need to be held accountable and the first person responsible is Secretary of Health Dr. Rachel Levine who should resign immediately — or be fired by Governor Tom Wolf.” Henry called it a case of “epic ineptitude.”
And it doesn’t end there.
For months, the Pennsylvania Department of Health website listed daily the number of COVID-19 cases and deaths in nursing homes county by county. As of last weekend, that table is gone. On the plus side, there’s a new table that breaks down nursing homes on a facility-by-facility basis. But that improvement is offset by other failures. For instance, one can no longer view or tabulate the state’s total nursing home cases and deaths. Moreover, what is reported doesn’t seem very reliable. The liberal Philadelphia Inquirer noted (without mentioning Levine once):
If you accept the state data released this week about the coronavirus’ scourge of long-term-care facilities, no staff members at the Philadelphia Nursing Home in Fairmount have gotten the disease — and across the city’s 47 nursing homes, fewer than 20 staffers have tested positive.
That would be wonderful news for seniors in those facilities and their loved ones. Staff members who carry the virus without showing symptoms all too often bring the disease into the homes, with deadly results.
But neither of those statements is accurate. In fact, 30 staff members at the Philadelphia Nursing Home alone have tested positive for the virus, according to the city, which owns the 402-bed facility.
It’s another dubious example of the Department of Heath’s failures.
Finally, as alluded to earlier, an added problem is that the excessively high deaths in nursing homes are inflating the overall COVID-19 fatality rate in Pennsylvania, which currently stands as the nation’s fourth highest. If comparing fatality rates outside of nursing homes, however, Pennsylvania’s numbers fare much better. That lower rate is a great credit to top health-care providers like the University of Pittsburgh Medical Center and Penn Medicine and Allegheny Health Network (AHN). And yet, one wouldn’t know that from the overall state numbers, jacked up as they are by nursing homes. The inflated numbers are a disservice to what the likes of UPMC and Penn and AHN are truly doing, and quite heroically.
Alas, that work by those private-sector providers is so outstanding that, if not for the plague eviscerating nursing homes, Gov. Tom Wolf and his health secretary could be touting the Commonwealth of Pennsylvania as a success story in which the fatality rate for COVID-19 is much lower than other states. But what has been unleashed in nursing homes literally killed that possibility.
So, the questions remain: to what extent is Rachel Levine responsible? How about Tom Wolf? Did they (very) imprudently allow COVID-19 unnecessary access to nursing homes? Is that a fair charge? What is their response to the accusations?
Pennsylvania’s Republican-led Legislature is growing impatient. The Legislature is scheduling a vote on a resolution calling on Levine to resign (sponsored by State Rep. Russ Diamond, R-Lebanon).
In the meantime, people nationwide should know that Gov. Cuomo’s New York isn’t the only state with a COVID-19 fiasco in its nursing homes.