ALBANY — Every New York hospital will lose money this year as medical experts prepare for a possible second wave of the COVID-19 pandemic, they said during a Legislature hearing Wednesday.
They declined to provide an updated count of virus-related nursing home deaths in state hospitals.
National controversy has surrounded the state’s 6,300-plus COVID-19 deaths in nursing homes, especially after lawmakers grilled state Department of Health Commissioner Dr. Howard A. Zucker at an Aug. 3 hearing.
Zucker did not answer questions or provided vague responses to queries posed by representatives, leaving them unimpressed.
Zucker again Wednesday declined to provide an exact number of nursing home residents who were transferred to hospitals where they later died.
The state’s fatalities in adult care facilities account for about 25% of the state’s 25,218 deaths to date.
“We have already discussed the issues of the nursing homes — I’m really here to talk about the hospitals,” the health commissioner said.
Greater New York Hospital Association President Kenneth Raske and Healthcare Association of New York State President Bea Grause also did not have the information, they testified Wednesday.
COVID-19 death information is delayed by the time it reaches the state, Grause said, referring lawmakers to Zucker’s earlier responses.
“Didn’t he say at the end of the pandemic he would provide more data?” she added in response to a question asked by Assemblyman Kevin Byrne, R-Mahopac. “We certainly are willing to look at it. I think the commissioner said he would be doing that.”
Hospitals collect data about every patient, Raske said, including where a patient comes from, where they were picked up and more.
“I don’t know if our hospitals report that information to the Department of Health,” Raske said. “Is it readily available to either Bea or me? We both say no.”
New York City Councilwoman Carlina Rivera, who chairs the city’s Hospitals Committee, said she is concerned about the state DOH’s lack of transparency and its failure to provide a number of nursing home patients who died from COVID-19 in state hospitals.
“I think the data behind nursing home transfers and hospitals and deaths must be publicly released for an independent review,” she said. “I would certainly be interested in that data. If I have to FOIL it, I will. … This has affected internal mortality and bringing more awareness around it.”
Elective surgeries were suspended at hospitals statewide for several weeks this spring because of the coronavirus pandemic, which negatively impacted medical revenue — especially upstate where COVID-19 numbers did not hit the same peak as the city and downstate counties. Elective surgeries resumed in stages as the state’s 10 regions reopened through May and June, but patients remain nervous to enter or stay in the hospital out of fear of becoming infected with the virus, Raske said.
“We cut our volume deliberately by eliminating elective surgeries,” he said. “There was a super big revenue loss as a result of that. Coupled with that now is, will the patients return? Their attitudes about going to the hospital have been affected.”
The changes led to fewer commercial payments for hospitals and a greater number of New Yorkers receiving Medicaid after the pandemic left millions unemployed.
“It put enormous fiscal pressure on our institutions,” he added. “Every hospital in New York state is going to lose money this year. The question is, how much?”
The comments came as Senate and Assembly lawmakers held a public hearing Wednesday on COVID-19 in New York hospitals and funding for medical facilities as the state anticipates a $30 billion budget deficit over two years and the pandemic continues. The hearing started at 10 a.m. and featured testimony from panels of state health experts and questions from representatives in the Health, Investigations and Government Operations committees and the bicameral Administrative Regulations commissions for the rest of the day.
Grause and Raske highlighted the need for federal assistance to help close state budget gaps caused by the pandemic. The state had a $6.1 billion budget hole at the beginning of the year, which officials expected to reduce with $2.5 billion in Medicaid cuts. Gov. Andrew M. Cuomo and his top aides have said they expect widespread 20% cuts to health care, education and local governments in next year’s budget because of unprecedented pandemic spending.
“Through April 2021, hospitals will have suffered between $20 (billion) and $25 billion in losses and new expenses,” Grause said. “The pandemic has had a staggering fiscal impact. We need the federal government to do its part. Additional provider cuts are unthinkable, and we cannot let that happen.”
The federal $2.2 trillion CARES Act coronavirus relief bill provided $9 billion of relief to state hospitals — a figure Grause said is a “drop in the bucket” compared to the overall need for state medical centers.
“We are lobbying ferociously for state and local relief for all municipalities and states across the United States,” Raske said, adding that House Speaker Nancy P. Pelosi, D-Md., addressed the association board last week. “I am deeply concerned about the record unemployment and economic recovery,” he said. “We have to pull this state out of what could be a dire situation economically post-COVID as we go forward.”
The state’s 214 hospitals, especially downstate and in New York City where the coronavirus outbreak hit hardest this spring, battled a shortage of COVID-19 testing supplies; personal protective equipment (PPE), such as gowns, gloves, face shields and masks; ventilators; and in-patient and intensive care bed capacity. Hospitals shared and transferred services, staff and supplies statewide. At one point, hospitals struggled to have enough of the drug that sedated critically ill COVID-19 patients to put them on a ventilator.
“It was truly a team effort,” Grause said.
Raske agreed, joining Grause in profusely thanking the health care workers who risked their lives to save others fighting the novel coronavirus.
Both health officials praised the coordination among hospitals across New York to work together and with state officials to save lives.
“It was the largest deployment of health care resources in the history of the United States,” Raske said. “Hospital workers are the heroes, and I will never ever forget that. They put their lives on the line.”
New York has 53,000 hospital beds and 3,000 ICU beds statewide. Before the height of the pandemic, the National Guard constructed temporary medical centers for overflow coronavirus patients, with several downstate, on Long Island and in college dormitories and former nursing homes. The state’s initial COVID-19 hospitalization numbers and people in intensive care were projected to leave the number of beds thousands short.
“It was under wartime conditions,” Raske said. “We put hospital beds in cafeterias, lobbies — we put them in places we never even dreamed of having beds. … We were probably within 5 to 7% of the breaking point. That’s how close it came.”
The “breaking point,” Raske said, means placing patients in hallways or choosing which patients receive a ventilator or similar treatment and have the highest chance of survival.
More than 30 states continue their COVID-19 battle, fighting rising hospitalizations, infection and death rates, with Texas, California, Arizona and Florida leading the pack in surging cases.
The hospitalizations in those states is lower than New York’s numbers in March and April, although California, Texas and Florida have larger populations.
“It’s not ramping up to the degree it had in New York,” Raske said. “New York’s history on (COVID-19) hospitalization is substantially more than twice as bad than in Texas, California and Florida.”
Lawmakers did not ask Raske why.
Raske replied to Assemblyman Brian Manktelow, R-Lyons, saying he would compile a list of suggestions on how the state can help local, rural hospitals without additional federal assistance.
Raske said he would speak with hospital staff and give suggestions to Sen. James Skoufis, D-Woodbury, about legislative policies to change before a second COVID-19 wave.
Grause and Raske encourage hospitals to implement expanded regulations, including mandatory temperature checks and wearing PPE, to allow patients to safely receive in-person visits.