Coronavirus’ greatest toll in many upstate N.Y. counties is in inside nursing homes

In some rural upstate New York counties, 100% of coronavirus deaths are happening in nursing homes.

While Yates County has only recorded seven deaths to date, 100% of those deaths have been elderly residents of one local nursing home, The Homestead. According to Yates County Public Health, all the victims ranged in age from their 60s to over 100 and had underlying health conditions.

Lara Turbide of Finger Lakes Health confirmed the figure, saying everyone at the Homestead is “deeeply saddened” by the residents’ deaths. The Homestead is working to share all information with residents’ families and Public Health, she added. 

“Patient Zero” at the Homestead was a local resident who returned to Yates County from another hospital to undergo rehabilitation in early April. That person was only admitted after two negative tests, and was placed in an isolation room. On day 14 of isolation, the patient showed mild symptoms and tested positive, says Turbide. Since then, that patient did recover and has returned home. 

Turbide says the State Dept. of Health tested 87 of the 107 residents last Tuesday, and all the tests proved negative Thurday. Of those not tested, three had tested negative within a few days prior; nine had previously tested positive and had recovered, and eight declined to be tested. All staff are tested twice weekly, a policy Turbide says the Homestead adopted before the state requirement. 

Other counties are reporting similar statistics. In Warren County, 100% of deaths have been linked to nursing homes. In Tioga County, 95% of deaths have been linked to nursing homes. In Steuben County, 76% of deaths have been linked to nursing homes. Steuben County confirmed people who tested positive for the virus traveled to The Homestead, but would not confirm if the people were nursing home residents or health care workers.

Three new cases were reported to Yates County Public health Monday, May 25, bringing the total positive cases to 41 for the county, with 29 recovered. Forty people are currently in isolation or quarantine.

Death Toll

New York’s coronavirus nursing home death toll is staggering, and in some upstate counties, more than three quarters of virus-related deaths can be linked to elder-care facilities. In Warren and Yates counties, 100% of deaths were linked to nursing homes, and in Tioga County, 95% of deaths are linked to one facility.  

Gov. Andrew Cuomo halted visitors to nursing homes in mid-March as the state tried to slow the spread of COVID-19, but cases and deaths continue to rise, possibly from health care workers or other employees bringing the virus into facilities.

May 10, Cuomo ordered mandatory testing for all nursing home employees, but positive coronavirus cases in some facilities had already risen to extreme levels among those who are most vulnerable to COVID-19. In New York, more than 5,300 deaths have been linked to nursing homes.

Dr. David Grabowski, Professor of Health Care Policy at Harvard University, said resources haven’t been concentrated to protect nursing home residents and other vulnerable people from contracting COVID-19. He said mass testing of employees seems extreme, but it would allow resources to be focused on the residents.

“Also, by spending money on increased nursing home testing, we might be able to open up other parts of the economy, assuming good social distancing, use of masks, hand-washing, and the immediate quarantining of anyone that shows symptoms,” Grabowski said.

As parts of upstate continue with the opening phase of reopening, nursing homes continue to struggle with active COVID-19 cases, even as the state, counties and facilities have tried to alleviate the impact of the coronavirus on the elderly.

Warren County

Health Services last week confirmed a total of 221 COVID-19 cases among county residents since the outbreak began. Of those, 113 involve residents in nursing homes, 11 in assisted living and 97 in the community. Twenty-nine nursing home or assisted living residents died from the virus. According to county health officials, 23 of those who died lived in nursing homes, four resided in assisted living, and two lived at home. 

Tioga County

Nineteen of Tioga County’s coronavirus 21 deaths were residents of Elderwood in Waverly, including 16 who died at the facility. Sixty-eight residents at the facility have been diagnosed with COVID-19.

Steuben County

County health officials confirmed last week, 31 of the 41 coronavirus deaths in the county are connected to three nursing homes: Hornell Gardens, Elderwood at Hornell, and the Ira Davenport SNF. Twenty-one Hornell-area nursing home residents have died. Ten Bath-area nursing home residents have died.

Virus ‘likely’ brought in by staff

Cuomo put a halt on visitors to nursing homes March 13, with exceptions made in end-of-life situations. Grabowski said since facilities don’t see visitors, new COVID-19 cases are likely being brought in unknowingly by asymptomatic staff.

“In order to stop these outbreaks, we need to provide nursing homes with testing for staff and residents,” Grabowski said, adding that ideally, staff could be tested prior to each shift and residents would be tested at least twice per week. When Cuomo mandated nursing homes must begin testing all employees twice a week, he said the rule was made possible by the expansion of testing capacity statewide.

According to the Long Term Care Coalition’s Emergency Action Plan for elder-care facilities, a New York Department of Health surveyor should conduct daily onsite monitoring visits at each facility with residents who have COVID-19 to ensure infection control practices and staffing levels are safe.

Testing of nursing home staffs has largely been left to the discretion of home administrators. Some have done only limited testing to date, and both employees and family members have claimed staff members at some homes worked when they were sick.

Becky Kostyshak, a nurse who was employed at the Susquehanna Nursing and Rehabilitation center, said she’s not sure of her job status since she went public about some concerns. 

“I was notified on March 23 I was exposed to COVID-19 by a visitor in the nursing home,” Kostyshak said. “The problem with this there were no visitors allowed.” Kostyshak said she asked administration if she would be contacted by the Broome County Health Department, but said she never heard from it, and opted to self-quarantine. Kostyshak said she eventually called the health department to say she was exposed to the virus.

“I found out a few days later I was the nurse of people that tested positive for COVID-19,” said Kostyshak, who later developed some symptoms of the virus but did not fit the criteria to be tested at the time so she isolated and recovered at home.

Grabowski said if staff test positive for the virus, nursing homes need to be able to pay these staff to stay home, quarantine, and draw on additional workers to fill needed shifts, and he said hazard pay may need to be instituted. Cuomo said if a nursing home operator does not follow the new testing procedures, it will lose its license.

‘Gram’ Greene

Florence Green, a Hornell Gardens resident for 11 years, tested positive for the virus on April 8, according to her granddaughter, Tarah Green. Three days later, Florence died. Tarah said she strongly believes her grandmother contracted the virus through an employee at Hornell Gardens. 

“I felt the miscommunication, the grossly large number of COVID-19 cases in that one building, and the lack of communication from staff,” Tarah said.

Florence’s COVID-19 test was administered April 7, and Tarah said her parents would be called with the results, but they never received a call. When Tarah’s aunt called to speak with Florence the next day, an employee told her Florence had tested positive. Her parents did not receive a call from the home; instead, Tarah’s father called the facility himself to check in.

The day before Florence died, Tarah was told she could visit Florence at her own risk, but she opted for a video chat instead. “Gram knew who I was, she addressed me by name and told me that she loved me.” But as they were speaking, Florence was spitting up and Tarah said she asked the activities director to give Florence something to spit into so she wouldn’t choke. “The activities director got her a Kleenex,” Tarah said.

“I have friends that are facing what my family faced with my Gram in Hornell Gardens,” Tarah said. “Friends that have loved ones who have tested positive for the COVID-19 within Hornell Gardens. My heart breaks for these residents and their families.”

Tarah said the circumstances surrounding her grandmother’s death are troublesome. She said she contacted Hornell Mayor John Buckley, U.S. Rep. Tom Reed and state Sen. Tom O’Mara, and filed a complaint with the New York State Department of Health.