Governor Cuomo. Dr. Fauci and the CDC Errored: Following are excerpts from my latest book “Health Care for All” (How to Fix Nursing Homes)

 Governor Cuomo, Dr. Fauci and the CDC errored: Unfortunately, by not doing risk analysis showing that Covid-19 nursing home patients should not be kept at the nursing homes but should be transferred to and kept in hospital ICU’s, though overcrowded. He was also the one that demanded that he needed 30,000 ventilators now! And failed to use most of them or the extra beds at the Javits Center or the Naval Floating Hospital. With New York leading the way with 1.4 million Covid-19 cases, 43,200 deaths of which 12,000 to 15,000 were nursing home patients the Governor and Dr. Fauci errored. Subsequently, Governor Cuomo who was the darling of the media on Covid-19, has his come upends. Though he denies any responsibility even the New York Times is questioning his actions and excuses. He may have to turn in his Emmy and book royalties as being a hoax.  As for Dr. Fauci and the CDC they never did categorize cases, deaths and location for risk management. Ironically, nursing homes aren’t allowed by regulations to provide acute care and must be certified for subacute care for any patient requiring hospital care for viral pneumonia, respiratory failure, high risk of stroke, heart failure, diabetic seizure, bariatric care for severe obesity must be transferred to an acute care hospital. As a result, the skilled nursing homes don’t have respiratory therapists, trained RN’s and support personnel on staff for servicing viral pneumonia and Covid-19 patients, therefore aren’t allowed to provide complex respiratory and ventilator care. Also, since they don’t have negative air filtration rooms, 24-hour on-site RN coverage and physicians making daily rounds for continuous supervision of Covid19 interventions, evaluations and treatment they generally don’t have a subacute certification to provide post hospital complex respiratory and ventilator care.  As a result, in New York over 8,000 patients in nursing homes expired due to the decision by Governor Cuomo to require hospitals to send patients with Coved19 back to nursing homes and not accept Covid-19 readmissions. Across the country 1.6 million nursing home patients were the highest risk group and highest death rate due to Coved19. Unfortunately, the uniformed Governors, Scientists and the CDC used nursing homes as dumping grounds to alleviate overcrowded hospitals.  This not only caused deaths it exposed the other patients, the caregivers (70,000 tested positive across the country) and their families (hundreds of thousands) to the deadly virus. Following are the citations in the nursing home regulations on the requirements to provide ventilator care and the rules for involving families in the decision to discharge and readmit Covid-19 patients. These rules were obviously not followed when the families weren’t allowed in the nursing home or in ICU or visit the patient in a hospital bed. At the same time those making the decisions forgot that in the 1990’s Medicare removed Respiratory care in skilled nursing homes as a covered service unless they complied with the following costly regulations. Even then the reimbursement was averaged in with all other clinical care and watered down the amount a facility could be paid for the high compliance costs. Thereby eliminating Respiratory Therapists from the nursing home caregiver team. Vent units then disappeared from skilled nursing centers and left the hospital or subacute care providers as the provider of those services. Then under the Obama administration hospitals and skilled nursing facilities were penalized for admitting and readmitting such cases (elderly patients were referred to as frequent fliers between the nursing home and the hospital) to reduce the Medicare and Medicaid costs. Following are excerpts from the rules and regulations pertaining to complex respiratory care, including procedures for including the family in any decision to transfer patients back and forth to the hospital.