A follow-up to my January 2026 meeting with staff for New York State Senator James Skoufis
This is a follow-up on my meeting today with New York state Senator James Skoufis’s office.
Unfortunately, Senator Skoufis was not in attendance. Participants were Chief of Staff Emma Greaven, myself, and Daniel Arbeeny. Arbeeny is lead plantiff in Arbeeny v. Cuomo, a wrongful death suit against the former Governor of New York over the 25 March 2020 nursing home directive that disallowed nursing homes from using results on a COVID test as the basis for admission.
Presentation slides can be accessed below:
Although I was disappointed the Senator was not there, I appreciated Ms. Greaven as an audience. She reviewed materials I sent in advance, listened attentively, and asked several good questions, paraphrased below.
- Why did so many nursing home residents appear to die in hospitals rather than in facilities?
Greaven asked whether nursing home staff decision-making under stress and fear about catching COVID themselves could have resulted in sending residents to hospitals unnecessarily. - What exactly do you mean by an “out-of-hospital cardiac arrest event”?
When I pointed out that deaths at personal homes were very high as well, driven by a high-magnitude out-of-hospital cardiac arrest event, Greaven asked what I meant and was intrigued by that data point. (I did not have the slide in the Power Point deck but described it.) - Is the hospital-death spike tied to U.S.-specific financial incentives, or does it appear internationally as well?
Greaven asked whether other countries without CARES-Act-style reimbursement still saw similar hospital mortality surges, and how those patterns compare. - Could family pressure have influenced death certification or reporting?
COVID versus non-COVID deaths was not my focus, but Greaven wondered if families might have pushed providers to list COVID-19 on death certificates.
My responses, written for Wood House 76 readers, and which capture the essence of my points to Ms. Greaven, follow. (It’s best to review the content in the presentation slides first.)
On the question of why so many nursing home residents appear to have died in hospitals, my first answer is that we first need to know how many died in hospitals (or shortly after being discharged to a personal residence, as Daniel Arbeeny’s father did). The data needed to answer that question have never been released. Senator Skoufis’s August 2020 question to NY DOH Commissioner Howard Zucker – “How many of New York’s nursing home residents died in hospitals?” – remains unanswered. There is no resident-level accounting of nursing home deaths by place of death, either for New York or any individual state or the U.S. as a whole.
What we do have are significant challenges to the prevailing narrative. Hospital discharge data show a sharp decline in discharges to skilled nursing facilities in 2020, not an increase. That alone complicates the claim that hospital-to-nursing-home transfers explain the toll. Pre-2020 research also shows that roughly 75% of nursing home residents normally die in the care facility (not the hospital) and that nursing-home-to-hospital transfers are often inappropriate or harmful. Spring 2020 appears to have seen an inversion of norms, one that did not account for what was already known and understood to be harmful. Why the focus remains on nursing homes when it’s not where the majority of deaths occurred is perplexing.
There was also a “structural incentive” problem that is rarely acknowledged by elected or appointed officials. Hospitals were financially incentivized to diagnose, treat, and certify COVID cases and deaths; nursing homes were not. Under the CARES Act, hospitals received enhanced reimbursement for COVID-positive admissions and additional payments tied to ventilation and COVID-attributed deaths. Nursing homes did not receive comparable dollars. This raises the question of whether nursing homes were initially encouraged via certain policies or other communications (emails) to send suspected COVID patients to the hospital.
Similar to what was said in summer 2020, I have also heard anecdotes from New York EMTs about patients with DNRs being sent to hospitals on purpose and arriving near-dead. Once this transfer occurred, and the resident tested positive by PCR, and died there, the death entered a reporting and reimbursement framework that rewarded its classification as COVID. This is a racket at best and depraved inhumanity at worst.
But without transfer data, place-of-death data, and other records or proof, we don’t know how often this occurred. Especially given the number of hospital deaths, we need to know.
When I refer to the NYC out-of-hospital cardiac arrest event, I am describing a sudden and pronounced spike in out-of-hospital cardiac arrests immediately after “15 Days to Slow the Spread,” followed by a rapid decline.
This coincided somewhat with changes in EMS protocols that essentially told paramedics to not administer full life-saving procedures. Those orders don’t explain what motivated the calls in the first place, why “15 days to slow the spread” was a trigger, or the shape and trajectory of the curve (which I would expect to be more “random” and build more slowly if fear were a trigger). Elsewhere, I’ve posited that a drug poisoning could be in the mix, but that still wouldn’t explain the shape of the curve.
Chicago did not experience a comparable OHCA event. Detroit, London, Paris, and Lombardy did, but on a lesser scale than New York. I’ve unsuccessfully sought additional related data from NYPD and FDNY data and have been denied.
On whether hospital death spikes are unique to the United States because of CARES Act incentives, my answer is that, as far as I know, the incentives were U.S.-specific, but the lack of hospital scrutiny is not. Other countries also saw large hospital death increases. [Caveat: I haven’t found official place of death data for Lombardy, Italy, as a region, or for Bergamo]. What is consistent across jurisdictions is the focus on nursing homes and the protection of hospitals from investigation. Hospitals are presumed to have done everything right, despite the absence of third-party witnesses and despite concerns raised by families and some doctors. In New York City, the military was in at least some hospitals (see Pietro’s testimony) but that is hardly ever discussed and their role has never been independently examined, to my knowledge.
As for the idea that families pressured providers to change death certificates, that explanation does not account for the scale of the New York City toll. FEMA funeral assistance may have created some incentive pressure, but that program was instituted later, in early 2021, and only about one-third of New York City’s reported deaths are substantiated through federal funeral assistance claims.
The bottom line from the last three years of investigating the New York event remains the same: The city’s spring 2020 death toll is unsubstantiated. Most of the reported increase occurred in hospitals, yet hospitals have faced the least scrutiny. Basic proof that ~38,000 people died in the timeframe, and as represented by the all-cause curve, must be released. That can be followed by all data needed to show what occurred systematically; corroborative, individual record review; investigations of hospitals and patient records, etc.
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