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Is it a hospital death … or a nursing home death?

Here is why the answer to that question might impact Western New York in its quest to reopen in the wake of the state’s coronavirus shutdown orders.

BUFFALO, N.Y. — One of the benchmarks in Western New York’s hoped for path to reopening which has proved stubborn to meet, is having a 14-day decline in hospital deaths or fewer than five hospital deaths on average over three days.

For purposes of lifting his coronavirus related shutdown orders, Governor Andrew Cuomo considers the Western Region to include Erie, Niagara, Chautauqua, Cattaraugus and Allegany counties.

As well, while Erie County represents the overwhelming number of positive cases, hospitalizations and deaths, Cuomo says the counties within the region cannot be considered individually when it comes to a phased in reopening. The region must be considered in its entirety.

In Erie County, many deaths involve nursing home patients, according to County Executive Mark Poloncarz, “Nursing home patient deaths made up more than 50 percent of the deaths at least as of last week,” he said.


The most vulnerable to the virus

Mostly frail, elderly, and with underlying conditions, nursing home patients represent the most vulnerable population to the virus.

If they get it, they have much greater chance of needing to be hospitalized and dying from it.

During a meeting of the Erie County Legislature’s Health and Human Committee, Legislator Joe Lorigo posed questions surrounding how the death of a nursing home patient is listed if they die in a hospital, how that determination is made, and whether it might be impacting the regions inability to meet one of the re-opening benchmarks.

“It’s a great question,” said Erie County Health Commissioner Dr. Gale Burstein, when speaking to lawmakers at a virtual meeting conducted via Zoom on Thursday.

“For that metric, they are counted as a hospital death,” she confirmed.

However, there may be some gray area.

Hospital death or nursing home death?

According to a hospital source speaking on background, it’s a judgment call. If a patient from a nursing home were to die within a day or two of admittance to a hospital, it could be listed as a nursing home death. If they survive for a few days, it could be listed as a hospital death.

This means the determination would be more than an issue of semantics, because a “hospital death” counts against the metric, while a “nursing home death” does not.

“If they are counted as a hospital death, that goes against our ability to reopen," Lorigo said.

Dr. Burstein acknowledged as much, and shared that the county had asked the state about this topic, wondering if it might make an accommodation in that regard, due to the region’s high population of elderly residents in nursing homes.

“We had the same thought and when we proposed it to the state it was rejected,” she said.

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