Theresa Sari, left, and her daughter Leila Ali look at a section of a memorial wall after a news conference in New York, Sunday, March 21, 2021. Sari's mother, Maria Sachse, was a nursing home resident and died from COVID-19. Families and their supporters brought a memorial wall to remember the approximately 15,000 people that died from COVID-19 in nursing homes in New York. (AP Photo/Seth Wenig)

ALBANY — The state Comptroller’s Office this week released an audit highly critical of the state Department of Health and its response to nursing homes amid the COVID pandemic.

Among the key findings were that DOH:

¯ was ill-prepared to respond to infectious diseases even before the pandemic hit New York in March 2020;

¯ became part of Gov. Andrew Cuomo’s deliberate under-reporting of the terrible death toll in nursing homes;

¯ stalled on a federal directive to survey nursing homes for infection control problems;

¯ knew one of its key informational systems was incomplete and unreliable long before the pandemic but took no steps to fix it;

¯ ran interference on the comptroller’s audit as it was underway

The audit also blamed underfunding for public health during Cuomo’s decade long-tenure as governor for leaving DOH without critical information systems and staff that could have helped limit the spread of COVID-19 in nursing homes.

More than 15,000 New York nursing home resident deaths in the past two years are blamed on COVID.

DOH submitted a lengthy response to the draft report, defending its actions in extensive detail and in some instances rebutting what it inferred from the wording. With the comptroller’s office adding its own rebuttal to some of DOH’s points, the DOH response stretches to 13 pages, about a quarter of the final audit.

One point the DOH agreed on was improvement: It said it appreciates the stated goal of the audit, promotion of stronger infection control policies.

Some specific objections DOH raised:

¯ the audit did not take full account of all of DOH’s efforts at improvement, all the types of information DOH used to respond to the pandemic, and the practical tradeoffs between different types of data.

¯ Cuomo’s executive office, not DOH, determined which DOH data were released to the public; DOH’s internal use of data was not constrained by the public obfuscation.

¯ the audit doesn’t address the challenges that existed in the earliest days of the pandemic, nor does it acknowledge the progress DOH has made in improving data collection protocols.

¯ DOH disagrees with the assertion that it was less than fully cooperative with the audit.

¯ the audit does not address the complexities of compiling and analyzing multiple types of data from multiple sources through multiple systems in a pandemic.

Finally, DOH addresses the allegation of the state misleading the public, as Cuomo and top aides including then-Health Commissioner Dr. Howard Zucker, were accused of doing. None of what was released to the public was wrong, DOH states. Rather, it was accurate as far as it went.

DOH also noted that Kathy Hochul, who became governor in August after Cuomo resigned, has directed more data be publicly posted.

It gradually has, with COVID data now available online that were not accessible easily or at all under Cuomo.

Included in the audit is a letter from Kathryn Garcia, Hochul’s director of state operations, saying that upon taking office Hochul directed her administration to “dramatically change course” and prioritize transparency, cooperation and communication.

As he released his office’s audit Tuesday, State Comptroller Thomas DiNapoli had harsh words for the state’s handling of the nursing home COVID crisis. In a prepared statement, he said:

“The pandemic was devastating and deadly for New Yorkers living in nursing homes. Families have a right to know if their loved one’s COVID-19 death was counted, but many still don’t have answers from the state Department of Health. Our audit findings are extremely troubling. The public was misled by those at the highest level of state government through distortion and suppression of the facts when New Yorkers deserved the truth. The pandemic is not over, and I am hopeful the current administration will make changes to improve accountability and protect lives. An important step would be for DOH to provide the families who lost loved ones with answers as to the actual number of nursing homes residents who died. These families are still grieving, and they deserve no less.”

Critics have charged that Cuomo obfuscated the death toll to burnish his stature as a leader fighting the worst public health crisis in a century. He is credited as the author of a book on exactly that subject, published in October 2020.

The dam broke in January 2021, when a bombshell report by the state Attorney General’s Office found that the state Department of Health had underreported nursing home deaths by as much as 50% and faulted the Cuomo administration for decisions that may have worsened the death toll.

Less than a week later, a judge ordered a full data release at the request of the Empire Center for Public Policy, a think tank that took its drive for information to court after the Cuomo administration denied and delayed its request for months.

The state in one day bumped its official nursing home COVID death toll 45% higher.

Bill Hammond, the Empire Center senior fellow who pressed the case, tweeted Tuesday:

“This audit confirms that DOH helped Cuomo cover-up the true death rate in nursing homes, which we already knew. But @NYSComptroller also uncovered operational failings within DOH itself, which is new and valuable info.”

State Attorney General Letitia James in a prepared statement Tuesday said:

“This audit affirms many of the findings that we uncovered last year about the state’s response to COVID, most notably that DOH and the former governor undercounted the number of deaths in nursing homes by as much as 50%. I am grateful to Comptroller DiNapoli for bringing much needed transparency to this critical issue. My office will continue to monitor nursing home conditions and ensure the safety of our most vulnerable residents. If anyone has concerns about nursing home conditions, I urge them to contact my office.”

The state lists the following COVID-related nursing home death tolls for area counties through March 14, 2022. (Assisted living facilities and other elder care facilities are counted separately, and have had a much lower death toll than nursing homes.)

¯ Albany, 141

¯ Fulton, 57

¯ Herkimer, 68

¯ Montgomery, 89

¯ Rensselaer, 100

¯ Saratoga, 45

¯ Schenectady, 46

¯ Warren, 72

¯ Washington, 50

A list of fatalities at individual facilities is available at https://coronavirus.health.ny.gov/long-term-care-fatalities