"Right here, we are doing it alone," Cobble Hill Health Center CEO Donny Tuchman shouted Monday to cheering neighbors outside the nursing home in Brooklyn, New York. "These people right here," he said, pointing to the line of the health care staff members in full protective gear who'd walked out of the facility to accept the applause.
It had been yet another challenging day at Cobble Hill. A report by the New York State Health Department listed 55 deaths presumably caused by the coronavirus at the facility since the outbreak began, the highest toll at any senior care center in New York.
The CEO's impromptu pep rally was just one way Cobble Hill spent the day pushing back, insisting that the 364-bed nonprofit community had had little help from the city, the state or the federal government.
"These people are deserving of everything that there is in this world," Tuchman said of his workers. "These people right here."
For more than a century, the massive five-story red-brick building has stood on a narrow tree-lined residential street. A garden of spring flowers and shrubs rings the property. People wearing masks, pushing strollers and walking dogs pass back and forth. Nothing about Cobble Hill Health Center, which serves older adults who are "chronically ill, or disabled, or debilitated," according to its website, suggests it would the nursing home in New York with the highest number of deaths presumably linked to the coronavirus epidemic.
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New figures from the Health Department list 14 communities with at least 25 deaths. Five have had 40 or more deaths. The staggering toll is one of the most tragic aspects of the pandemic in New York and in nursing homes and senior care centers across the country.
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For weeks, state officials refused to release nursing home numbers, citing concerns about residents' privacy. But after calls grew for transparency from families with loved ones in long-term care facilities, as well as local leaders fielding their complaints and concerns, Gov. Andrew Cuomo last week issued an executive order requiring communities to report deaths and tell families when a resident tests positive for the coronavirus. "We have had really disturbing situations in nursing homes," Cuomo said.
Cobble Hill said in a statement seeking to put the crisis in context: "Our resident population is, by definition, fragile and vulnerable and almost all have significant underlying health issues. Any deaths we've reported have been based on the possibility of Covid-19 being a factor. Because Covid-19 testing in skilled nursing facilities has been extremely difficult to obtain, there is no uniform measure to determine conclusively whether Covid-19 was a contributing factor in a resident's death."
A spokesman added that the facility has made repeated requests for more resources, like test kits and personal protective equipment for its depleted staff. As many as 100 of its 350 health care workers have needed to take sick time.
The facility also tried to move some residents suspected of carrying the virus to the military field hospital set up at New York City's Jacob Javits Convention Center. The response to those requests, Cobble Hill says, was that the area's main hospitals were more overwhelmed and a higher priority for relief.
But all of that is of little comfort to families with relatives living at Cobble Hill, who demand to know what's happening behind those red brick walls.
"The biggest thing is the lack of knowing," said Brooklyn Borough President Eric Adams. "Families are calling me. They have not seen or heard from their loved one, many since right after the virus hit the city."
Cobble Hill and other senior communities that are anywhere near the pandemic's center stopped visitation weeks ago to keep the deadly virus out. The center's website encourages families to sign up for email updates and to schedule virtual visits with frail loved ones.
"We all know these are difficult times and there's a level of complication," Adams said. "That became exacerbated by a lack of communication."
Tuchman felt the stress, too. "The decision wasn't easy," the CEO wrote in a statement. "I lost sleep last night thinking of the anxiety and fear that patients and family members may feel as a result of the ban."
The Trump administration has taken steps to increase transparency at nursing homes. One new rule requires facilities to report COVID-19 cases to the Centers for Disease Control and Prevention to help the government build a database.
A federal rule now also requires nursing homes to inform residents and their families when someone tests positive at a facility.
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Seema Verma, administrator of the Centers for Medicare and Medicaid Services, has called the requirements "a critical component" of the effort to build a national COVID-19 surveillance system as the U.S. economy begins to reopen.
The hope is that more information, transparency and data about the alarming numbers of nursing home cases and deaths will help shed light on this especially tragic and widespread aspect of the epidemic. There have been calls for investigations and special monitors and even calls for the National Guard to step in at a nursing home in New Jersey where as many as 70 residents have died.
In Brooklyn, several dozen residents who lined the street outside and clapped and cheered the nursing home staff members seemed to understand that they have been doing everything they can under enormously difficult circumstances.
"Thank you from the bottom of our hearts," Tuchman said before he led the team back inside to resume caring for hundreds of frail, sick residents.
CORRECTION (April 21, 2020, 12:40 a.m. ET): A previous version of this article misspelled the last name of the administrator of the Centers for Medicare and Medicaid Services. She is Seema Verma, not Verman.