ALBANY, N.Y. — The administration of former Gov. Andrew Cuomo failed to publicly account for the deaths of about 4,100 nursing home residents in New York during the pandemic, according to an audit released Tuesday by the state comptroller, Thomas DiNapoli.

The audit found that Health Department officials at times underreported the full death toll by as much as 50% from April 2020 to February 2021, as Cuomo faced increasing scrutiny over whether his administration had intentionally concealed the actual number of deaths.

The 41-page report concluded that the Health Department often acquiesced to the narrative Cuomo and his top officials wanted to promote during the pandemic, sometimes failing to meet its “ethical” and “moral” imperatives to act transparently.

“Our audit findings are extremely troubling,” DiNapoli said in a statement. “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.”

Health officials did not provide auditors with a breakdown by name of the nursing home residents who died from COVID, according to DiNapoli’s office, and the actual number of nursing home residents who died is still uncertain.

The audit marks the third state inquiry to corroborate how Cuomo’s administration significantly downplayed the number of nursing home deaths during the pandemic. Those efforts coincided with Cuomo’s attempts to elevate his public image at the height of his national popularity in 2020, including through daily televised briefings and the publication of a book that burnished his response to the pandemic.

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Cuomo, a Democrat, resigned in August as a result of the controversy over nursing home deaths and other scandals that engulfed his administration, including accusations of sexual harassment from numerous women.

For much of the pandemic, the Cuomo administration’s nursing home death toll counted only residents who had died in such facilities, excluding residents who died in hospitals. That led to an artificially lower tally of nursing home deaths that Cuomo used to argue New York had fared better than other states.

Cuomo officials were especially eager to deflect scrutiny from political opponents who could use the higher nursing home death toll to argue that Cuomo’s initial coronavirus policies had led to more deaths.

Cuomo argued at the time that the residents who died in hospitals were being included in the state’s overall coronavirus death toll, even if they were not detailed in the nursing home death numbers. His administration also claimed that the data was unreliable and needed to be vetted before being released.

But the comptroller’s report refuted that assertion, finding that the administration was aware of the higher death toll and continued to withhold it even after it had apparently corrected most discrepancies by May 2020, a few months into the pandemic.

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Rather than providing accurate and reliable information during a public health emergency, the [Health] department instead conformed its presentation to the executive’s narrative, often presenting data in a manner that misled the public.”
— Audit released Tuesday by the state comptroller

“Rather than providing accurate and reliable information during a public health emergency, the department instead conformed its presentation to the executive’s narrative, often presenting data in a manner that misled the public,” the report said.

The overarching findings of the comptroller’s audit track closely with a damning report issued by the state attorney general in January 2021 that said the Cuomo administration was undercounting nursing home deaths by the thousands. Under pressure, Cuomo officials at the time released previously undisclosed data that added more than 3,800 deaths to the state’s tally at the time, increasing the death toll tied to nursing homes by more than 40%.

In November, after Cuomo’s resignation, a state Assembly investigation corroborated reporting by The New York Times that found Cuomo’s top aides had overruled health officials and rewrote a department report to keep hidden the true extent of deaths related to nursing homes.

Cuomo’s handling of nursing homes has also been the subject of a federal investigation. At the beginning of this year, that investigation was ongoing, a person familiar with the matter said, although it was not clear how much momentum remained. A spokesperson for the federal prosecutor’s office in Brooklyn declined to comment.

“As the number of out-of-facility deaths were reported last January, this is not news,” said Richard Azzopardi, Cuomo’s spokesperson. “However, what is peculiar is the comptroller’s release of this audit now — but no one has ever accused him of being above politics.”

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The comptroller audit lays out the shifting methodologies the Health Department used to collect nursing home death data, outlining how many nursing home deaths it was aware of, but failed to disclose at different points during the pandemic.

The report found that the underreporting of the death data was initially a result of poor data collection by the Health Department when New York unexpectedly became the epicenter of the pandemic in March 2020. But officials still failed to release the full extent of nursing home deaths even as the data gathering improved.

The report suggests that, by May 2020, health officials had audited internal discrepancies and possessed mostly reliable numbers that could have been made public.

For example, the Cuomo administration had internal data showing that the deaths of 13,147 nursing home residents were reported as of Feb. 3, 2021. But it publicly reported that only 9,076 deaths were tied to nursing homes during that time period, failing to report 30% of the deaths, the report said.

At the time, the Health Department was led by Dr. Howard Zucker, who resigned after Cuomo was succeeded by Gov. Kathy Hochul. More than 67,000 people have died because of the coronavirus in New York since the beginning of the pandemic. As of Tuesday, 15,360 of those were nursing home residents, according to state data.

In a 12-page rebuttal to the report’s findings, the Health Department forcefully pushed back against conflating the Cuomo administration’s issues with transparency with the work of the department’s staff and the manner in which they use public health data.

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“Whatever criticisms may now be directed at the prior administration relating to issues of transparency, or the particular categories of information that were publicly disclosed, those ultimately were matters for the executive chamber of the prior administration and not department personnel,” Kristin M. Proud, the department’s acting executive deputy commissioner.

Auditors rebuked other aspects of Cuomo’s pandemic response, too.

The report detailed long-standing issues with the Health Department’s oversight of conditions in nursing homes and found there was often a lack of coordination with local health officials during the pandemic.

The report said that the audit, along with previous reports and inquiries, paints a picture of a governor’s office that was, “micromanaging with top-down decision making on every matter, regardless of size, and tight control over information.”

It also criticized the way in which the department collects data from nursing homes and other health care facilities, recommending that health officials streamline their three main internal databases in order to identify patterns and trends to better “shape its infection control practices and policies and its oversight of facilities.”

The audit’s release comes as Cuomo is wading back into public life, seeking to rehabilitate his image after his resignation in August.

At a Brooklyn church this month, in his first speech since his resignation, Cuomo railed against “cancel culture,” blaming it for his downfall. He released a television ad Monday that touts his record as governor, including his response to the pandemic, and claims that, “some have attempted to rewrite history.” And on Thursday, he is expected to meet with the Rev. Rubén Díaz, a former state and city lawmaker, at his Bronx church.