Official figures from New York state likely under-represent the real number of nursing home residents who died as a result of COVID-19, according to a new report on Tuesday.

Officially, New York claims to have lost 6,600 nursing home residents to COVID-19, which would be just over 20% of the state's total deaths. In neighboring New Jersey, nursing home residents account for 44% of the state's total death toll, and in Pennsylvania, that figure rises to 68% of the total number of COVID-19 deaths. 

Unlike other states, New York only tallies nursing home deaths from COVID-19 if they actually occurred in a nursing home. A resident of a nursing home who died from COVID-19 after being transported to a hospital for intensive care would not be considered a nursing home death in New York. 

In an August 12 report by Associated Press, the New York statistics do not appear to tally either with regional patterns or with the current occupancy rates in nursing homes.

Geriatrics expert Thomas Perls told AP that the numbers given by New York do not make sense: "Whatever the cause, there is no way New York could be truly at 20%," Perls said. 

If New York's nursing home death percentage were the same as New Jersey, over 14,000 nursing home residents would have died from COVID-19. If it were the same as Pennsylvania, the number of nursing home residents who died from COVID-19 would rise to 22,012. 

According to the AP report, there are 21,000 empty nursing home beds in New York state this year. That number is 13,000 higher than the expected vacancy rate. 

While some of the "missing" nursing home patients were removed from nursing homes by concerned relatives, or died from other causes, the AP report suggests that it is likely some if not many of these "missing" patients died from COVID-19 but were not counted in state figures.

Even with the potential under-counting, New York's reported number of nursing home deaths is already the highest in the country. 

On March 25, Gov. Andrew Cuomo ordered that nursing homes accept residents who had previously been hospitalized with COVID-19, but who had not yet fully recovered. Approximately 6,300 COVID-19 patients were sent to nursing homes, which Cuomo has defended as an attempt to free up beds in hospitals. 

Cuomo's March 25 order stated that "no resident shall be denied re-admission or admission to the (nursing home) solely based" on their COVID-19 status. Over a month later, on April 29, nursing homes were given the go-ahead to deny COVID-19 patients if the residence did not think it was properly equipped to care for the patient.

The order was revoked on May 10. By that point, New York's COVID-19 deaths had peaked and were on a steady decline. 

In the weeks following, Cuomo has condemned questions of his handling of the nursing home situation and dismissed calls for an independent assessment as "all politics." 

By New York's own metrics, the state ranks 35th nationally on percentage of COVID-19 deaths in nursing homes. 

COVID-19 ravaged at least one Catholic religious order during the time Cuomo's order was in place. At least 10% of the 300 Maryknoll Sisters who live at the Maryknoll Sisters Center in Ossining, New York tested positive for COVID-19, plus 10 members of the center's staff also tested positive. 

A total of 13 Maryknoll Sisters died from COVID-19, per the order's Instagram page. According to obituaries posted on the order's website, at least two of these sisters died in a hospital, meaning that their deaths would not be included in the nursing home tally. 

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Nationally, approximately 164,000 people in the United States have died during the COVID-19 pandemic.