Former NY Gov. Andrew Cuomo grilled on COVID-19 nursing home policies

Former New York Gov. Andrew Cuomo was grilled during his public testimony before Congress on Tuesday, defending his administration's nursing home policies during the early days of the COVID-19 pandemic.

The hearing, before the Republican-led House Oversight and Accountability Select Subcommittee on the Coronavirus Pandemic, saw a defensive Cuomo who largely stood by his decision-making during the pandemic -- including a March 2020 directive to readmit COVID-19 patients back into nursing homes -- and blamed the outsized death toll on what he described as former president Donald Trump's lack of leadership

Cuomo previously testified before the subcommittee during a closed-door hearing in June. Transcripts from that interview, as well as with high-ranking officials during Cuomo's administration, were released Tuesday morning ahead of the public hearing.

"The U.S. Centers for Disease Control and Prevention, the CDC on March 13, 2020, [Centers for Medicare & Medicaid Services] CMS issued guidance -- let us trust the word 'guidance' -- that specifically directed nursing homes to not accept COVID-19-positive patients if they were unable to do so safely and to only accept individuals if the nursing home could follow CDC transmission based guidance," subcommittee Chairman Rep. Brad Wenstrup, R-Ohio, said in his opening statement on Tuesday.

In March 2020, as COVID-19 cases were surging, Cuomo issued an order requiring nursing homes to readmit all residents who were "medically stable" and returning after being hospitalized for the virus.

"No resident shall be denied re-admission or admission to the [nursing home] solely based on a confirmed or suspected diagnosis of COVID-19," the order read. It further stated that nursing homes were "prohibited from requiring a hospitalized resident who is determined medically stable to be tested for COVID-19 prior to admission or readmission."

However, Cuomo responded that the CMS and CDC, under former President Trump's administration, advised that "COVID-positive people could go from hospitals to nursing homes, even if they were still infectious. That was your ruling."

"'The March 25 guidance was consistent with the CMS guidance. The March 25 guidance was consistent with the CMS guidance if nursing homes have the ability to adhere to infection prevention and control recommendations.' That's the attorney general's position opinion," Cuomo said, referring to New York Attorney General Letitia James.

At the time of the directive, Cuomo explained that the order would help expand hospital capacity to meet the demands of caring for the sickest COVID-19 patients. After facing criticism from nursing home advocates, however, the governor amended the order in May 2020 , prohibiting hospitals from discharging patients to nursing homes unless they first tested negative for COVID-19.

"The March 25 directive was dubbed a 'must admit order' by the public and press, and rightfully so," Wenstrup said, addressing the former New York governor. "Your directive was not consistent with federal guidance, nor consistent with medical doctrine. You do not put highly contagious patients in with vulnerable patients. subject to infection, and in this case death."

Wenstrup added that the former White House coronavirus coordinator, Dr, Deborah Birx, testified in Oct. 2021 that Cuomo's order violated CMS guidance. When asked if Birx lied, the former governor said Wenstrup and other Republications misrepresented that precautions weren't in place.

"That was not true. As you know, the attorney general conducted this investigation … the attorney general of New York, who governs the New York law and interprets the New York law, found exactly contrary to what you are saying," Cuomo replied.

In 2020, Cuomo fought back against criticism of his policies and, in July of that year, a report from the New York State Department of Health (NYSDOH) stated that COVID-19 was introduced into nursing homes by infected staff, and that peak staff infections correlated with peak nursing home resident deaths. The report also found that "admissions policies were not a significant factor in nursing home fatalities."

However, in January 2021, New York Attorney General Letitia James released a report that found the NYSDOH had undercounted the number of nursing home residents who died of COVID-19 by as much as 50%, and failed to count in its official death tally nursing home residents who died of COVID-19 after being admitted to hospitals.

In total, more than 15,000 nursing home residents in New York died of COVID-19.

During his testimony, Cuomo said the tally of nursing home deaths was "problematic" because his administration received rolling updates from nursing homes.

"Every night, we got a census from the nursing homes, total nursing home deaths, total hospital deaths," he said. "The numbers were less than certain, and they were highly problematic, because you were calling up a nursing home and basically asking them to do a forensic audit in the middle of a pandemic."

Cuomo also testified that he never directed his staff to report the number of nursing home-related fatalities as lower than they actually were.

"No, we said these are the numbers without the out-of-facility death numbers, which we will add when they're accurate," Cuomo said.

In a particularly fiery exchange, Rep. Elise Stefanik, R-NY, demanded that Cuomo provide details behind negotiations for his COVID-19 memoir, published in 2020, suggesting that he was concerned with a book rather than with his response to the pandemic.

"There is a reason why you were the former governor of New York state, and you will never hold elected office again," Stefanik said.

Some attendees applauded, leading the chairman to remind the audience to refrain from applause or cheers, in keeping with the rules of the hearing.

In 2022, Cuomo's representative said the Manhattan District Attorney's office would not file criminal charges in connection with the former governor's handling of nursing home deaths during the pandemic.

Earlier this year, an independent investigation , commissioned by current New York Gov. Kathy Hochul, found that although Cuomo's nursing home response policy was based on "the best available data at the time," communication to the public was poor and caused anxiety for family members of nursing home residents.

"Even the most well-intentioned policy had unforeseen consequences in [New York state] nursing homes," the report read.

ABC News' Peter Charalambous contributed to this report.