Mass Fatality Management Guidance for NYC Long-Term Care Facilities

The COVID-19 pandemic resulted in an unprecedented surge in COVID-19 infections, hospitalizations, and subsequent deaths in New York City during the spring and early summer of 2020. The result was a cascading impact on health care facilities across the City—including long-term care (LTC) facilities—and an immense amount of pressure on the entire deathcare system. The sheer volume of deaths within a short period of time made management of decedents extremely difficult and resulted in backlogs throughout the funeral industry. Additionally, deaths in health care facilities were supplemented by an increase in residential deaths, causing further strain on the system and available resources.

Specifically, within the LTC sector, the ability to handle a large number of

decedents was complicated by a complete lack of or limited amount of available mortuary space. Facilities were only able to hold decedents for a very brief period due to limited refrigeration, unlike hospitals which generally have designated space and personnel to oversee decedents.

Additionally, LTC facilities do not have the resources or space to oversee the use of large, refrigerated trailers to act as temporary body collection points (BCPs), which were being used by hospitals to manage decedent overflow. Due to this, LTC facilities relied heavily on immediate retrieval by funeral homes or the New York City Office of Chief Medical Examiner (OCME). OCME was able to provide long-term storage for decedents while families and funeral homes made final arrangements.

Compounding the difficulty in managing large numbers of decedents were shortages in necessary resources, including staffing and supplies. In particular, heavy-duty, or ruggedized body bags were required for long-term storage of decedents. These were difficult to source and store, especially at the height of the fatality surge. Additionally, staffing shortages resulted in difficulties in the management of decedents and associated documentation.

To address the challenges related to staffing, New York City and New York State developed tools to identify and assign both paid and volunteer staff through online portals and coordination through the Medical Reserve Corps (MRC) and other commercial employment resources.