New York state may have undercounted by 50 percent the number of people in nursing homes who died from coronavirus, its attorney general said Thursday.
Almost 43,000 people have succumbed to Covid-19 in New York, more than any other state in the US.
New York officials say that around 8,500 of those were elderly people in care homes.
But in a 76-page report, Attorney General Letitia James said she had found large discrepancies between deaths reported to her investigators and numbers released by Governor Andrew Cuomo's government.
"As the pandemic and our investigations continue, it is imperative that we understand why the residents of nursing homes in New York unnecessarily suffered at such an alarming rate," she said.
The issue of deaths in nursing homes has been a sore one for Cuomo, who has largely been lauded for his handling of the coronavirus crisis.
He has been criticized for ordering nursing homes to take patients who had tested positive early on in the outbreak last March.
His health department denies that the order led to the virus spreading like wildfire in homes, instead blaming staff who did not know they were infected.
James says an unnamed facility reported 11 deaths to the health department but 40 deaths to her investigators.
The undercounting is partly due to the state only counting residents who died in their nursing home, not those who were transferred to hospital and died there.