ALBANY, N.Y. (AP) — New York may have undercounted COVID-19 deaths of nursing home residents by as much as 50%, the state’s attorney general said in a report released Thursday.

Attorney General Letitia James has, for months, been examining discrepancies between the number of deaths being reported by the state’s Department of Health, and the number of deaths reported by the homes themselves.

Her investigators looked at a sample of 62 of the state’s roughly 600 nursing homes. They reported 1,914 deaths of residents from COVID-19, while the state Department of Health logged only 1,229 deaths at those same facilities.

If that same pattern exists statewide, James’ report said, it would mean the state is underreporting deaths by nearly 56%.

Part of the gap is explained by a decision by New York’s health agency to exclude from its count the number of nursing home patients who die after being transferred to hospitals. Hospital and nursing home officials say the state has ready access to that figure.

Health Commissioner Howard Zucker has said at times that the state is working on compiling that data. His department has not responded to repeated requests by The Associated Press for that figure in recent weeks.

As of Tuesday, the state was reporting 8,711 deaths in nursing homes statewide.

James’ report, which her office described as preliminary, mirrors findings by others who have scrutinized New York’s statistics on nursing home deaths.

An Associated Press analysis published in August concluded that the state could be understating deaths by as much as 65%, based on discrepancies between its totals and numbers being reported to federal regulators. That analysis was, like James’ report, based on only a slice of data, rather than a comprehensive look at all homes in the state.

Gov. Andrew Cuomo promised to take a “special” effort to protect nursing homes early on last spring. He tasked James last year with investigating how nursing homes were complying with COVID-19 guidelines last year.

James said her review found that a lack of infection controls at nursing homes also put residents at increased risk of harm, while nursing homes that had lower federal scores for staffing had higher COVID-19 fatality rates.

“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,” said Attorney General James. “While we cannot bring back the individuals we lost to this crisis, this report seeks to offer transparency that the public deserves and to spur increased action to protect our most vulnerable residents.”

You can read the full report below.