Advocacy group slams state Health Department’s ‘weak’ nursing home enforcement

(WIVB) – Nursing homes are often under a microscope, but an advocacy group says the state Department of Health has done a poor job of holding facilities accountable.

The Long Term Care Community Coalition report found that New York ranks last in citations per resident with one violation for every 50 residents from 2018 to 2020. It turns out the national citation rate is nearly four times that of New York, according to the report. find.

Additionally, New York regulators file fewer citations deemed to cause immediate harm or danger to nursing home residents compared to most other states.

For example, the report found that only 2% of state citations were considered to fall under the harm category, which ranked 48^and in the nation. And only 0.4% of state citations were deemed to have caused immediate danger, which ranks 49^and in the nation.

Some argue that fewer violations should be seen as a good thing because it could mean nursing homes are doing a better job than the advocacy group described in the report.

But Richard Mollot, executive director of the Long Term Care Community Coalition, said that’s not the case because nursing homes across the state rank poorly on other metrics and enforcement by the State was not as present as it should be.

Specifically, the group looked at federal data on infection control, staffing, rates of antipsychotic drugs administered to residents and those who allegedly had pressure ulcers, which together paint a disturbing picture of the New York nursing home industry. Mollot said each of these measures are indicators of the safety and well-being of nursing home residents, but are rarely reflected in state enforcement practices due to the small number of quotes considered an immediate danger or causing damage.

For example, the report found that pressure sores are a medical issue for some 9,000 nursing home residents in New York City, but nursing homes were only cited 0.4% of the time a resident had a pressure sore, ranking 44^and in the nation.

Pressure ulcers are dangerous injuries that have killed some residents, but New York City health officials only identified substandard pressure ulcer care as harmful to a resident only 14% of the time.

The report also found that of the 22,554 infection control citations, only 3.2% were classified as causing harm or putting residents at immediate risk.

Additionally, the report found that despite a rampant understaffing, the state only filed 55 citations for personnel issues, which is less than one tenth of a percent of citations per year. per 1000 inhabitants. This ranked New York 46^and in the nation.

“It’s totally unacceptable,” Mollot said. “The majority of people who reach my age or older… will need nursing home care, so it affects every family. But as a consumer advocate, from our perspective, it’s people getting hurt, people’s lives sometimes being really destroyed or just living in horrible conditions for no reason when often someone is taking advantage of these care.

Sen. Sean Ryan, D-Buffalo, said New York’s nursing home problems are well known. He said state-level enforcement was so poor that he joined Erie County Mark Poloncarz a few years ago in supporting a change in county law that allowed the local health department to impose fines on operators of retirement homes. This law, known as “Ruthie’s Law”, was struck down by the court last year.

Additionally, state lawmakers passed legislation last year that requires nursing homes to spend 70% of their revenue on direct patient care and at least 40% on resident staffing. These new rules are suspended by the Governor in response to the ongoing Covid-19 pandemic.

“Sometimes it feels like the Department of Health is the three monkeys, see no evil, hear no evil, speak no evil,” Ryan said. “Like you don’t know what’s going on with them and they want to be willfully ignorant. That’s a real problem.

But Gov. Kathy Hochul will set the tone, Ryan said, and he’s confident the state Department of Health’s new direction could lead to improvements in New York City’s nursing homes.

“The governor is going to put his stamp on the Department of Health, and we hope part of that stamp will be more aggressive enforcement and more transparency,” Ryan said.

A spokesperson for the state Department of Health said holding nursing homes accountable for the quality of care they provide is “of the utmost importance”.

“From 2020 through 2021 alone, the Department issued approximately 4,500 citations — 51 at the level of harm and 36 immediate threats — resulting in more than $1 million in federally-imposed civil penalties,” the Department of Justice said. state health.

While the state stopped short of criticizing the LTCCC report, Stephen Hanse, president and CEO of the New York State Health Facilities Association, did not.

Hanse said the report was “flawed” and said the state’s regulatory framework for nursing homes was “arguably the strictest in the nation.”

“I would say nursing homes after nuclear power are the most regulated industry in New York State,” Hanse said.

Hanse said the analogy he finds when reviewing the report blames the police for a low crime rate.

But, again, Mollot said the state’s law enforcement record doesn’t match the poor work he said some nursing homes are doing on other metrics, such as pressure sores. and infection control measures.

Mollot said the study’s findings indicate that even before the Covid-19 pandemic, federal and state regulators’ response to serious problems in nursing homes was weak.

Much of the money flowing into nursing homes is Medicaid taxpayer money, Mollot said, so state citizens deserve more from their state and federal regulators.

Mollot’s report contains numerous recommendations, including that state and federal regulators identify, assess and address patterns in nursing homes with low citations that rarely identify harm to residents or immediate danger. The report also calls on state regulators to increase the frequency of surveys to one for each facility every six to 12 months.

“We already looked at this data in 2016, unfortunately we published a similar report,” Mollot said. “We saw that things had not changed. But we hoped that things might change in the future. We have a new governor, and we can take this in a new direction if we want. »