DiNapoli: NY slow to penalize nursing home violations

nursing home


New York needs to change how it fines nursing homes in violation of state laws to protect some of New York’s most vulnerable, according to the Comptroller Tom DiNapoli,

DiNapoli recently met with senior citizen advocates in Albany to address the need to improve enforcement of nursing home violations.

According to DiNapoli, New York’s Department of Health needs to fix problems and delays with how it is assessing fines to nursing homes after violations are found. There are currently more than 95,000 New Yorkers who are 65 or over living in the state’s 631 nursing homes.

Statistics show this is a recent, worsening trend. According to DiNapoli’s audit, in 2011 the DOH collected $628,000 in fines, but in 2014, that figure was only $152,000. Not only are fewer fines being levied, the length of time the DOH takes to issue a fine has increased from an average of six months in 2007, to nearly four years in 2014.

DiNapoli and senior citizen advocates say there are several reasons behind this steep drop off in enforcement.  DiNapoli’s auditors found that the DOH only has one part-time employee assigned to process enforcement referrals and prepare enforcement packets.  They also found that the agency routinely waits a minimum of six months before processing enforcements in the event that fine assessments are amended or withdrawn as a result of appeals and that they also use a database that is fragmented and incomplete.

“We are relieved that a leader in New York state government is finally listening.  It is decades overdue and indeed, this should just be the first step toward systematically preventing abuse and neglect of vulnerable nursing home residents,” said Jack Kupferman, president of Gray Panthers NYC Network, a senior citizen advocacy group.

To fix this problem, DiNapoli has called for the Department of Health to eliminate the backlog in enforcement activity and maintain timely processing of future assessment of fines; take steps to initiate the assessment of fines earlier; develop a single, more comprehensive system to track and monitor all enforcement actions; and consider assessing fines for citations covering lower-level infractions, especially for those facilities that demonstrate a pattern of repeated citations.

“Families need to know their loved ones have safe accommodations and providers are being held accountable when problems are found,” DiNapoli said.

According to Richard Mollot, an advocate from the Long Term Care Community Coalition, the Department of Health cites nursing homes at one-third of the national average, the second lowest rate in the nation.

DOH officials indicated that they have taken steps to implement the recommendations in DiNapoli’s February 19 audit report.  DiNapoli did credit DOH with frequently inspecting nursing homes and acting quickly on the most serious complaints.

The comptroller is calling for legislative action to help remedy the problem.

DiNapoli’s auditors noted that prior to 2008, the maximum fine allowed for a violation was just $2,000 per incident even for those that result in serious physical harm or death. The law was amended to allow DOH to assess a $5,000 fine for some repeat violations and a $10,000 fine if a violation results in serious physical harm to a resident, but that change is slated to expire in April 2017.

Unless action is taken by lawmakers, the maximum fine for any violation will revert to $2,000 – less than the equivalent of one week’s revenue derived from one nursing home bed.

“Residents have a right to dignity, respect and a healthy environment. Unsafe conditions in nursing homes have a cost,” said Gail Meyers, an advocate at Senior Action Council, a grassroots senior organization founded more than 40 years ago.