Nursing Home Abuse Update:
An audit released by New York State Comptroller Thomas P. DiNapoli on Monday, February 22nd declared that the state Department of Health (DOH) needs to fix and improve how it inspects and disciplines nursing homes in the state. The audit notes that while the DOH is regularly assessing nursing homes and quickly responds to serious complaints, there have been a number of nursing homes with multiple violations and worsening problems but little discipline to show for it.
Acting as an agent of the federal Center for Medicare and Medicaid Services (CMS), the DOH monitors the quality of care being provided at all the nursing home facilities in New York. The agency makes sure all nursing homes in New York meet both federal and state operating standards.
For the period of January 1st, 2012 to September 17th, 2015, the audit found that DOH met federal quality standards for conducting surveys, including assessment and scope of citations. DOH also inspected all nursing homes within the required statewide cycle of 15.9 months.
Failure to Use All Enforcement Actions
The issues - according to DiNapoli's office - have come in the collection and enforcement of fines. Auditors found that DOH does not levy fines for categories of violations that make up almost 85% of the issues found in nursing homes, instead choosing to focus more on violations that result in actual harm to an individual or place individuals in immediate jeopardy. While important, these issues only account for 4% of all violations in nursing homes.
Delays and Inefficiencies in Fines and Enforcement
When fines have been imposed, DOH has not collected them efficiently, taking up to 6 years between issuing a violation citation and actually imposing a fine. As of 2014, the average time between when a problem was first identified and the imposition of a fine was roughly 4 years. In 2007, this figure was only 6 months. DOH also only collected 12 fines totaling $152,000 between January 2014 and July 2015, compared to the $628,000 in fines collected in 2011. Additionally, in 2008 the law only permitted a maximum fine of $2,000 for a violation. This was increased to $5,000 after the law was amended - with $10,000 fines available for violations resulting in serious harm to individuals - but the maximum fine will revert to $2,000 if legislative action is not taken by April 2017.
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