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State Comptroller Issues Report on Nursing Home Oversight

New York State Comptroller Thomas P. DiNapoli, issued a press release  Feb. 22, 2016, which referenced the results of a recent audit of nursing home oversight by the NYS Department of Health (DOH) for the period of Jan. 1, 2012 through Sept. 17, 2015. 

The audit outlines changes that have been noted in the enforcement trends of survey deficiencies cited by DOH. Department officials have indicated they have taken steps to implement the recommendations made by the Comptroller, and DOH’s comments are included in the audit. According to the audit:

  • Some facilities had repeated violations that escalated into more serious problems;
  • DOH does not use the full array of enforcement actions available to it, choosing to not levy fines for categories of violations that account for almost 85 percent of the problems found;
  • Between Jan. 2014 and July 2015, DOH collected only 12 fines totaling $152,000. This compares to $628,000 in fines levied in 2011;
  • When fines are imposed, problems with DOH’s enforcement procedures have resulted in delays of up to six years between when a violation is cited and a fine is imposed. This compares to just six months for fines issued in 2007;
  • 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;  
  • The agency routinely waits at least six months before processing enforcements in the event fine assessments are amended or withdrawn as a result of appeals; and
  • DOH uses a database that, by its staff’s own admission, is fragmented and incomplete.

DiNapoli has recommended that DOH:

  • eliminate the backlog in enforcement activity and maintain timely processing of future assessments of fines;
  • take steps to initiate the assessment of fines earlier to better align survey results with the assessed penalty;
  • 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 repetitive citations.

LeadingAge NY staff regularly monitor survey trends, as noted in a recent summary in our weekly Intelligence publication. We also routinely meet with DOH officials to review trends noted by the enforcement teams, as well as by providers. 

It is possible that you may be contacted by the media to comment on the Comptroller’s audit. LeadingAge New York staff are available to assist you with formulating a response or respond directly to local media.

Contact: Dan Heim or Michelle Synakowski; dheim@leadingageny.org or msynakowski@leadingageny.org