Comptroller Audit Faults Cuomo Administration on Nursing Home Oversight

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New York State Comptroller Thomas DiNapoli has issued an audit that finds the Cuomo administration dropped the ball on some aspects of policing nursing homes.

The New York State Comptroller has issued an audit finding that Gov. Andrew Cuomo’s administration has dropped the ball when it comes to policing nursing homes.

Comptroller Tom DiNapoli took the unusual step of holding a news conference to highlight the audit. It concludes that the Cuomo Administration is not adequately fining or enforcing violations at nursing homes.

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

The Comptroller credits the health department for frequently inspecting nursing homes and for following up on serious complaints. But the audit says the department lets other violations slide, and some nursing homes with repeated unresolved issues “escalated into more serious problems."

The audit finds that, in the vast majority of cases where a violation occurred, the health department did not issue any fines at all, and only tried to impose monetary policies when the problem resulted in actual harm to a patient or placed the patients in immediate jeopardy.

DiNapoli said that approach can also end up costing more money in the long run for patients and the state-funded Medicaid program, which often pays for the medical care in nursing homes.

The audit also found that it can take as long as six years from the time when a violation is cited and a fine is imposed, and the average time is four years.

The amount of total fines issued declined significantly from 2011 to 2015, even though the legislature has authorized the health department to impose fines of up to $10,000 for violations. In 2011, the health department levied $628,000 in fines, compared to less than $50,000 in 2015.

Richard Mollot, Executive Director of the Long Term Care Community Coalition, was one of several advocates at the comptroller's announcement. Mollot said the health department is too cozy with nursing homes, and that it views its role as more of a helper than an enforcer.

“They see themselves as assisting the providers, being there as a resource for the providers, rather than holding the providers accountable," Mollot said.

The audit found staffing is also an issue — only one part-time employee handles nursing home enforcement issues. Gayle Meyers, Deputy Director of the Statewide Senior Action Council, said her group often gets calls from people who have filed complaints to the health department against nursing homes, and never hear back.

“Why not hire sufficient surveyors?” Meyers asked.

In statements, the chairs of the Senate and Assembly health committees were also critical, and asked that the problem be resolved.

Gov. Cuomo has had a contentious relationship with Comptroller DiNapoli. In the past, his spokespeople have taken issue with the Comptroller’s assessments. In this case, though, the Department of Health issued a formal response to the audit. It said the department recognized the issues and is taking steps to correct them.

The statement also said that the department implemented a new enforcement process last year to “ensure that fines are assessed in a timely manner." Spokesman Jim Plastiras added that the health department is “committed to protecting the health and safety of New York’s nursing home residents."

The Comptroller is taking a wait-and-see attitude toward the changes.

“It’s great to recognize when an audit is underway that folks are looking,” DiNapoli said. “But the question is what will be the priority placed on this issue a year from now.”

DiNapoli said he’s considering a follow-up audit to make sure that the health department sticks to its new plan.