New York Official Calls for Tougher Skilled Nursing Facility Inspections

A top official accused the New York State Department of Health of performing insufficient inspections of nursing home equipment, recommending more in-depth surveys in the future.

Health officials only look at very small samples of medical and generator equipment when performing inspections, according to a report issued this week by the office of New York comptroller Thomas DiNapoli, while many nursing home operators failed to demonstrate that they had been performing regular tests of backup generators.

For instance, though the report found that the state health department meets federal requirements for equipment inspections, DiNapoli’s office claims that the standard should be stricter: Under current rules, inspectors touring a 120-bed facility with 500 separate pieces of resident care equipment would only need to look at four machines.


“We question whether the department’s standard sample sizes based on a facility’s number of beds are optimal to identify equipment deficiencies, such as at facilities with histories of poor survey results,” DiNapoli’s office wrote in the report.

In addition, the comptroller’s Division of State Government Accountability visited 36 nursing homes across the Empire State to conduct in-person inspections of medical equipment and backup generators. All but one failed to produce maintenance records for 33% of the inspected items, and 13 could not prove that they had conducted the required tests of its electrical generators.

“At one facility, maintenance staff told us three months of generator test logs were missing because a prior administrator did not think it was necessary to keep the logs,” the report noted.


The report points out that generators aren’t strictly medical equipment, but operators in the state are required to prove that they work for four continuous hours every 36 months. Backup power sources took on even greater importance in the nursing home world last year with the introduction of federal emergency preparedness rules from the Centers for Medicare & Medicaid Services (CMS), as well as the deaths of nursing home residents in Florida in the wake of Hurricane Irma.

DiNapoli’s office recommended that the health department consider basing its inspection requirements on the quantity of equipment on hand, as opposed to the bed count, and place greater emphasis on the generator rules in its communication with providers.

Written by Alex Spanko