OIG Calls on New York to Crack Down on Nursing Home Safety

The federal government’s top health care watchdog has called on state officials in New York to beef up enforcement of nursing home safety rules after uncovering multiple violations in a recent audit.

The Department of Health and Human Services’ (HHS) Office of the Inspector General (OIG) this month released a report accusing the Empire State of failing to ensure that nursing facilities fully comply with a range of safety rules — from proper emergency planning to the installation of carbon monoxide detectors.

OIG officials toured a random sample of 20 facilities in New York during the first four months of 2018 with the goal of testing their compliance with the most recent set of emergency preparedness rules, which went into effect in November 2017.

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The results, according to the OIG, were not positive, with inspectors finding a wide swath of deficiencies. For instance, 18 out of the 20 buildings had at least one deficiency related to emergency exits, while 11 were called out for carbon monoxide detector deficiencies — including two that didn’t have a detector at all.

In addition, 13 of the inspected buildings had issues with their emergency plans, a cornerstone of the federal government’s crackdown on nursing home safety. Providers across the country faced increased scrutiny around disaster planning in the wake of several hurricane-related nursing home deaths in Florida back in 2017, but at least in the winter and spring of 2018, 19 of the 20 facilities in New York had deficiencies related to their emergency power and supply plans, according to the OIG.

“As a result, nursing home residents at the 20 nursing homes were at increased risk of injury or death during a fire or other emergency,” the OIG concluded in its report.

To combat the perceived problems, OIG recommended that New York State officials increase the frequency of safety inspections for facilities with a history of deficiencies, while also working with the Centers for Medicare & Medicaid Services (CMS) and other states to better standardize its safety training programs for nursing home staff.

The New York State Department of Health generally agreed with the federal government’s findings and recommendations, though officials objected to how the OIG timed its inspections so close to the implementation date of the new emergency rules.

“With respect to the audit’s recommendations, the Department agrees with the goals of the recommendations and will consider implementing them as appropriate,” the state DOH wrote in a letter to CMS.

The federal government has brought increased attention on nursing home safety over the last year, with CMS administrator Seema Verma rolling out a five-point plan to improve enforcement and prevent neglect and abuse in long-term care facilities. Part of that initiative includes more uniform standards for state survey agencies, which officials have noted can vary widely in inspection quality and enforcement.

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