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DiNapoli: DOH doing "bare minimum" in nursing home inspections

Post-Star - 9/23/2018

Sept. 23--Some nursing homes in the state are not testing their generators to make sure they will work in a power outage, the state Comptroller's Office found in an audit.

Auditors also found that the state Department of Health was only checking a few pieces of health equipment during inspections -- four pieces out of 501 at one nursing home.

That's within the federal requirements, but the audit said the Department of Health should do more.

"New York state is doing the bare minimum when it comes to inspecting life-saving equipment used at nursing homes," State Comptroller Thomas DiNapoli said in a statement announcing the audit. "The state Department of Health deserves credit for monitoring nursing homes and reporting deficient practices to the public. But this is New York, and we should be going above and beyond the minimum to make sure some of our most vulnerable residents are protected."

The Comptroller's Office did its own inspections of some nursing homes and found an airway suction machine covered with dust at one facility. At another, auditors found a wheelchair covered with rust or mold.

In addition, 164 pieces of electronic patient care equipment (31 percent of the items inspected by the Comptroller's Office) were not maintained as directed by the manufacturers and 35 nursing homes did not keep maintenance or service records for equipment, accounting for another 33 percent of the items inspected. That means a majority of the items inspected were either not maintained properly or had no record of maintenance.

"Given the extent of deficiencies we found during our site visits, we question whether the Department's standard sample sizes based on a facility's number of beds are optimal to identify equipment deficiencies," auditors wrote.

The Department of Health responded by noting that the federal government doesn't require inspectors to look at a specific number of electronic items.

"Federally trained surveyors do consider several factors when deciding what equipment to sample, including OSC's recommendation to include a facility's prior survey history. Other factors considered include complaints received since the last survey and identified concerns based on federally trained observations, record reviews and interviews noted during the survey," DOH officials wrote in response to the audit.

The Department of Health also complained that the Comptroller's Office was overstating the issue. After all, the DOH wrote, auditors found "only two isolated instances of equipment in varying stages of disrepair during 36 site visits."

The dirty wheelchair would not even fall under the inspections of electronic equipment used to care for patients, since it was a manual wheelchair, the Department of Health added.

"This lack of significant findings further supports the fact there is no evidence to support OSC's opinion that the Department's sample size is inadequate in identifying facility noncompliance with electrical equipment testing and maintenance regulations," the Department of Health wrote.

As for the generators, the Comptroller's Office checked them because they are used to power electronic patient care equipment. They are not normally checked during DOH inspections.

At 36 nursing homes, auditors asked for maintenance records on the generators. Each generator is supposed to be turned on for four continuous hours every three years to make sure it works. But four of the nursing homes did not know that, the auditors wrote. Another 11 nursing homes had no records showing that they had performed tests on their generators. The rest had done the appropriate tests, according to the audit.

The Department of Health said its inspectors have told nursing home administrators to test their generators, and that it began surveying them in 2016 to make sure they were complying. But the department agreed to send out another letter reminding them.

"The Department agrees ongoing education is important and has already taken steps to address," the Department of Health wrote. "The Department is committed to protecting the health and safety of New York State's nursing home residents. The Department's ongoing surveillance of nursing home operations ensures residents receive high-quality services that are consistent with federal and State regulations."

At local nursing homes owned by Centers Health Care, workers inspect all the equipment regularly, a spokesman said.

"The safety of our residents is, first and foremost, our chief concern," a spokesman said. "The maintenance department of each of these facilities conduct regular inspections of all our equipment to ensure the equipment is functioning within manufacturers parameters for use and safety."

Centers Health Care owns the Warren Center in Queensbury, Washington Center in Argyle, Glens Falls Center, Slate Valley Center in Granville and Granville Center in Granville.

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