Great things are happening in New York regarding enforcing safe staffing levels at troubled nursing homes. Last month, a persistently low-rated Buffalo nursing home, Safire Rehabilitation of Southtowns, has been fined $7,000 by the state after it was cited for failing to have sufficient staff on duty and other violations. It is extremely rare that investigators cite a facility for short-staffing. Very rare. The New York Health Department has come under pressure for allowing nursing homes to operate without enough nurses.
Last year state lawmakers considered legislation backed by unions representing nursing home workers that would have set for the first time minimum safe staffing levels for each of the state’s more than 600 nursing homes. At present, nursing homes are required only to have “sufficient” staffing levels, with no specified ratios. The nursing home industry balked and sent campaign contributions to the politicians.
The state Health Department in November fined Safire Rehabilitation, a facility with about 110 residents, the maximum allowed because understaffing has been a recurring problem, said a spokesman for the agency. Meanwhile, Safire of Southtowns’ staffing logs showed the nursing home did not meet its own internal guidelines for safe staffing on 21 out of 51 shifts during a period in the summer of 2019 that the Health Department reviewed, according to a report written following an Aug. 22 inspection.
“Based on multiple sufficient staffing deficiencies cited by the department during three unannounced inspections, Safire Rehabilitation of Southtowns has been fined the maximum of $7,000,” said spokesman Jeffrey Hammond.
He said the Health Department only cited 26 nursing homes statewide for insufficient staffing in 2019, including two in the Buffalo Niagara region.
“Doing a safe staffing report was the Health Department’s idea, to put off doing a real law. Now it’s lagging on releasing the report,” said Assemblyman Richard Gottfried, D-Manhattan, the chairman of the Assembly health committee. “It undoubtedly shows the need for action on safe staffing, which the department doesn’t want to confront.”
Understaffing at nursing homes cause serious consequences, residents and nurses told the state.
A person identified only as Resident #53 told inspectors she had not been out of bed all day because there was not enough staff to help her. “The staff don’t get me out of bed because I need two people to get out of bed, there is not enough staff and it happens often,” the woman told inspectors.
Resident #95 complained, “Yesterday I didn’t get my morning meds (medications) until after 2:00 p.m. Some of the meds off schedule are my pain meds.”
A licensed practical nurse admitted he sometimes has to cover a unit with more than 30 residents alone, without any certified nurses aides helping, and as a result he’s unable to complete all of the required checks on residents every two hours.
“I worry about if we had a fire or an emergency, we won’t be able to do everything and get the things done that we need to for safety,” LPN#3 told the inspectors, according to the state report.
The nursing home’s staffing coordinator told inspectors the staffing shortages occur because too many workers call in sick or just don’t bother to show up.
The Health Department has cited the nursing home’s owners five times in the past two years for having insufficient staffing.
The staffing crisis was particularly bad on Christmas Eve 2017, when all four of the licensed practical nurses scheduled to take care of about 100 residents called in sick for the day shift and a registered nurse scheduled to work didn’t show up, according to the state reports. The home’s administrator scrambled to find replacements.
The $7,000 fine on Safire of Southtowns increased its total state and federal penalties for the past five years to $98,925, one of the highest totals for nursing homes in Erie and Niagara counties.
The facility’s biggest penalty came in 2016 when the federal government fined it $85,925. That fine was imposed after Health Department inspectors in May 2016 found that a licensed practical nurse failed to disinfect a shared blood glucose meter when testing up to 20 residents, including two who had known communicable bloodborne diseases.
Statewide, the Health Department has imposed more than $3.2 million in fines against 209 nursing homes since 2016, for a variety of violations, said Hammond, the agency’s spokesman.
Assemblywoman Aileen M. Gunther, D-Forestburgh, the sponsor of the safe staffing bill in the Assembly, said vulnerable residents in nursing homes deserve better care and the nursing staffs caring for them should not be overworked.
Inadequate staffing has the potential to contribute to negative situations, such as bed sores, which end up increasing the costs of treatment, she said.