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Advocates Fear Nursing Home Reform Bills Won’t Fundamentally Change Life For Residents
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Gwynne Hogan
Published Feb 24, 2021
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Yuki Iwamura/AP/Shutterstock
By
Gwynne Hogan
Published Feb 24, 2021
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A slate of reform bills are moving through the New York State Senate amid mounting pressure on Governor Andrew Cuomo for his administration’s handling of nursing home safety and the withholding of the total death count of nursing home residents during much of the COVID-19 pandemic. He’s pushing for reforms as well.
But those seeking a broader overhaul of the long-term care industry, both the operators and the patient advocates, told Gothamist that they fear the proposals don’t go far enough to address the most pressing issues — low staffing levels, state funding, and lax oversight — much less incorporate innovative approaches to redesigning how communities manage end-of-life care.
“Everything they’ve put out is smoke and mirrors,” said Vivian Zayas, with the group Voices for Seniors, whose mother died of COVID-19 after catching it at a Long Island rehab facility last spring. Her mother had been scheduled for release back to her Brooklyn apartment just days before she passed away.
“There’s no staffing [requirement]," Zayas said. “If staffing is one of the keys to keeping seniors safe, why isn't it in the reforms?”
While New York law requires nursing homes to have “sufficient nursing staff and related services to attain or maintain the highest practicable physical, mental, and psychosocial well-being,” the law doesn’t set specific patient-to-staff ratios, unlike all but 12 other states in the country, according to an analysis from 1199 SEIU. A report from the New York Attorney General Tish James published in January found that facilities with lower staffing levels had higher COVID-19 death rates.
Instead of mandating specific staffing levels, Cuomo’s proposal mirrors a bill passed by the State Senate that would mandate nursing homes spend 70% of their revenues on “direct patient care.” In addition, 40% of the facility's revenue would have to go directly to “resident staffing,” proposals they say translate to more staff. Cuomo also has proposed raising fines on nursing homes as well as capping executive salary at $250,000.
"We all share the same goal of reforming these facilities and fixing the inequities laid bare by this pandemic,” said Rich Azzopardi, a spokesperson for the governor. “The governor laid out a legislative package in the 30-day amendments and said he wouldn't sign a budget without them. To the extent there are other ideas, we're open to reviewing them.”
But Susan Dooha, the executive director of Center for the Independence of the Disabled, New York, said while capping executive pay is a step in the right direction, it won’t necessarily result in more staffing.
“That doesn’t mean that the money goes into paying those with the toughest workloads and it doesn't mean that there will be enough staff, so it doesn't go far enough,” she said.
Her group often hears concerns that inspections don’t lead to enforcement action. Reporting from THE CITY last year found a similar trend in facilities with many COVID deaths getting cited for no violations of infection protocol. “We’ve seen inspectors go into facilities that are not good, safe, clean well-run facilities and they come back not reporting anything.”
The Workmen’s Circle MultiCare Center, a 500-bed nursing home near Co-Op City in the Bronx, lost 65 residents to COVID-19 in the last year. Yet, regulators who visited the facility three times in recent months documented no health or safety violations, according to federal records.
“We always pass, and it’s like everything is perfect,” said Jaqueline Lord, a certified nursing assistant at the facility and union member of 1199 SEIU, who described struggling to provide more than 15 minutes of care a day to her assigned patients. “I can't believe it.”
The facility has not yet returned a request for comment.
Assemblymember Ron Kim, who chairs the Aging Committee, and recently earned the Governor’s ire for his continued criticism over how he handled nursing homes, acknowledged there are “many band aid” bills that don’t get to the root of reforms needed. He said the “tougher” legislation like one that mandates minimum patient to staff ratios for hospitals and nursing homes could be discussed in the coming weeks.
“We are working toward them,” he said.
Kim and other critics have accused Cuomo of pandering to the powerful nursing home and hospital lobby, pointing to the provision passed in the state budget last year that shielded those facilities from some liability for COVID-19 deaths.
But union representatives with 1199 SEIU have come out in support of the governors’ proposals, arguing that the reforms would indirectly boost staffing levels.
Meanwhile, the trade group that represents nursing home operators opposes them.
“New York’s historic underfunding of Medicaid and New York’s long-term care workforce crisis, those two issues are not addressed,” said Stephen Hanse, the president and CEO of the New York State Health Care Facilities Association which regularly calls for more state funding from Medicaid reimbursement payments.
The pandemic has brought many issues advocates have warned about for years inside nursing homes to the forefront. State records now show more than 15,000 New Yorkers who were residents of long-term care facilities died from COVID-19. Advocates like Dooha are hoping the newfound focus on nursing homes might bring about more foundational reforms, like phasing away from the nursing home model altogether.
“Children are not saying, when I get old I want to die in a urine-soaked bed with bed sores. That’s not what they’re saying,” Dooha said. “There needs to be a transition to much greater emphasis on home and community-based care."
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Gwynne Hogan
Gwynne Hogan is a former Gothamist reporter.
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Gothamist is funded by sponsors and member donations
Gothamist is funded by sponsors and member donations
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