| Free Toolkit: Speak Out to Advocate for Safe Nursing Home Staffing Standards
Study after study has indicated that sufficient staffing is key to quality of life and quality of care. Yet while we give nursing homes millions of dollars a year, and trust them with our most vulnerable loved ones, we do not require that they maintain adequate staffing to provide decent care.
It is time that our elected officials, who sign off on payments to nursing homes, sign on to hold them responsible for having safe staffing levels. But they wont do that unless they hear from us – a lot of us – that this is an important issue.
LTCCC Report Examines Nursing Home Oversight Across New York: Major Problems Still Exist - Many Regional Differences Found
Vulnerable nursing home residents depend on the state to hold nursing home providers accountable for the care they receive by identifying problems during regular inspections and through investigations of complaints.
This report, supported with a grant from the New York Community Trust, examines the effectiveness of each regional office in ensuring resident safety and quality of life.
It is a follow up to a study LTCCC issued last year (see link below to that report) which compared New York’s oversight performance to that of other states and the federal government. The motivation for the new study was to identify strengths and weaknesses among the regional offices overseeing nursing homes in New York and develop recommendations for the NY Department of Health to protect residents no matter where they live.
The full report (see link on the right), examples of surveyor ratings that were too low, examples of superior surveying, region by region differences, possible reasons for these differences and recommendations for improvement.
CLICK HERE TO READ PRESS RELEASE
CLICK HERE to read our previous report, which compared NY State as a whole to other states: Nursing Home Residents at Risk! NYS' Failure to Oversee Nursing Homes |
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Legislation
for Safe Nursing Home Staffing in NY State:
Numerous studies have indicated that
nursing home staffing levels are the most critical indicators of
good care and resident safety.
LTCCC supports NY State legislation to
encourage better staffing in nursing homes. Introduced in the
Assembly by Assemblyman Richard Gottfried (with many other
sponsors), A8220 would
mandate ratios of nurse aides, RNs and LPNs. We also support federal legislation to mandate minimum safe staffing levels, such as that introduced in 2005 by Representative Waxman of California.
CLICK
HERE for the text of the Assembly's Safe Staffing bill.
Another bill that is very important,
especially if A 8220 does qnot pass, is
A03791 , the Nursing
Home Diversion Act (NHDA). This bill, introduced by Assemblyman
Richard Gottfried, would not permit nursing homes to accept any
new residents if their staffing levels drop below a dangerous point.
CLICK
HERE for the NHDA bill text.
CLICK
HERE to read about the NHDA and what it would do.
The NHDA now has over two dozen sponsors
in the NY Assembly. Unfortunately, not a single NY State senator
has stepped forward to support this critical minimum protection.
CLICK
HERE to voice support for the NHDA.
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LTCCC Fights Allowing Poorly
Trained Feeding Assistants in Nursing Homes:
The federal government has announced
a relaxation in standards for nursing home workers who provide care
to residents. Until now, one had to be at least a certified
nurse aide (CNA) to give resident care. CNAs must have at least
75 hours of training under federal law (100 hours in New York) and
meet other requirements. Under the new interpretation, states are
permitted to allow nursing homes to use "feeding assistants"
with less than 10 hours training, no certification and little oversight
to feed vulnerable residents.
This is a vital function, and there
are serious risks for the person being fed. In addition, it
is dehumanizing to the resident to be treated as the subject of
tasks rather than to be cared for as an individual and treated with
dignity. LTCCC is working to prevent the use of feeding assistants
by joining in an amicus brief to support a lawsuit to stop feeding
assistants.
See button on right side of page,
LTCCC Position on Poorly Trained Feeding Assistants, for more information
and a copy of the brief.
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LTCCC Testifies at Assembly Hearing
on DOH Oversight:
"The findings of this study
indicate that NYS is failing in this job a significant amount of
time and is putting nursing home residents at risk."
Cynthia Rudder and Martin Sobel, LTCCC.
CLICK
HERE to read testimony.
"There is no adequate and
effective DOH oversight. The major obstacle ...appears to be its
(DOH's) willingness to cooperate with the administration."
Shirley Genn, family member and retired Executive Director
of Brooklyn-wide Interagency Council on Aging.
CLICK
HERE to read U.S. Government Accountability Office Report
on Nursing Home Oversight
The Government Accountability Office
(GAO) has issued a new report which assesses problems with nursing
home oversight from 1998 to the present. The report, Nursing
Homes: Despite Increased Oversight, Challenges Remain in Ensuring
High-Quality Care and Resident Safety (GAO-06-117), presents
the findings of GAO's investigation in which they reviewed trends
in nursing home quality from 1999 to January 2005, evaluated the
extent to which CMS (Centers for Medicare and Medicaid Services)
has addressed nursing home survey and oversight problems and identified
the key challenges to greater progress in ensuring resident health
and safety. The investigation found widespread, serious issues,
from understatement of serious deficiencies to inconsistency in
state surveys. The GAO's findings corroborate many
of the findings in LTCCC's recent report, Nursing Home Residents
at Risk! NYS' Failure to Oversee Nursing Homes, which
compared nursing home oversight in NY State vs. other states and
found that New York had serious underperformance issues in a number
of areas critical for nursing home resident protection and safety.
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What Lies in the Future for NY’s Nursing Homes and Those Who Will Need Them?
LTCCC Hosts Two Unprecedented Meetings of NY State Political Leaders, Charitable Foundation Reps and Major Stakeholders
The future for nursing homes and those who will need them is looking bleak. Problems in nursing homes are widespread and well known. Too many of our loved ones suffer because of neglect and abuse. As a result, there is a strong and growing movement in New York and nationwide to enable people who need long term care to receive that care outside of nursing homes. These developments are wonderful for people who are able to get care in their home or in a more community-like setting, such as assisted living. But what will happen to those who need or want care in a place that offers 24 hour skilled nursing? With money and public attention turning away from nursing homes – while the numbers of frail elderly continue to rise dramatically - how will we ensure that people have access to good and safe nursing home care?
To address these critical questions, LTCCC convened two invitation-only roundtable meetings of state policy makers, leading consumer and provider representatives, and representatives of several of the state’s foremost foundations to begin the dialogue necessary to guide New York’s planning and policy development in the future.
Click on the link above to read more or download our report.
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Read testimony on Medicaid fraud by LTCCC's
Director of Special Projects, Cynthia Rudder, at the NY Assembly
hearing on Medicaid fraud on September 9, 2005.
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Joint meeting of LTCCC
committees to discuss federal and state issues. |
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Final Nursing Home Staff Posting
Requirements Issued:
In 2001, the Centers for Medicare and
Medicaid Services (CMS) mandated that every nursing home in the
country post in a prominent, public place the numbers of licensed
and unlicensed direct care staff on duty for every shift. LTCCC,
with funding from the Robert Sterling Clark Foundation, conducted
a study to determine if this requirement was adequate to give consumers
the information they need to determine staffing levels in their
nursing home. Based on this study, LTCCC made recommendations to
CMS for improvements to the initial regulations. The final regulations
on posting nurse staffing information in nursing homes were published
by CMS in late October 2005.
The final regulations have much of
the core information as in the proposed regulation issued in 2004.
However, they do not include some of the important comments which
LTCCC and other groups had urged the federal government to require,
such as requiring a standardized form that would be readily identifiable
to residents and family or posting information for more than one
shift (to give people a better understanding of the home's staffing
levels).
CLICK
HERE for final nursing home staff posting requirements.
CLICK
HERE to read LTCCC's report, Is the CMS nursing home
staff posting requirement serving consumers?
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CLICK
HERE
to read LTCCC's Report: Results
of LTCCC's Survey
of NYS Ombudsmen
"Poor care, accidents leading to hospitalization and several
deaths,.... I also find that care plans are not always followed
because staff is in a hurry, accidents occur because toileting residents
is delayed so residents attempt to toilet themselves."
Additional LTCCC Reports:
Building upon its Certified
Nurse Aide Training "Model" Program (2002), in 2004,
the Coalition released a number of reports and studies demonstrating
the need for more staff and better screened and trained staff: (1)
Certified Nurse Aide Screening and Continuing Education: A National
Survey of State Requirements with Recommendations for Improvement,
(2)
LTCCC Urges New York State Leaders to Consider Costs of Poor Care
(discusses the cost of poor care related to low staffing) and (3)
Are the Federal Nursing Home Staff Posting Requirements Serving
Consumers? a report on a year long campaign of consumer experience
with postings in their nursing home(s), with recommendations for
regulatory improvement.
With support from the New York Community
Trust, LTCCC published a report on improving working conditions:
Improving Working Conditions for Nursing Home Direct Care Staff:
A description of a project in two nursing homes in New York City
and A Ten-Step Guide to Improving Working Conditions. |
