Case Types -Nursing Home Care Giver Institution Abuse

Commision report page 2

The following are among the highlights of the Governor's recent adult home proposal:

Expands current law by requiring that DOH notify OMH, local social service districts, the State Department of Corrections (DOC), the State Division of Parole (DOP), hospitals and state licensed psychiatric centers of those ACFs cited for violations that directly affect the health, safety and welfare of residents, including enriched housing programs and residences for adults. Health facilities would be strictly prohibited from discharging a patient to a home which has been cited by the State for such violations; Prohibits agencies and health care providers who receive a "Do Not Refer" list from directly referring a patient to any ACF required to be licensed that does not have a valid operating certificate; Authorizes issuance of a "Do Not Refer" list and prohibits referrals from commonly used sources, when there are conditions found to be unsafe. This will provide DOH with a tool that can be used in serious but less egregious situations. It provides another source of information about conditions in a facility that are important to consumers, allowing them to make more informed choices; Sets forth a maximum fine of $5,000 per violation. If a recurring violation is cited against an adult home, residence for adults or enriched housing program within a 24-month period, the maximum fine levied would increase to $10,000 per deficiency. The proposal would also remove a provision of current law that allows ACF operators to avoid State monetary penalties if they submit a written corrective action plan to DOH within 30 days of being cited for deficiencies; and Requires that all State Office of Mental Retardation and Developmental Disabilities (OMRDD) developmental centers and all inpatient programs operated or licensed by OMH or the State Office of Alcoholism and Substance Abuse Services (OASAS) to assure that before discharging patients to an adult home, residence for adults or enriched housing program, that the residential placement is consistent with the patient's needs.
Current law requires DOH to notify OMH, local social services districts, and hospitals in the locality when the Department issues an adult care facility a notice of revocation, suspension or denial of an operating certificate, limitation on admissions, Department order, Commissioner's order or an enforcement action to seek fines for violations of provisions specified in SSL Section 460-d (7)(b)(2), which are commonly referred to as endangerment violations.

New York State law also provides for civil penalty for violations occurring in adult homes, residences for adults and enriched housing programs of up to $1,000 per day for violations in accordance with a fine schedule promulgated in regulations. Current law does not provide for an increased penalty for repeat violations. Also, current Social Services Law provides that an adult care facility operator can avoid fines for most violations by rectifying the violations within 30 days of receiving a notice of the violations. Under the newly proposed legislation, these provisions would be changed as noted in the bullets listed above.

State Surveillance Initiatives Underway

Important State initiatives that are being taken by the State Department of Health (DOH), the State Office of Mental Health (OMH) and the State Commission on the Quality of Care for the Mentally Disabled (CQC) to ensure quality care in ACFs, include:

Creation of joint surveillance teams comprised of surveyors from DOH, OMH and CQC to complete unannounced inspections of ACFs in New York. The joint surveillance teams will enhance the State's current initiatives to review the care being provided, especially mental health services, as well as the living conditions in specific homes. Providers are required to submit written corrective action plans; Development of a DOH automated ACF survey report process to provide greater access to report findings, violations and corrective action plans so that surveillance staff from the three agencies can better track and analyze the latest information on homes statewide; Strengthened OMH surveillance teams to more closely monitor the quality of mental health services being provided to residents on-site, including dedicated staff to complete surveys. The surveillance teams are responsible for conducting unannounced site investigations of ACFs in response to complaints and reported incidents; Strengthened CQC ACF oversight so that the Commission can routinely conduct programmatic and financial reviews of homes, and respond to complaints regarding the services provided to residents. This includes dedicated staff to complete surveys; Implementation of a contract with the New York City Health Services Review Organization to compliment state staff and conduct additional surveys of ACFs with histories of violations. Homes surveyed include those in which 25 percent of the residents are receiving mental health services on an ongoing basis. To date, inspections at 50 homes statewide have been completed as part of this ACF surveillance program. Quality of Care Priorities