Assembly Begins Passing Sweeping Nursing Home Reform Legislative Package

Speaker Carl Heastie, Health Committee Chair Richard N. Gottfried and Aging Committee Chair Ron Kim today announced the Assembly has begun to pass a series of bills to increase safety and improve the quality of life for New Yorkers living in nursing homes. The Assembly began passing the legislative package yesterday and will continue its work today. Additional nursing home reform bills will be passed in the near future. The bills included in the package address issues including quality improvements, visitation, oversight, transparency and immunity from liability.

“The COVID-19 pandemic has exposed and exacerbated so many of the issues and challenges that have long existed in our state, especially in our nursing homes,” said Speaker Heastie. “This legislative package will go a long way to increase the safety and protect the wellbeing of our most vulnerable New Yorkers. We owe it to our nursing home residents and their families to do better.”

“Along with patients, their families, workers, and advocates, we have long fought to strengthen New York’s oversight of nursing homes, increase transparency of their operations, and improve patient care,” said Assemblymember Gottfried. “Our August hearings on COVID-19, combined with the recent report by N.Y. Attorney General Tish James, shined a bright light on problems of inadequate staffing, financial misdeeds and patient neglect by for-profit operators, and the damage done by the legal immunity for health care providers inserted by the governor into last year's budget at the very last moment. The Assembly today takes critical steps to improve the quality of nursing home care, and we will be taking up additional measures shortly.”

“The COVID-19 pandemic has shined a light on the desperate need for these reforms, and they are long overdue for our nursing home residents and their families,” said Assemblymember Kim. “These bills will help ensure a higher standard of care in our nursing homes, as well as increase transparency and accountability for bad actors who continue to put profits over people.”

Quality Improvements

The legislative package includes a measure that would establish the Reimagining Long-Term Care Task Force with advocates from across the long-term care system (A.3922-A, Cruz). The task force would be required to study and produce a report to the governor and Legislature on the state of long-term care services, both in home-based and facility-based settings, and examine the impact the COVID-19 pandemic has had on long-term care in New York on issues including but not limited to staffing shortages, visitation bans, and infection control protocols and enforcement. The Assembly passed this measure yesterday.

Other measures included would prioritize sanitation efforts in nursing homes and adult care facilities, including a bill that would require the establishment of an antimicrobial stewardship program and training on antimicrobial resistance and control (A.5847, Woerner). Yesterday, the Assembly passed legislation that would require adult care facilities to include infection control in their biannual plans regarding quality assurance activities (A.5846, Kim).

During the pandemic, reporting indicated that residential health care facilities around the country inappropriately released residents to homeless shelters and other unsuitable locations that were not adequately equipped to continue care for these individuals. The Assembly will pass legislation that would codify New York regulations and federal law that establish certain requirements prior to an individual being transferred or discharged from a residential health care facility (A.3919, Hevesi).

Visitation

For many individuals living in nursing homes, visitation from family and loved ones provides critical informal channels of care that are crucial to their well-being. Yesterday, the Assembly passed a measure that would allow exemptions for personal care visitors and enhanced compassionate care visitation during declared local or state health emergencies (A.1052-B, Bronson).

Oversight and Transparency

In recent years, for-profit nursing homes in New York have grown from about one-third of the market to two-thirds. National data shows that for-profit nursing homes do worse on staffing, infection control and other quality indicators. They have higher rates of patient deaths and cost more. Another bill the Assembly intends to pass would prohibit granting of new for-profit nursing home licenses or expanding the capacity of existing for-profit nursing homes (A.5842, Gottfried). 

The package also includes the Long-Term Care Ombudsman Program Reform Act to increase the effectiveness of the program (A.5436-A, Clark). The act would promote greater awareness of the Long-Term Care Ombudsman Program, strengthen communication between ombudsmen and the agencies that are responsible for licensing or certifying long-term care facilities, and include ombudsmen within a residential care facility’s pandemic emergency plans.

Another bill would codify the Health Emergency Response Data System (HERDS) under the Department of Health (DOH), and require information collected under the system be published on the DOH website (A.244-A, Gottfried). HERDS was created in response to the World Trade Center disaster on September 11, 2001. It is a statewide electronic web based data collection system linked to health care facilities across the state through a secure internet site that allows hospitals to relay resources or needs to the DOH during emergencies, or respond immediately to rapid request surveys in preparedness planning efforts.

Other legislation the Assembly passed yesterday as a part of the legislative package would require each residential health care facility to provide residents and their families with a separate document as part of an intake application that includes information on how and where a potential resident and their family members can look up complaints, citations, inspections, enforcement actions and penalties taken against the facility, as well as nursing home quality information provided by the state and federal governments (A.5848, Wallace).

Immunity from Liability

Another bill in the package would repeal Article 30-D of the Public Health Law, also known as the Emergency or Disaster Treatment Protection Act, to ensure that health care facilities, administrators and executives are held accountable for harm and damages incurred (A.3397, Kim).

“It is unconscionable that during a health care crisis residential facilities would inappropriately and carelessly discharge patients or transfer them to facilities that lack the care they need,” said Assemblymember Andrew Hevesi. “This legislation would codify New York regulations and federal law to close any loopholes and protect nursing home residents.”

“During the Assembly’s nursing home hearings last year, we heard from many families said that DOH restriction effectively banned visitation in many facilities and led to a decline in the physical and mental health of their loved ones,” said Assemblymember Harry Bronson. “This bill addresses that issue through a safeguarded process to allow family members and caregivers to once again visit these residents. The bill will also expand the definition of'compassionate care visitation’ from strictly end-of-life situations to other cases where a decline in physical, mental or emotional wellbeing requires needed attention from family, while maintaining the health and safety of all the residents.”

“The COVID-19 health crisis has shined a light on the need to have better health and safety protocols in our hospitals and nursing homes,” said Assemblymember Carrie Woerner. “My legislation will require that these facilities follow the Centers for Disease Control and Prevention recommendation and establish an antimicrobial stewardship program to better protect our most vulnerable populations from the spread of infectious disease.”

“When the Legislature held a public hearing on the impact of COVID-19 in residential health care facilities, it became clear that many residents and their families were not aware of how to access information maintained by the Department of Health on these facilities regarding their compliance with applicable laws and regulations,” said Assemblymember Monica Wallace. “Nursing home residents and their families deserve full transparency when evaluating the quality of care provided by residential health care facilities.”

“Nursing homes and adult care facilities have been the hardest hit by the COVID-19 pandemic, but our long-term care system was troubled long before this health crisis,” said Assemblymember Catalina Cruz. “Now more than ever, this task force is required to ensure our seniors are given the chance to age with dignity. It is our duty as lawmakers to deliver that for them. The Re-Imagining Long-Term Care Task Force will help us examine the existing need and services, as well as the impact of COVID-19 on long term care in New York, allowing us to use the findings to build a more resilient system for our future. I am proud to carry this bill and to fight for the quality of life our seniors deserve.”

“New York State's Long-Term Care Ombudsman Program has one primary purpose, to advocate for residents in nursing homes and other long-term care facilities. To be more effective, we need to increase the number of volunteers through education, promotion, and recruitment. We also need a strong line of communication between the program’s staff and volunteers and the agencies that investigate and resolve these complaints. We must ensure access for our ombudsmen to all nursing homes during any emergency, like a global health pandemic, since they serve as our eyes and ears,” said Assemblymember Sarah Clark. “The Long-Term Care Ombudsman Program Reform Act will address these issues, and strengthen the program so we can better protect our seniors and most vulnerable populations”