On Monday, March 1, the Assembly Health Committee advanced several bills to improve patient safety, accountability, and quality of care in nursing homes.These are part of an Assembly package of nursing home reform bills, including additional legislation expected to be advanced shortly.

In January, NYS Attorney General Tish James issued a report that shined a bright light on the COVID-19 death toll in nursing homes, identifying concrete steps to make nursing homes safer during and after the pandemic.After the report’s release, and an adverse court ruling in a Freedom of Information lawsuit, the NYS Health Department (DOH) finally released long-overdue statistics showing that far more nursing home residents in New York had died from COVID-19 than DOH had previously reported.

I have long fought to strengthen New York’s regulation of nursing home and to increase the transparency about their operations and level of care.New York needs to require increased staffing and better oversight through inspections and higher fines for violations, and should never again grant virtually unlimited legal immunity to institutions responsible for caring for hundreds of thousands of New Yorkers, even during a pandemic.

We also need to enact laws to ensure that nursing home operators spend their funds on patient care, not profits and administrative waste.Studies show that for-profit nursing homes often have higher infection rates, more instances of bedsores, and low federal ratings for patient-to-staff ratios, and it’s time to halt their expansion into the New York state “market.”Nursing homes should be operated to care for people, not as cash-generating profit centers.

Below are the nursing home reform bills advanced at Monday’s Health Committee meeting.Further bills to be advanced soon will directly address staffing and patient care spending and the certificate of need process.For more information on a bill, please contact the sponsor listed after the description. For the text of a bill, supporting memorandum, and information on its status, go to: http://public.leginfo.state.ny.us/menuf.cgi

• Repeal Provider “Immunity” – Health care providers were granted broad immunity from liability in language inserted at the last moment of the 2020 budget process.The recent report by Attorney General James states that this immunity language contributed to damaging behavior by nursing home operators.While the language has been limited by amendment, this bill would fully repeal it.It is important to note that health care providers already have sufficient protections under long-standing “crisis standards of care” legal doctrines.(Kim, A.3397)

• Nursing Home Psychotropic Drugs – Psychotropic drugs are used inappropriately in nursing homes as a means for behavioral control without an actual diagnosis of mental illness.This seriously damages residents.This bill would require that before such drugs are ordered for a nursing home or adult care resident, the patient or surrogate be fully informed of the effects of the medication, reasonable alternatives, and other information, and that the patient has the right to refuse or revoke written consent.(Gottfried, A.5841) 

• Prohibition of New or Expanded For-Profit Nursing Homes – 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.The Attorney General’s report documented the impact that dubious real estate and service contract transactions had in increasing COVID-19 risks to patients.This bill prohibits granting of new for-profit nursing home licenses or expanding the capacity of existing for-profit nursing homes.(Gottfried, A5842)

• Quality Assurance Committees – Requires adult care facilities to establish quality assurance committees involving frontline workers, employees, residents, and family members of residents, who will review the facility’s practices and standards including infection control.(Kim, A.5846)

• Antimicrobial Resistance Prevention & Education – Requires hospitals and nursing homes to establish anti-microbial stewardship programs that meet or exceed Federal requirements including establishing training for staff regarding antimicrobial resistance and infection prevention and control.(Woerner, A.5847)

• Facility Violations Transparency – This bill requires that residential facilities provide potential residents and their families with documentation at the time of intake on how to look up complaints, enforcement actions, and penalties levied against the facility, as well as informing the public how to find and use State and Federal nursing home profiles websites.(Wallace, A.5848)