After nursing home explosions in Pennsylvania, a renewed focus on Long Island safety plans

In the aftermath of Tuesday's explosion at a Pennsylvania nursing home that killed at least two people, a renewed focus has been placed on safety and risk assessments at elder care facilities throughout Long Island and across New York.

Nursing homes statewide are required to maintain a comprehensive emergency preparedness plan that addresses their specific vulnerabilities and risks, according to industry representatives and former state Health Department officials.

Facilities must also conduct regular drills and staff training on protocols and policies, said Tarrah Quinlan, director of education program development and member operations at the New York State Health Facilities Association, a trade group that represents nursing home and assisted living facility operators.

'Totally unexpected' is always possible

The plans, required by federal and state authorities, run the gamut from communications assessments and fire safety to the maintenance of water, heating, waste and ventilation systems. The records are reviewed by health inspectors during annual nursing home surveys, Quinlan said.

The state is "very thorough in trying to ensure that facilities are looking at this," said Quinlan, who previously served as the director of the Health Department's Bureau of Quality Assurance and Surveillance. "You do a risk assessment based on your specific geographical placement or community risks. But, unfortunately, there's always the potential of something totally unexpected happening."

In a statement, Health Department spokeswoman Monica Pomeroy said: "Ensuring all nursing home residents receive proper care is a priority of the New York State Department of Health. Nursing homes are surveyed against National Fire Protection Association, Life Safety Code and Health Care Facilities Code standards."

On Wednesday, construction crews and drones were searching the rubble of the 174-bed Bristol Health & Rehab Center in Bristol Township, Pennsylvania, after a pair of explosions killed a resident and an employee, collapsed part of the building and sent at least 20 people to the hospital.

While the cause of the blasts has yet to be determined, investigators are looking into whether a gas leak — the incident occurred shortly after a utility crew responded to reports of a gas odor at the facility — may have caused the explosions.

State records show the facility was cited for multiple violations during an October inspection by the Pennsylvania Department of Health, including failing to provide accurate floor plans and to properly maintain stairways and fire extinguishers on one level. Inspectors also cited the facility for lacking required smoke barrier partitions designed to contain smoke across floors.

'Serious' oversight concerns

Richard Mollot, executive director of the Manhattan-based Long Term Care Community Coalition, which represents elder care residents, said the Pennsylvania tragedy highlights the need for strong fire safety inspection and emergency preparedness monitoring.

But Mollot maintains that state oversight of New York nursing homes is "historically weak," pointing both to the coalition's own research and pre-pandemic audits by the U.S. Department of Health and Human Services' Office of Inspector General, which found the Health Department failed to ensure that nursing homes were in compliance with federal requirements for life safety and emergency preparedness or that they regularly corrected identified problems.

"These indicate an astounding failure to ensure that New York nursing homes are taking the baseline steps necessary to ensure that residents are safe and that policies are in place to protect resident lives during emergencies," Mollot said. "Taken together, long-standing oversight failures and the growing corporatization of New York’s nursing home sector raise serious concerns about the system’s ability to safeguard residents during an emergency."

Stephen Hanse, president and chief executive of the New York State Health Facilities Association, said the risks to elder care facilities is exacerbated because the state no longer provides capital reimbursement to nursing homes for improvements after they're 40 years old.

"As buildings get older, they need investment," Hanse said. "It's like your home. You need roofs. You need boilers. You need heating systems. You need windows. And the state is refusing, after 40 years, to reimburse those investments. And they're cutting capital investments for all nursing homes that need to invest in their equipment and building."

The Health Department announced the cost-cutting move last year, stipulating that no Medicaid reimbursement would go toward ongoing and necessary capital costs for facilities that  have exceeded or are going to exceed their "useful life" of 40 years. 

In response, 92 nursing homes statewide — many of which are in buildings that are at least 40 years old — filed suit in New York’s Northern District, alleging that the decision is unconstitutional and violated their equal protection rights.

State officials have said their new reimbursement methodologies make capital improvements at long-term care facilities more flexible and improve reimbursement for cost of care.

The Associated Press contributed to this story.

By Robert Brodsky

robert.brodsky@newsday.com@BrodskyRobert

Robert Brodsky is a breaking news reporter who has worked at Newsday since 2011. He is a Queens College and American University alum.