Nursing homes on LI, in state, poorly staffed, have lowest fines, report finds

More than 95% of all New York nursing homes, including those on Long Island, don't meet federal minimum staffing requirements, and rank among the lowest in the frequency and total dollar amount of fines, according to a new watchdog report. 

The report, issued Tuesday by the Manhattan-based nonprofit Long Term Care Community Coalition, which advocates for nursing home residents, examined state and federal oversight of nursing homes nationwide from 2022-2024 using data from the Centers for Medicare & Medicaid Services.

The data shows that in the wake of the COVID-19 pandemic, the number of health citations issued nationwide to eldercare facilities increased 12%, from 128,675 in 2022 to 143,821 in 2024.

However, during that same time period, the number of reported fines fell 55% from 11,501 in 2022 to 5,210 in 2024, while total financial penalties declined by about 14%, even as the number of residents living in those facilities continued to grow, the group found.

New York State, the data showed, ranked among the bottom nationwide, adjusted for resident population size, fine frequency and dollar totals during that three-year time period. It also placed near the bottom for the number of citations that found actual harm to residents, the report said.

"The message is that you can provide that level of substandard care, and you really don't have to worry about facing any penalty," said Richard Mollot, executive director of the Long Term Care Community Coalition, during a webinar on Tuesday detailing the report's findings. "You'll continue to get paid. You'll continue to be a part of the system. You'll continue to get referrals. And everything as far as your bank account is concerned is perfectly fine."

Fines per resident

For example, Montana's rate of fines — the highest in the nation relative to its resident population — was nearly 10 times higher than that of New York, the data shows.

Meanwhile, Illinois averaged approximately $465 in fines per resident per year, while in New York the number was $41, the report concluded.

John Emery, a spokesperson for the state Health Department, said in a statement the "report does not accurately reflect the strength of New York’s nursing home oversight system. While staffing levels at nursing homes is a national problem ... New York has established strong minimum staffing requirements, ramped up enforcement actions against facilities that fail to meet those requirements, and made major investments in workforce development efforts. The department also has a robust and thorough system for monitoring patient care and will continue to hold nursing home operators accountable and protect residents across the state."

Newsday previously reported that 20 Long Island nursing homes — or about a quarter of the region’s 79 largely private facilities — received $144,250 in combined fines in 2022. That figure was mostly steady in 2023, as 20 Island-based nursing homes were fined a combined $148,000, Newsday reported.

But in 2024, the Health Department fined only 12 Long Island nursing homes a combined $108,000 — the lowest amount collected by the state since $52,000 in penalties was issued in 2018, according to a Newsday analysis.

State fines are supplemented annually with additional penalties by CMS investigators, which have oversight of nursing homes nationwide.

Low staffing nationwide

The report found that staffing levels at a majority of nursing homes nationwide, particularly for registered nurses, were well below federal standards for what's needed to care for their most vulnerable residents.

New York joined Texas, Indiana and Georgia as the states with the highest concentration of facilities — 96% — operating at below-expected staffing levels, even as few providers in these states were cited for those violations, the LTCCC found.

Additionally, New York ranked near the bottom nationwide for citations involving infection control, resident rights, inappropriate medication distribution and pressure ulcers, commonly known as bedsores, the data shows.

The group points to Wisconsin's resident-adjusted citation rate for pressure ulcers, which was more than 17 times higher than New York's over the study period.

Stephen Hanse, president and chief executive of the New York State Health Facilities Association, an Albany-based group that represents nursing homes, said the report showed the state's oversight system was working as intended, identifying problems and correcting them before they escalated.

"The state’s lower rate of severe citations and financial penalties highlighted in the report reflects a system that identifies and corrects minor issues early, ensuring they are resolved before they result in resident harm," Hanse said. "Since the pandemic, providers have worked closely with state regulators to strengthen preventive, long-term, and subacute care in the face of a significantly aging population."

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.