Reform at nursing homes key

By Laurie Kash, Commentary
Published in the Albany Times Union Op-Ed section, February 29, 2016

Laurie Kash (in red) at Comptroller DiNapoli's press conference

Laurie Kash (in red) at Comptroller DiNapoli’s press conference

Here is how bad it has gotten: New York state nursing homes cause pervasive harm. And the state Department of Health‘s lack of oversight is a major part of the problem.

My late mother was a poster child for the horrors that occur daily in these facilities. The catastrophic breakdowns in her care did not happen in a vacuum. Horribly, hers is one of many flesh-and-blood examples of systems that are in utter failure and must be held to account.

I learned all of this only after my mother walked on her own two legs into a nursing home for temporary care, physically intact, and three weeks into her stay became a paraplegic, paralyzed from the chest down. She was injured in repeated episodes of neglect and medical malpractice at the institution entrusted with her care.

The background: One night my mother fell after a nurse failed to follow a physician’s order detailed in her care plan. Her subsequent 13 days of progressive neurological deterioration and severe pain were ignored or dismissed as exaggerated. Instead of receiving the critical treatment, she was referred to a psychiatrist.

It took a brief neurological examination by my brother-in-law, a heart surgeon who came from out of town, to diagnose her paralysis. But by then it was too late to reverse her spinal cord injury. My mother spent the remaining three years of her life confined to the nursing home, in a wheelchair, without autonomy or independence.

We filed a complaint with the Department of Health, which, after six investigations, dismissed most concerns. Despite clear evidence of neglect, DOH found only one deficiency and rated it as “causing no actual harm.” Meanwhile, outside expert physicians saw clear violations of the state’s standards of care, and the record shows that nursing home staff repeatedly violated their own care plans.

Our family filed a lawsuit against the nursing home and repeatedly asked the state to act. DOH stonewalled us. I prepared a “Contrast Study” in 2013, comparing my mother’s case to one in which the state shut down a nursing home, and submitted it to the state health commissioner. Even after seeing these documented disparities in applying federal and New York law, DOH took no meaningful action.

Finally, two years ago, I approached the state comptroller’s office with my study, along with fellow advocates at New Yorkers for Patient and Family Empowerment, the Gray Panthers, and other organizations. We asked for an Audit and Policy Analysis of DOH’s Nursing Home Oversight agency, which was last done 16 years ago in 1999. Thankfully, the comptroller agreed to conduct this long-overdue audit. It is what I hope will be the beginning of the resuscitation of our state’s lapsed nursing home oversight.

In my nine-year pursuit of nursing home reform, I have encountered countless family members experiencing agony and incredulity at the harm done to their loved ones by the state’s systemic dysfunction. New York nursing homes now operate with practical impunity.

This is intolerable. There are solutions. The oversight agencies and the nursing homes they oversee must be held accountable to standards that assure care with dignity for our most vulnerable citizens. This is not a privilege. It is a right.

I appeal to Gov. Andrew Cuomo and the Legislature to stiffen enforcement with significant and consistent fines against nursing homes when they violate legal standards of care, and to preserve the right to sue — which has been opposed by the industry — to help ensure accountability.

And I implore every concerned citizen to act — on behalf of our shared futures and those of our loved ones — by contacting the governor’s office and their state Legislators to press for these reforms.

Our failure to act will literally be the death of us.

Laurie Kash lives in Rochester. The nursing home reform website is

NY State Comptroller Audits Department of Health - Enforcement of Nursing Home Violations Needed

Mike Groll Mike Groll, APPhotograph by Mike Groll, AP

Laurie Kash of Last Stop Advocacy Project of Rochester talks about her mother’s experience at a nursing home during the NY State Comptroller’s Press Conference on Nursing Home Reform in Albany, on February 22, 2016.

The NY State Comptroller’s Office released a 28-page audit which concludes that the State Health Department should improve enforcement of nursing home violations, fines are delayed for up to six years, and nursing homes are cited repeatedly for problems with limited consequences. “The state Department of Health (DOH) needs to fix problems and delays with how it is assessing fines to nursing homes after violations are found, according to an audit released today [Monday, February 22, 2016] by State Comptroller Thomas P. DiNapoli.

Click here to read NYS Comptroller’s Press Release and Audit

Here is Laurie Kash’s speech at the comptroller’s press conference.

Below is a 2 minute clip of the Comptroller’s Press Conference regarding the Nursing Home Surveillance Audit, where Comptroller DiNapoli is joined by speakers Laurie Kash, Executive Director, from Last Stop Advocacy Project of Rochester; Gail Myers, Deputy Director, Statewide Senior Action Council; Jack Kupferman, President, Gray Panthers; and Richard Mollot, Executive Director, Long Term Care Community Coalition.

During the Comptroller’s Press Conference on Monday, Laurie Kash spoke about her mother entering a nursing home on her own two feet, physically intact, in what was going to be a temporary stay. After three weeks – over a 13 day period, her mother became paralyzed from the chest down … Kash states, “When I speak about my mom – what happened to her did not happen in a vacuum, could not have happened in a vacuum. There are countless people every day suffering. You read it in the newspapers. What we’re hoping this [the NY State Comptroller’s Audit of the DOH] opens the door for is really active change, and a movement to start to address our legislators, and the DOH, and nursing homes. Because nursing homes are harming people and it needs to stop.

Comptroller DiNapoli’s Press Conference has been a great success and has generated national interest. We are truly grateful that a governmental agency has audited the New York State DOH. Here is one news media link, among many:

State Health Department blasted for enforcement of nursing home violations, by Tom Precious of The Buffalo News


Read Laurie Kash’s full op-ed from the Albany Times Union.