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December 26, 2007

DiNapoli: Slow Response to Some Nursing Home Complaints

The State Department of Health (DOH) was late in investigating one out of every five complaints filed against nursing homes, according to an audit released today by State Comptroller Thomas P. DiNapoli. Under state law, DOH is required to investigate complaints against nursing homes. Complaints are rated on scale of A-D, with A being the most severe. From April 2005 to September 2006, auditors found that 1,186 of about 6,700 investigations by DOH started late. Auditors found that DOH responded promptly to Priority A complaints when residents were in immediate danger, but failed to act quickly on Priority B complaints.

“When a complaint is made about a nursing home, DOH has to act and act quickly,” DiNapoli said. “The department is doing its part to investigate very serious complaints in a timely manner. But it needs to get to other complaints faster. Failing to respond on time could put elderly and dependent New Yorkers at risk.”

DOH is required to investigate Priority B complaints within 10 days. Of the total number of late investigations, 899 of them were for Priority B complaints. Such complaints entail patient neglect and quality of care issues, which could include: patient accidental injury, inattentiveness to patients with incontinence issues, verbal and mental abuse of residents and complaints concerning drug and medication issues.

Among the report’s findings:

  • the bulk of the late Priority B investigations occurred in DOH’s New York City (733) and Central New York offices (121), with staffing deployment and/or staff shortages to blame; of 6,696 cases evaluated, 560 remained open beyond the state-required 180 days, largely because management decided to open newer priority cases (although DOH’s rate of case closure has improved over the past five years);
  • by not closing cases on time, DOH has missed opportunities to be reimbursed for investigation expenses in a more timely manner by the U.S. Department of Health and Human Services;
  • case files in the Central New York, New York City and Long Island offices were missing necessary documentation, potentially putting residents’ health and safety at risk; and
  • incorrect data was entered into the department’s complaint/investigation logging system.

Comptroller DiNapoli recommended that the DOH:

  • re-evaluate staffing needs among its individual offices based on need so investigations can be completed in a more timely manner;
  • continue efforts to hire sufficient staff for the Central New York office;
  • improve the timeliness of investigations after analyzing case loads, staff deployment and best practices;
  • ensure that supervisors in the Long island, New York City and Central New York offices sign off only on cases that have complete documentation on file; and
  • retrain staff members on the department’s complaint logging system.

DOH officials blamed much of the late response on staff shortages and growing caseloads – a burden shared by similar agencies across the country. The full response from DOH is included in the audit.

Click here for a copy of the audit.



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