"If you don't have the staff to do this, to be at the bedside, then we aren't going to do very well," said Karime Raymond, a registered nurse in New York City and a board member for the New York State Nurses Association.
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7 On Your Side Investigates examined federal staffing grades for nursing homes throughout the Tri-State Region last updated in March 2020 and made available by the Centers for Medicare and Medicaid Services.
CMS evaluates nursing homes using a five system.
We found, out of nearly 1,200 nursing facilities, roughly two out of five had received only a one or two-star rating and fewer than one out of ten nursing homes had received five stars.
According to CMS, the rating is based on overall staffing hours taking "into account that some nursing homes have sicker residents than others and therefore more staffing may be needed."
Out of the three states, Connecticut had the highest percentage of nursing homes with 3 or more stars followed by New Jersey, then New York.
In the March 2020 data, CMS also indicated the number of hours each resident received with a registered nurse per day in a metric called "RN hours per resident per day." CMS made the calculation based on the number of hours worked by RNs each day during a two-week period before the inspection, divided by the number of residents.
On the low end, at nursing homes with a one-star rating, residents received on average about 20 minutes with an RN a day.
On the high end, at nursing homes with five stars, residents averaged just under two hours of attention a day.
"I just want them to stop thinking about the dollar and start thinking about the lives, the lives of the people in the beds," Raymond complained.
Continuing our look at nursing homes, 7 On Your Side Investigates specifically examined CMS staffing grades at nursing homes and adult care facilities that have recently experienced patient deaths due to Coronavirus.
Severe staff shortages preceded nursing home outbreaks
Andover Subacute and Rehabilitation Center II in Sussex County, where officials found more than a dozen bodies in an on-site morgue, had a two-star staffing rating. Andover Subacute and Rehabilitation Center 1 had a slightly higher, three-star rating.
Governor Phil Murphy called for a state investigation.
"The owners, administrators and our heroic healthcare staff of nurses and nurse aides have been working relentlessly to contain the virus and safeguard our residents and staff. The health and safety of our residents and staff is our utmost priority and responsibility. Ownership and administration is working around the clock to ensure we are able to resolve the pandemic," said Andover Subacute Owner Mutty Scheinbaum in a statement addressing patient care.
Additionally, on Friday, April 17, the New York State Department of Health released a list of more than 70 nursing homes and adult care facilities that had reported five or more deaths likely related to COVID19 as of April 15, totaling more than 1,100 people.
The four facilities experiencing the most deaths according to DOH were Cobble Hill Health Center Inc. with 55 individuals lost, Kings Harbor Multicare Center with 45 individuals lost, and Franklin Center for Rehabilitation and Nursing and Carmel Richmond Healthcare and Rehabilitation Center with 44 individuals lost each.
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All four of the facilities had received two-star staffing rates from CMS.
In statements on their websites, Cobble Hill wrote, "Our leadership team is working around the clock to ensure we are implementing all CDC and DOH recommendations to keep everyone safe... We understand the difficulty of this situation on all involved and are doing our best to optimally serve everyone."
Kings Harbor wrote, "We want to reassure you that all Department of Health and CDC Guidelines and Recommendations are being followed at Kings Harbor. Staff has gone above and beyond the call of duty to ensure all of our residents are appropriately getting the care they need. To those of you who have lost loved ones to COVID-19... we extend our deepest condolences."
Franklin Center wrote, "We are following the guidance of the Department of Health and the CDC and check daily for new information... Please be reassured to know that New Franklin is equipped to manage this situation and has successfully dealt with situations regarding viruses and infections before."
A spokesperson for Franklin added, "The patient to staff ratio is adequate to provide care in a safe environment."
"We welcome Governor Cuomo's efforts to bring light to the tragedy of COVID-19 in nursing homes throughout New York. However, reducing the battle against Coronavirus to a simple tally of lives lost ignores multiple realities and does a tremendous disservice to the thousands of dedicated healthcare workers who are putting their lives on the line each day to care for ArchCare's 1,700 residents and tens of thousands of other vulnerable nursing home residents across the state," wrote ArchCare President and CEO Scott LaRue, who oversees Carmel Richmond. "On their own, these figures do not accurately reflect the overall quality of care a facility provides or its diligence in trying to control the infection."
Sapphire Center for Rehabilitation and Nursing of Central Queens also had a two-star staffing rating from CMS.
According to DOH, more than two dozen patients at Sapphire have died, and families with loved ones at the facility have complained to Eyewitness News they are struggling to get information about their loved ones' conditions from nursing home staff.
"I feel tremendous frustration and anger. I'm really afraid for my mom," said Berna Lee, whose 77-year-old mother is inside the facility.
The facility addressed the pandemic on its website writing, "Sapphire Center for Health and Rehabilitation is taking precautionary measures in response to the Coronavirus COVID-19 Pandemic."
The American Nurses Association - New York said that the needs of long term care facility residents have continued to increase and with that so has staffing needs.
"LPNs and Nurses Aides have been the primary care providers in these settings and are stretched thin, many times being asked to function beyond their scopes of practice. The current situation has further exacerbated these conditions. We applaud Governor Cuomo and his actions to expand the pool of eligible providers that can help assist with the exacerbated staffing challenges that have arisen during this pandemic. We need all available and qualified personnel in New York to assist in many different capacities," wrote Jeanine Santelli, Executive Director of the American Nurses Association - New York.
Santelli indicated that following the crisis, the state allows needs to work to address ongoing staffing challenges at these facilities.
According to a spokesperson for CMS, "By law, facilities are required to have a registered nurse on-site at least eight consecutive hours a day, seven days a week."
More information about staffing requirements at nursing homes can be found at this link to federal regulations.
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