Tag Archives: New York

Investigation reveals N.Y. lax on home care oversight

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

In the Albany (N.Y.) Times Union, Matt Drange’s investigation is titled “Home health care in crisis.” Having read the piece, I can say it’s safe to take that declaration at face value. At the very time that home care is booming in New York as a cheaper, more convenient alternative to nursing homes, the state has cut back on its number of health inspectors. Meanwhile, the complexity of home care cases is rising, as hospitals release patients earlier and the population as a whole ages. The results, Drange writes, have been predictable.

Lapses have gone undetected or, in many cases, unpunished by the Department of Health, the arm of state government tasked with overseeing home health agencies. Providers are not required to notify the department when patients experience sudden or unexpected changes in their condition, including death. And even when the state does learn about these incidents, it doesn’t always act on the information, records show.

For the investigation, Drange looked at public records regarding Medicaid billing, home care agency registration and plenty of state inspection reports. He focused his review on 40 of the worst offenders, and found more than enough examples to illustrate a system in crisis. Drange’s anecdotes recount numerous egregious lapses in care, and I strongly recommend digging into the meat of the piece, if only to see what incredible detail he found in public records. For now though, at the risk of mild spoilers, I’ll just reveal that they all end in the same way: The problem goes undetected, unenforced, or underpunished.

In the end, as reporters have found in other states as well, the root of the problem seems to be a weak and vaguely defined regulatory system. In his investigation, for example, Drange found a sharp contrast between the oversight of nursing homes and home care, two institutions which often perform similar functions.

(Researcher Sam Krinsky of the United Healthcare Workers East 1199 Union) said the culture of home care differs vastly from that of nursing homes, which have received more attention in New York and elsewhere.

Statements of deficiencies issued to home care agencies by the Department of Health are “not something that we take seriously,” Krinsky said.

“In nursing homes, the inspections are a big deal. There are a lot more regulations they have to comply with … It’s just a much more robust system,” he said. “In home care, it’s more of a review of paperwork. It [Department of Health] doesn’t have any teeth.”

Your thoughts on this story?

Drange, an AHCJ member and recent graduate of the Columbia Journalism School, did this investigation as his master’s project. He invites feedback from other health care reporters about the story and anything he could have done differently. Feel free to comment below or send your thoughts to him at mattdrange@gmail.com or on Twitter (@mattdrange).

Critics say New York soft on disciplining dentists

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

The (Syracuse, N.Y.) Post-Standard‘s James Mulder has found that, when it comes to cracking down on less-than-competent dentists, his state appears pretty lax.

teeth

Photo by radiant guy via Flickr

In New York, the 18,000 dentists are among, Mulder writes, the 800,000 people from “48 professions — from acupuncturists to veterinarians — policed by the state Education Department’s Office of Professional Discipline.” Last year, the board disciplined 24 of them, revoked the licenses of two and accepted the surrender of four more licenses.

The office took 1.54 disciplinary actions per 1,000 dentists last year, about half the rate of disciplinary actions taken against medical doctors and physician assistants. Discipline against doctors accused of misconduct in New York is handled by a different arm of state government — the state Health Departments Office of Professional Medical Conduct.
Also, the number of serious disciplinary actions against New York dentists declined by 53 percent between 2006 and 2010.

Fellow, veteran reporter is ‘miles ahead’ after day 1

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

He’s only been in New York for a day, and David Gulliver, already appears to be a big fan of the AHCJ Media Fellowships on Health Performance which took him (and three other AHCJ members) there. “I’m already miles ahead of where I was as a healthcare reporter,” Gulliver writes on his local health site, Sarasota Health News.
Logo:  AHCJ  Media Fellowships on Health Performance

Today we met with some of the sharpest people analyzing and leading the efforts to improve the nation’s health care. I’ve already developed a dozen ideas for new stories or ways to improve what I’m doing — and, more importantly, found people willing to volunteer their time and expertise on future projects.

The fellowships are supported by The Commonwealth Fund, and are designed to give mid-career journalists an opportunity to learn about examples of high-performing health care systems, to focus on innovations in care delivery, and to explore a system or its significant parts to determine what makes that system effective or ineffective. Fellows will be able to examine providers of care, insurers, regulators and policymakers.

Residents put dispute with Bronx hospital online

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

Interns and residents at St. Barnabas Hospital in the Bronx are attempting to formally organize in response to what they  believe are poor, unacceptable working conditions.

As part of their effort, they have launched “Examining St. Barnabas,” a site that solicits community input, rounds up (mostly unfavorable) coverage about the hospital and adds a sort of disgruntled-employee spin to St. Barnabas-related issues. It’s an interesting nexus of special interest and community service, as well as a window into the workings of a sometimes troubled hospital. The effort also has a presence on Twitter as @examinebarnabas.

Bedbug complaints proliferate in New York City

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

Bedbug complaints are on the rise in the Big Apple, reports Adam Lisberg in the New York Daily News. Complaints have increased 34 percent in the most recent fiscal year, Lisberg said. According to Lisberg, the almost-10,000 complaints an advocacy group found through a Freedom of Information request probably understate the problem, because many folks call the exterminator instead of the city.

Several central Brooklyn neighborhoods are among the worst hit, with spikes also hitting parts of the Bronx, midtown Manhattan and Queens.

“Not all exterminators know how to spot and treat bedbugs, and critics say the city doesn’t do enough to stop infected mattresses from being reused. Some victims may be too embarrassed to seek help, and some small landlords may not be able to afford a competent exterminator, advocates say.”