Federal and State Enforcement for Comprehensive at Williamsville

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Federal and State Enforcement

Nursing homes in NYS must follow Federal and NYS laws in order to remain in operation (or at least receive Medicare and/or Medicaid payments). Federal enforcement actions (“remedies”) are imposed by CMS when the state survey agency (DOH for NYS) determines there are violations of nursing home law and regulations.102 The worse thing that may happen, is CMS terminates the Medicare/Medicaid contract with the facility. This is rare. CMS may also impose a fine (referred to as civil monetary penalty) or deny payment for new Medicare/Medicaid resident admissions.

Comprehensive at Williamsville was issued a federal fine of $9,750 on August 27, 2021, due to the serious health issues identified upon inspection.

At the state level, the DOH imposes fines for violations of NYS law and regulations. Fines were seen to be increasing in many WNY nursing homes during the COVID-19 pandemic for safety violations. 103 Comprehensive at Williamsville has agreed to pay for fines to the NYSDOH on 3 separate occasions for violations of COVID-19 safety regulations:

- July 9, 2021 Stipulation and Order NH-21-134104 o Comprehensive to pay $2,000 for regulatory violation 10 NYCRR §415.19(f)(1) Quality of Care. DOH ordered this from its review of COVID19 NH Daily data for NHs (nursing homes) report and found that Comprehensive failed to maintain the required supply of all necessary items of PPE required.

- April 1, 2021 Stipulation and Order NH-21-062105 o Comprehensive to pay $12,000 for regulatory violation 10 NYCRR §415.19(a)(1) Infection Control and Quality of Care. On October 7, 2020, the DOH cited numerous deficiencies for violations under infection control for a failure to check all staff for COVID-19 symptoms at the start of each shift and every 12 hours on duty.

102 See 42 CFR 488.406, and State Operations Manual, Chapter 7 for additional information. 103 Specht, Charlie, “WNY nursing homes were fined $214,000 for COVDI-19 deficiencies”, WKBW (Jan. 29, 2021) https://www.wkbw.com/news/i-team/wny-nursing-homes-were-fined-214-000-for-covid-19-deficiencies 104 https://profiles.health.ny.gov/nursing_home/stip_detail/pfi274nh_21_134.pdf 105 https://profiles.health.ny.gov/nursing_home/stip_detail/pfi274nh_21_062.pdf

- July 8, 2020 Stipulation and Order NH-20-027106 o Comprehensive to pay $14,000 for regulatory violations 10 NYCRR §415.19(a)(1), 10 NYCRR §415.19(a)(2), and 10 NYCRR §415.19(b)(1) Infection Control, social distancing and hand hygiene. On May 20, 2020, the DOH cited numerous deficiencies for violations under infection control: failure to practice social distancing on 2 of 4 units, failure to assess residents for COVID-19 symptoms, failure to ensure staff wore gloves when entering resident rooms and completing hand hygiene upon leaving resident rooms.

Comprehensive at Williamsville also agreed to pay fines prior to the pandemic. The largest fines agreed to were during the months of February and June 2016, where Comprehensive at Williamsville paid $20,000 and $21,000 respectively for multiple deficiencies:

- March 27, 2019 Stipulation and Order NH-19-016107 o Comprehensive at Williamsville to pay $6,000 for regulatory violations identified by the DOH on October 16, 2018, June 8, 2017, and June 8, 2015.

- December 12, 2017 Stipulation and Order NH-17-063108 o Comprehensive at Williamsville to pay $8,000 for regulatory violations identified by the DOH on June 8, 2016, June 8, 2017, and August 20, 2015.

- December 6, 2016 Stipulation and Order NH-16-208109 o Comprehensive to pay $21,000 for regulatory violations 10 NYCRR §415.12(c)(2), §415.4(b)(1)(ii)(a,b), §415.26, §415.27(c)(3)(v), and §415.4(b). DOH cited the deficiencies on June 8, 2016 where it determined Comprehensive at Williamsville violated many codes including quality of care- pressure sores, investigate report, administration, quality assurance, and develop abuse neglect policies.

- June 28, 2016 Stipulation and Order NH-16-177110 o Comprehensive at Williamsville to pay $20,000 for regulatory violation 10 NYCRR §415.12 Quality of Care-highest practicable care and enteral feeding tubes. DOH cited the deficiencies on February 29, 2016

106 https://profiles.health.ny.gov/nursing_home/stip_detail/pfi274nh_20_027.pdf 107 https://profiles.health.ny.gov/nursing_home/stip_detail/pfi274nh_19_016.pdf 108 https://profiles.health.ny.gov/nursing_home/stip_detail/pfi274nh_17_063.pdf 109 https://profiles.health.ny.gov/nursing_home/stip_detail/pfi274nh_16_208.pdf 110 https://profiles.health.ny.gov/nursing_home/stip_detail/pfi274nh_16_177.pdf