"Safe Patient Handling Policy" Bill and Memo

Stephen B. Hanse and Nancy Leveille in Legislative, Advocacy

The legislative committee has been working with Senator Maziarz and Assemblyman Gottfried on the current edition of Bill S.1123-A, the "Safe Patient Handling Policy". Next Tuesday this Bill will be going to the Senate Health Committee and is already on the Assembly's calendar. Last year the Senate passed their version of this bill and Assemblyman Gottfried has indicated that he expects the bill to pass the Assembly this Session. Additionally, NYSNA pushed for this legislative passage at their May 22, 2013 advocacy day as well as the safe staffing bill.

NYSHFA members need to contact their legislators as soon as possible to discuss the key issues of this Bill, noted below, that affect Skilled Nursing Homes. The bill is proposed to:

  • Establish a statewide safe patient handling workgroup consisting of the Commissioners of Health and Labor, as well as representatives from health care organizations, employee organizations, and specialists in ergonomics and occupational health.  This workgroup would prepare a statewide policy statement outlining the requirements of a safe patient handling policy to be implemented by all health care facilities.
  • By January 1, 2015, the Commissioner of Health would be required to promulgate regulations establishing a statewide safe patient handling policy in consultation with the workgroup. among other things, the policy regulations are required to include recommendations regarding the appropriate utilization of equipment or technology and patient handling strategies, as well as establish a ratio of equipment or technology based on the type of facility and number of beds in the facility.
  • Nursing homes are required to file a compliance plan with the DOH by July 1, 2016 (all other facilities are required to file by July 1, 2015).
  • Requires the establishment of a health care facility safe patient handling committee with two co-chairs (1 management and 1 non-management). The facility committee is also required to consist of at least one-half non-managerial nurses or direct care workers.  Among other things, the facility committee is required to establish criteria for patient evaluation to determine what equipment is necessary, provide training and establish a process for incident investigation.
  • Establishes an enforcement procedure consisting of written notification and allows, in certain circumstances, a nurse or direct care worker to refuse to engage in patient handling until certain handling standards are met.

Our position is that SNFs already have a number of these initiatives for safe patient handling in place and legislation that is a "one size fits all" for hospitals and SNFs does not work.  Our key talking points are as follows:

  1. SNFs have had in place interdisciplinary safety committees since the late 1990s which report into the facilities' Quality improvement programs.
  2. Each resident in an SNF has a care plan developed, implemented and evaluated by the team of nurses, physicians, physical and occupational therapists, CNAs and with resident and family input on a regular basis.  The goal is to have the resident achieve their highest practical level of physical, medical and mental health.
  3. Residents' care plans dictate the method of assistance needed for ambulation, transfer, toileting and getting in and out of bed and chairs. The individual resident needs are based on a number of factors. For instance, many residents admitted for rehabilitation should not be using any lifting devices as they are relearning to walk, weight bear and / or transfer. Lifting devices may impede their ability to achieve their highest level of functioning. In addition, many of our residents with dementia can be frightened with the use of some of the lifting equipment and their anxiety may cause undo mental harm to them and physical harm to staff who try to apply this method of transfer/lift.
  4. The SNF staff must follow the care plan to determine how may staff or what devices are needed to assist a resident with getting out of bed, transferring between places or ambulation. If they choose not to follow the care plan, they are assessed for potential abuse, neglect or mistreatment of the resident.
  5. Lifting equipment and assistive device quantities are currently being identified through an assessment of specific resident populations over time and each SNF is unique to the population they service. Setting quotas by bed size does not meet the need.
  6. SNFs already have lifting and assistive devices for ambulation, transferring and moving residents in their beds or chairs. The SNF works closely with their vendors to determine the number they need of each device based on the type of population they service in their facility and on specific units.
  7. The DOH monitors the safe practice of SNFs at least every 9-15 months without any advanced notice. During these unannounced survey visits, they review all incident reports for any accidents, injury, lack of following the care plan or facility policy and procedure and can and do cite an SNF for non compliance. This can and does at times result in a financial penalty along with public reporting of the issue.
  8. We reject the idea of having to send in a formal safety plan to the DOH for review and approval. They already check on our systems via their unannounced 9-15 month visits. In addition, the DOH does not have the staff to do duplicative work in the SNF area.
  9. SNF focus is on the highest practicable achievement of physical, medical and mental well-being for each resident and already has very specific NYSDOH regulations and monitoring beyond that of other parts of the health care continuum to reach these goals.
  10. NYSHFA is working with other associations whose members will also be affected by this legislation to provide a revision to this Bill.

NYSHFA Contacts:



Stephen B. Hanse, Esq.
Vice President, Governmental Affairs

518-462-4800 x.25

 

Nancy Leveille, RN, MS
Sr. Director, Member Operational Support

518-462-4800 x.20