EP3: Part Two: The Great Debate: Regulation Vs. Reality, Beyond the Newsday Headlines

Headline: THE MATH DOESN'T ADD UP. 🧮❌

Newsday just put our industry on blast for $511k in fines. They’re calling it "neglect." But let’s look at the other side of the screen.

🚨 FACT: New York State just declared a Disaster Emergency in Nassau and Suffolk because there literally aren't enough nurses to go around. 🚨 FACT: The State is fining facilities $2,000 A DAY for not hitting staffing numbers that are physically impossible to meet in this labor market. 🚨 FACT: Taking $500k out of facility budgets doesn't hire more nurses—it makes the shortage WORSE.

How can you fine us for a shortage the Governor admitted is a "State Disaster"?

We aren't defending bad care. We are defending the people being set up to fail by a broken system.

Transcript

SPEAKER_00 0:01

Hi everyone, Joey Dave from Day to Day Senior Care. How are you? Welcome to our part two of our uh great debate, regulation versus reality. All right. Since our first show, all right, um, first, even before I get into this, I just wanted to thank everybody for uh attending last night. Um, it's appreciated. Uh, we are going to uh go a little deeper into this tonight because I have a couple of things here I wanted to put up. All right, just to get us started. We only have 30 minutes, but um, if you remember, we had this, which uh was part of the newsday investigation, uh, where Long Island nursing homes were fined more than$500,000 for violations, including assaults. And then if you look to your right, I'm posting on the screen now. Okay, New York governor declares disaster emergency as nurses walk out. And this was in January, and it's being extended, and it was extended in February. Um, so look, we we talked about the 500k in fines, but here's what Newsday didn't highlight, okay. New York ranks near the bottom in the nation for nursing staff hours, okay. Yeah, we have some of the strict strict strict strictest mandates around. Okay, so tonight we're talking about the compliance trap. All right. So here we are, you know, we're trying to be in compliance. Nurses are walking out, CNA's shortage. Um, New York State demands 3.5 hours per resident. But with 2,500 New York State Nursing Association nurses recently protesting for safe staffing on Long Island, where are these people supposed to come from? Okay, I did further research. I looked at this ad. I looked at some other um uh things I just posted, and you know, uh that's why, you know, why the headlines don't tell the whole story. That's that's the title tonight. I didn't even write the title in. I've just been coming straight from work, jumping in again. This is a special event. I don't normally do these on a Wednesday night, but I wanted to get part two in because I felt there were people yesterday. We had people that were viewing and listening, and I promised we'd come back and just get a little bit deeper into it, okay? Just a little deeper tonight. And I didn't have to go too far. All right. Um, so you know, we know from um last night that there were some very, very serious allegations, okay? And there were a lot of fines that are often issued because the facility uh was short one person on one shift, but it gets reported as a systematic neglect. All right, this is what uh New York State licensed nursing home administrators learn prior to taking their licensing exams with New York State. A lot, a lot of education and and years of experience is required before you can get your license. Um, and unless you've got you know your master's degree, then you can cut back on your experience levels. But I went the you know the route from bottom to top. Um, but you know what, when you're looking at the regulations, you know, you you look in deeper. The news days just puts out, you know, the juice, okay. And then of course, you know, I know reporting. You know, we we all know how reporting works. You want to put the the most intense stuff at the top, so everybody's like, oh, it's the it's the abuse, it's the you know, this, that. Um, people, you know, of um, you know fell, you know, escaped or whatever it is. Okay. But now we gotta we gotta step back. We gotta step back and see how this all came to be. Okay. Now when you when you're sitting with the state inspectors and they're they're in your building for a week or longer, you know, there's a lot of back and paper back and forth. There's a lot of uh looking, you know, to see how how uh you know where where where the system broke down. Was it uh the nurse's aide that called in sick and then there was a replacement? Was it the resident who inappropriately touched uh another resident and then you know um they took care of it and somehow he slipped away and got another resident? We want to look at how that happened. We want to see how we can correct it. They uh the state requires a plan of corrections, and we're supposed to be able to submit those after doing intensive investigations. So, you know, you want to hear, you know, you read one side, and that's why I I I titled it this, because you want to read one side, Newsday. Yeah, that's fine. You know, the general public reads that and immediately jumps to conclusions that every nursing home, you know, all the hundreds of nursing homes that are out here in Suffolk and Nassau County, that everybody's bad, or the majority of them bad. Um, and that's not the case. A small percentage, okay, over the last couple of years, the state has gone in and all of and now they put everything together for the last couple of years, and News Days posts all these, all these, um, you know, all these fines, and and and you know the majority, I looked at that too. I looked at, I broke it down and I looked at the fines from the state and the fines from the federal government. So when the state does their their survey and they impose fines at the state level, I looked. Some were 2,000, some were 8,000, some were 10,000. But then the federal government, when the feds come in and they do their survey, which normally doesn't happen on an annual basis, the only reason for feds to come in and do a survey with CMS is because something was triggered in either the state survey or or a phone call or or um uh a residence family member or something. But um that's where the hundred thousand dollars for um that serious alleged incident. Yeah, it was serious. The one where um I have it right here. There were a couple of serious ones that really got nail you know, nailed with the federal government, all right. So, you know, failed to properly investigate or report allegations of sexual misconduct by staff, 138,000 in penalties. All right, though that that one's big. Decided for physical mistreatment by staff and failure to perform CPR. That's huge. That's$118,000. A resident, and this is another facility, this is three separate facilities. A resident with known suicidal ideation escaped through an unsecured window, suffering multiple fractures, significant federal fines. Okay, so when Newsday posts the 500,000, you know, look, let's look at it again. Let's take a look at this. Look, this is where how reporting's done. Okay, and again, I'm not, you know, I am not trying to uh, you know, defend any of these serious allegations. They're serious, they're isolated, it occurred, and just like a you know, any uh, you know, professional, we would go back, we would read the plan of correction, we'd look at all the investigative reports, and then we could see how whether it was a systematic or isolated incident. And then we go from there, folks. And if you think that every nursing home in Suffolk and Nassau is gonna be deficiency-free, that's a perfect world. Like every restaurant you walk into, you're never gonna get sick from the food you eat. It's gonna happen. Okay, anyway, I don't want to get off key here. Um, okay, so then there was also uh uh where is it? Um second. Yeah, so I looked at all of that. Let me get back so you can see you see me down here. Okay, let me get back to this one. And look, look here. New York governor declares disaster emergencies as nurses walk out. Okay, executive order 56 signaled a serious healthcare strike, staffing crisis in New York. Folks, there's been a staffing crisis before COVID. Once COVID hit in 2020, it got progressively worse. It got progressively worse. But and I was there during the COVID. I was I was an active uh licensed nursing administrator in a uh nursing home when COVID snuck in in March. All right. I seen I seen multiple people, multiple residents pass away during the first few weeks when it came through like a like a tornado. Okay, and everybody was traumatized, including myself. And if they weren't, then I don't know. But anyway, but ever since then, you know, a lot of people don't, you know, people look at the the news article and they just oh well that you know that the owners aren't paying enough. No, that's not the case. We lost half of the nurses during the COVID because New York State, Governor Pataki, I mean Pataki, I'm sorry, Governor, Governor Como decided, okay, every nursing home is gonna take uh COVID residents from the hospitals. So instead of putting them in the Javit Center or Trump's uh huge ship that was sent out during Trump's first um time in office, instead he decides, oh yeah, let's just send them all to nursing homes. And he sent the letter saying that we need to take them. So here we go. We're doing what we can to mitigate COVID from spreading in the in the building, and now we're bringing in uh positive COVID residents with no vaccine, we're bringing them in and everyone's getting sick and people are dying. Okay, from staff to residents. It was tough. So when nurses were told that if they didn't get their COVID shots, they wouldn't be allowed to work after going through a viral war. That's what I'm gonna call it, folks. A viral war, okay? Because we had an unknown virus in our nursing homes in New York State and throughout the nation that was a hundred-year uh phenomenon, okay? Because this was unlike anything else that swept through these nursing homes. So we need to give the nurses the a credit, all the credit. All the staff get the credit for this. So when New York slapped them in the face and said, you know what? Now you can't work in a nursing home unless you get COVID. Now, this was after we had the vaccinations, they wanted us to continue the vaccines. Look, we there were other ways to work it out, and and all the lobbying agencies, the New York uh nursing home associations, everybody lobbied to try to help the nurses. And it didn't work. Okay, so now you got that. So now, years later, you want to bring all those nurses back? You want to bring them all back into the nursing homes? Huh. Half of them will never come back. And the other half, if they do come back, and then in isolated incidents like this, and and and this shows up on Newsday, you know, 500, this, that, you know, making it look really, really, really bad. I I'd like to call out that reporter and have a discussion with him. Have him come on and sit down with me here, and him and I can talk it out. Okay, because they you need to know both sides of the story, not just what they're reporting in Newsday on the front cover, making it sound like it, you know, the apocalypse is coming again in the nursing homes. That was not the case. Um, all right. I went way off script, folks. I'm sorry. Let me um let me go to uh what time we've got left. Okay. All right. So I'm close. I'm on pace here. All right, we're near the 15-minute mark. So let's jump into uh the next thing. Let me ask you a question, and let me pull up my chat. If anyone's listening, I'm gonna type in hello. So where I don't know who's on uh looking uh who's streaming live, I mean who's watching me live on Facebook, LinkedIn Live, or or YouTube live, but whoever's out there, um I'm gonna post hello and then I'm gonna ask a question. And if you want to answer it in the chat, if you want to join me and come on in, I've got space for uh at least 10 people. All right. Um, but I'm gonna open up um what did I want to show you? All right. Well, before I show you, let me read this. Okay, we saw Newsday mention medication errors. Is that a bad nurse problem or a one nurse doing the job of three problem? I'll read it again. If anybody if there's any nurses out there that are listening, but they don't want to jump in and uh talk to me here on on um our studio, that's fine. But if you want to chime in by chat, we're right there. Okay, you can just hit the comment button and type in. Uh so again, the question is we saw Newsday mention medication errors. Is that a bad nurse problem or a one nurse doing the job of three problems? Okay, I'll answer that. There may be a lot of people just waiting for the answer. I know I have viewers that have nothing to do with healthcare, but there they could be uh potential uh client families that are interested, um clients and our families that I I always invite. It could be my friends from Connequat, it could be my author friends, it could be my LinkedIn friends, my former peers just listening. What is Charlie doing nowadays? I can't believe this guy is talking all the time on on the on the studio, but I'm having fun with myself and and I'm having fun with this um this growing um place where we could really get out there and challenge things in today's world. And that's why I'm ready to challenge the Newsday reporter. He's welcome to come on anytime. I may even uh try and shoot him an email, see if he wants to do a debate with me. Um but anyway, uh let's see. So, you know, let's talk about that real quick. The medication, is that a bad nurse problem or a one nurse doing the job of three problems? Okay, yeah, many times you got one nurse on a floor, either a 20 or a 40-bed unit. You got one nurse or two nurses on the you could have two nurses, okay, and a couple of CNAs, but that's still never enough. You know, it's it's not adequately staffed. Back in the days when I was working, folks, before COVID, we were overstaffed a lot of times. Okay. We had to put, we we would go around and we would say, you know what? You need to go down on the on the you know ground floor, go into the uh subacute unit. I'm gonna send you over on the to the psych unit. Uh we don't have we only have 16 residents here, and we've got five staff on the unit. Those were the days I remember taking the the whiteboard and and trying to figure out where we could put all the staff because we got overage, we got too many, too many staff. Those days are gone, folks. For now, will it change? I'm positive, I'm optimistic. But anyway, so now you got a nurse that's got a problem, you know, trying to help someone that just fell out of bed. Another person's ringing the call bell because they got to use the bathroom. The other lady just walked out of a room, she's got some dementia, she's heading down the hallway. I can go on and on, folks. It only takes three, four, five residents, and you've got other aides uh changing briefs and putting them into bed, which is required, or another one who spilled all their dinner all over the floor and she's looking for a housekeeper that's not available because that person's on another floor. So now she's got to clean it up. You see what I mean? Simple. So now the nurse gets involved in something and she made a medication error. Yeah, it's serious because you know it could contradict uh what medications need to be, you know, given that time to that resident that may have had the medication error. And I again, it's it's wrong, it's got to be corrected. But now we got to look at this at the issue of we need better coverage in that nursing floor. Otherwise, guess what, owners? We're not gonna do an admissions until we have enough people for that floor. You can't bring any more uh uh patients up on that floor. That's how I would argue it. I've got 30 residents and I don't have enough staff. All right, so don't give me another 10, and and I still have to work with the same amount of staff. Not gonna happen. Oh, yeah, well, you know what? 10, you're you're gonna talk to admissions. We need we need staff. We need staff. We've got to we've got to pay our bills. Trust me, guys, we can pay our bills and still have adequate staff. We'll cut somewhere else. Give me your expenses list. I'll see where we can cut costs. Yeah, here we go. Let's take 5,000 off of marketing. Oh, you know what? You wanted to do this? Well, you know what? Let's hold off on that, on giving out those uh big bonuses to, you know. I I don't even want to get too deep into it, but trust me, it can be done. So, anyway, next question Okay, anyone wants to answer? The state is threatening a$2,000 a day fines for staffing levels. Okay, does that money go back into care or does it just make it harder for you to hire more staff? Does any of my viewers, anyone watching tonight who works in uh nursing homes want to answer that question? Or if anyone else knows the answer to it? The state is threatening a$2,000 a day fines for staffing levels in the nursing home. Does that money go back into care, or does it just make it harder for you to hire more staff? Folks, it doesn't go back into care. The government uses it, and and yet you see articles such as this. On January 9th, Governor Kathy Hulkle issued an executive order number 56 declaring a state disaster emergency in Bronx, Nassau, and New York counties, as well as neighboring counties due to severe health care staffing shortages. So you would think instead of fining everybody all these exorbitant amounts of money, maybe instead of fining saying, look, here's an extra$10,000. Let's, you know, show me all the information, give us all the prints, you know, gotta be accountable for the money the state gives you and use it to pay staff more money per hour until you can get your staffing levels up. Work it out, work a way to work at better rates to attract staff back to fill those those those areas again. Okay, folks. Look, I'm seeing what's going on. I saw what went on back in the 90s. I started, like I said, in the 80s, early 90s. I was in in family uh type adult homes, then assisted living. Nursing homes grew bigger and bigger, everything grew exponentially, and now the research I started seeing last year is everything is starting to change. People don't want to be in nursing homes anymore. People don't want to stay any longer than they can. They will do whatever it takes to either be uh home with their families. I mean, other countries, families take care of each other. Hardly will you ever see, you know, uh uh what you see here in the United States. And look, I'm not knocking families. We're busy. Today's families are not like the families in the 50s. Everyone's working, husbands, wives, their kids. But um still, you gotta find time. If you, you know, I look with my own mom, we hired some home care. Um, we hired uh two people. We had two people eventually living in the in the house with her to take care of her because she was she be she had advanced dementia and she was starting to get aggressive. And eventually she got to the point where you know you couldn't even get her into the shower without her swinging at you. And then we had to make the decision to put her into an assisted living facility. And I put her in with former peers that I knew in the business, three of them in administration, others in in um in aid care, and we they took care of her. Then they transferred her out. When I came back, uh, I couldn't get back in time. I was doing a gig up in Maine for almost two years, but my mom was placed in the Hampton Center nursing home where I had worked for many years. And um, I took care of her while I was there, and so did all the staff. And then when I left and went to another uh facility as uh the administrator, you know, my they still took care of, they still kept in touch with me and my and my uncle and my sister and my family until she passed. All right. So I've been on both sides. Okay. My mom went through it. I went through it. My grandfather had um had issues. All right. So um let's move on. Okay. We're uh at the almost at the 25, Mark. Any questions? Does anyone have any questions? Does anyone want to join in? We've got another eight minutes left, folks. But if somebody joins in, I go into overtime. That's fine. All right. Again, everyone, I really appreciate you being on here tonight, uh, listening to uh me discuss this. Um let's go back um over here. Okay, guys. All right, so now the the action plan. The final the final part of this uh I I I want to share, it's very important to me. Okay, we do need a narrative shift. We need the public to support funding for long-term care, not just fines for it. Think about that, okay? That's what I'm I'm looking at here. Don't let the headlines win. Share this stream with let's show Long Island that we aren't just cited facilities, we are the backbone, backbone of the community. Okay, I am gonna get in touch with the Newsday reporter. I'll try and get him on here. He can come on our Care with Confidence show. Um, I'll let you know if I get him on, obviously. Um and then um I wanna I I wanna take one moment. I have a letter here I'm gonna read to you real quick. And I'm gonna circulate this around and I'm gonna send it to the reporter too in an email. Okay, but this is an open letter. All right. A message to Newsday and the Long Island community. All right, I'll finish with this tonight, and then we'll I'll keep you updated. To the editorial team at Newsday and the residents of Nassau and Suffolk County. We have read your reports, we have seen the numbers, 18 citations, over 500,000 in fines. We don't run from those figures, and we don't excuse the errors mentioned. Every resident in Long Island deserves dignity, safety, and a level of care that we, the professionals in this industry strive for every single day. But your story is missing a heartbeat. Yes, it's missing a heartbeat. While you highlight 18 moments of failure, you are ignoring the 18 million moments of success that happened in these same facilities last year. You are ignoring the nurse who stayed three hours past her shift because of a resident's daughter couldn't make it to say goodbye. Okay, you are ignoring the aides who worked through the blizzard to ensure breakfast was served on time. You are reporting on the smoke, but you are ignoring the fire. The fire is a systematic collapse where the state demands 3.5 hours of care. That's okay per resident, but provides a Medicaid reimbursement rate that hasn't kept pace with inflation for years. Wake up, New York. You cite understaffing, yet you fail to mention the Long Island is facing its worst health care labor shortage in a generation. Yes, most of it because of COVID. The aftermath. When you find a facility,$100,000,$100,000, that money doesn't go toward a new hoyer lift, it doesn't go toward a sign-on bonus for a new RN. It goes into a government coffer, further starving the very bedside care you claim to protect. We are not bad actors, we are safety nets for new for Long Island seniors, inside and outside the nursing home. We invite you to step out of the archives and into our hallways, see the care, feel the pressure, and report on the reality of long-term care, not just the receipts of the regulators. We aren't just an industry, we are your neighbors, and we aren't good anywhere. And and we aren't going anywhere. We are not going anywhere. Sincerely, the Long Island long-term care community. Folks, I'll take care of that letter. I'll do my part. Please share this video. Present it in uh class in uh in your conference room. If I was working in the administrator's office right now, I'd present it, I'd have the staff come in. We'd get on, we'd debate, we and we we post it on social media. I'll have to go. I got an idea. One second, folks. I'll get in touch with a few of my um peers in the nursing home industry. We'll get something together and we'll go, we'll we'll do a special event again. Uh, hopefully, you know, we'll send an invite to the nursing, uh, to the newsday reporter. We'll open up to any other families that want to know. They can chime in. All right. I know a lot of families have had uh, you know, bad, you know, bad um, you know, results with nursing homes for their loved ones. So again, I I have I have the strongest passion and I offer my condolences. I don't ever want to see something like that happen. I've been in this industry industry for three decades. I know you know that I've seen a lot, okay? So I can't say that it's a perfect world because it's not, but every time there was something that warranted me to do a termination or to call the state and let them know, I'd let the owners know that I was about to call the state. We'd hash out all the details, make sure everything was correct, and we'd get it done. Okay, that's how we take care of things. All right. Any questions before I go? Oh, yeah. And don't forget to subscribe to our YouTube channel if you like. Um, this way you don't uh need to miss anything because we've got three series going on. We got a big um a big night tomorrow night. Join us for our uh on the road uh special event tomorrow night. Um it's it's personal. You're gonna see it's it's it's just me, no guests tomorrow night. It's personal. I have something I want to share about um my on the road series. Um I'm reaching out, I'll give you a hint. Um and I'm sure you you guys have probably seen it either on all you know on all my social media venues, but I'm reaching out to the to the to the heroes, the unsung heroes, the nurses' aides, the nurses, the housekeepers, anyone that wants to go on and talk about their experiences working in long-term care, in hospitals. I'm doing hospitals too. I have a special event coming up next month. You guys are gonna like it. It's gonna be a Southside hospital, uh, years of experience working there. I did like 12 years though. I 12 years, I made a lot of uh friends, peers that I still in touch with on Facebook and everything. We've all gone our separate ways, but we were we were all aides back then, psych aides. And then we grew up, you grew up and we became nurses and administrators. But that's gonna be, I'm probably gonna dedicate a few weeks on that one. But um, because we got a lot of people that want to um uh chime on and we're gonna have a good event. Um, but uh I'm gonna reach out. I got to get going. It's over 30 minutes. I'm gonna reach out and uh we'll do some more about this. All right. I'll keep you guys updated. I can't even tell you what's to come. If I get that newsday guy, I'll definitely be tweeting that, uh tweeting it. I'll definitely be sending that out. You can see them old school. All right, everyone. Have a great evening. Thanks for stopping by. Take care.