ALBANY, N.Y. >> The New York Health Department has been slow to penalize nursing homes for violations, often choosing not to levy fines or taking several years to actually impose them, according to state auditors.

In a report Monday, the comptroller's office said its analysis shows that from January 2014 to July 2015, the health department collected only 12 fines totaling $152,000, less than one-fourth of the fines levied in 2011. The department oversees 631 nursing homes where more than 96,000 New Yorkers reside.

The auditors and advocates for nursing home residents said the fines are so weak that they don't deter substandard care and neglect.

"The number and total amount of monetary penalties imposed peaked several years ago and have steadily declined thereafter," the audit report said. "These trends undermine the credibility and effectiveness of the threat of monetary sanction as a meaningful deterrent to deficient practices."

In response to an audit draft, the department said it had already recognized delays in issuing fines, updated its enforcement process last year and began clearing its backlog of cases. The agency noted Monday that the audit found it to be in compliance with federal regulations governing nursing home inspections.


Comptroller Thomas DiNapoli said the ongoing problem has been staff shortages, which were cited in a 2007 audit on nursing home oversight. The recent audit found the department had only one part-time employee assigned to process enforcement referrals. Staff members have been added since, but the question is whether that commitment will continue in another year or two if auditors aren't looking, he said.

The auditors found that the department did investigate complaints that a nursing home resident was in immediate jeopardy within two business days, as required, 98 percent of the time. It investigated less immediate high priority complaints within 10 business days 73 percent of the time, though the requirement is 95 percent, they said.

"The comptroller's audit found ... that the agency acts quickly on serious complaints," the department said. "We are continuing to work to ensure that fines are assessed in a timely manner."

From January 2007 through May 2015, the Health Department issued 50,431 citations, including 955 for immediate jeopardy and 1,026 for actual harm, the report said.

It issued 42,585 citations for violations described as "potential for more than minimal harm," nearly 85 percent of the total, declining to impose fines for those.

Laurie Kash, a member of the Last Stop Advocacy Project of Rochester, stood with DiNapoli on Monday with other advocates and said strong penalties need to be enforced and many people are suffering. Her mother, Gertrude, became a quadriplegic within two weeks of entering a nursing home in 2006 because of falls caused by neglect, and she died three years later, Kash said.

Kash filed a complaint. The Health Department found a deficiency but imposed no fine or meaningful sanction, she said. The family sued, reaching a court settlement with the nursing home in 2010.