Alleged Inadequate Nurse Staffing Led to Quality of Care Issues in the Community Living Centers at the Northport VA Medical Center, New York

The VA Office of Inspector General (OIG) conducted a healthcare inspection to assess allegations regarding inadequate nurse staffing that affected quality of care in the Community Living Centers (CLC) at the Northport VA Medical Center, New York. The OIG substantiated that nursing leaders were aware of staffing shortages in the CLCs, and the OIG confirmed the use of float staff and overtime. However, due to variables that contribute to the delivery of safe patient care, OIG inspectors were not able to substantiate or not substantiate that the use of float staff and overtime placed residents at a higher risk for adverse events. The OIG found the Facility failed to consider or utilize alterative staffing. The OIG found a lack of CLC nurse staffing due in part to a delay in filling vacant positions and a lack of approval to increase staff. In addition, OIG inspectors’ review of overtime data indicated that the overtime funding exceeded the cost associated with filling the vacant positions. The OIG substantiated that registered nurses assigned to administrative roles were utilized to provide nursing care in the CLCs. The OIG inspectors found no evidence of deficiencies or indications that the administrative nurses performed work outside of the registered nurse position description. The OIG substantiated that previous Facility leaders pressured CLC managers to accept admissions when nurse staffing was inadequate to provide expected levels of care for additional residents. However, CLC nurse managers reported improvement since August 2017 with the new Facility leadership team. The OIG substantiated that the CLCs were closed to admissions at times. However, OIG inspectors did not substantiate that residents were transferred to acute care inpatient units due to lack of CLC staffing. The OIG made three recommendations related to CLC nurse staffing and recruitment, alternative staffing, and overtime management.