Trends in Long-Term Care - U.S. Senate Special Committee on Aging

2919
MS. JARVIS. Yes; I am.
Senator Moss. To what extent did you f<strong>in</strong>d registered nurses on
duty <strong>in</strong> the homes you <strong>in</strong>spected? Was it usual or unusual?
Ms. TJARVIS. You always found at least one registered nurse, depend<strong>in</strong>g
on the size of the home.
I cannot say I went <strong>in</strong> and never found a registered nurse dur<strong>in</strong>g
the week, but they were not always the number of registered nurses
that were required by the New York City Nurs<strong>in</strong>g Home Code.
Senator Moss. What do they require?
MS. JARVIS. The New York City Nurs<strong>in</strong>g Home Code requires that
there be 2 registered nurses for the first 60 patients, 1 registered nurse
for every 60 patients thereafter; it requires that there be 2 licensed
practical nurses for 20 patients, and 1 for every 20 thereafter, and 1
aide for every 5 patients.
Senator Moss. Did you f<strong>in</strong>d a considerable variation from that
staff<strong>in</strong>g requirement?
MS. JARVIS. Not really, because we felt that there was someth<strong>in</strong>g
go<strong>in</strong>g on, but it is hard to put a f<strong>in</strong>ger on.
You <strong>in</strong>sist that they send you a schedule of their nurs<strong>in</strong>g staff for
the previous month. It is always just what the code requires, but it
seems almost impossible that every s<strong>in</strong>gle day you just meet the code
requirements.
Senator Moss. When you were <strong>in</strong>structed no longer to visit nights,
you suspect that maybe they were not there at night is one of the
reasons?
Ms. JARvIs. Yes, I don't know if that was the reason for the nights,
but I would suspect there were a lot of the th<strong>in</strong>gs happen<strong>in</strong>g at night
that did not happen when we made our visits.
Senator Moss. We may want to come back to you! but I would like to
hear from Ms. Hopper now, and then we may have some more
questions.
You may proceed, if you will, Ms. Hopper.
STATEMENT OF ANASTASIA HOPPER, FORMER CHIEF, CITY OF
NEW YORK INSTITUTIONAL REVIEW SERVICE
Ms. HOPPER. I am a registered nurse also, over 40 years, and I have
had considerable experience both as a sanitarian, and I spent time with
the State department of social welfare.
I was with the <strong>in</strong>stitutional review service for approximately 7 years.
I went there as a supervisor, and became assistant chief, and then chief
of the division.
I stayed <strong>in</strong> that position until approximately 1971, when it was taken
over by the department of health, from the department of hospitals.
The department of health gave me another position, so that the
special assistant was not very much of anyth<strong>in</strong>g, partly because I th<strong>in</strong>k
they wanted to put someone else <strong>in</strong>, because the policymakers did not
approve of what I wanted.
We had to have approximately 35 <strong>in</strong>spectors under us to do the
<strong>in</strong>stitutions that was covered by at least a third or more, the vacancies
were not filled. and people were tak<strong>in</strong>g special assignments and not
replaced, and the night <strong>in</strong>spections were detailed, and we went <strong>in</strong>, and
we tried.