2002-07-06 / Front Page

Local Hospitals Cited For Violations

In documents released last week by the State Health Department, 54 "teaching hospitals" have been inspected since November of 2001, and have been cited for violations related to resident working hours. Teaching hospitals are licensed by the state and allow residents and interns to participate in the learning process of becoming a doctor. The two local hospitals, St. John's Episcopal Hospital South Shore and Peninsula Hospital Center, are listed among those cited.

"The results of the initial inspections of State teaching hospitals further build on Governor Pataki's commitment to ensure that New York continues to have the best and safest health care system in the nation," said State Health Commissioner Antonia C. Novello.

"New York is the only State in the nation that limits resident work hours and ensures that residents have adequate rest. The Governor has made it clear that hospitals need to comply with resident working hours, and he has provided us with the resources to inspect and the tools to fine hospitals that are not complying with regulations," she continued.

To ensure that resident working hour regulations were being followed at State teaching hospitals, the Governor included funding in the Health Care Reform Act of 2000 (HCRA 2000) to support inspections that focus on resident working hours. The Island Peer Review Organization (IPRO), in conjunction with the Department of Health, is conducting the current surveillance initiative.

As part of their surveillance, IPRO inspectors conducted interviews with residents and other appropriate hospital staff; observed resident working conditions; and reviewed both medical records and operating room logs to determine if each of the hospitals were complying. IPRO also investigates complaints regarding resident working hours; conducts revisits where appropriate; and is continuing its efforts to conduct annual focus surveys at New York's 115 teaching hospitals. IPRO is under contract with New York State through September 2004.

The survey results for the 82 teaching hospitals inspected by IPRO, from November 1,2000 through June 21, 2002 found the following:

  1. 66 percent were cited for resident working hour violations.

  2. 56 percent were found in violation of the resident working hour limit of no more than 24 consecutive hours without time off.

  3. 34 percent were in violation of the 80-hour workweek limits for residents.

  4. 23 percent were cited for not providing residents with one full day off from work, which would constitute 24 hours off from work.

  5. 13 percent did not ensure that residents were provided required hours off between scheduled work assignments.

The Department of Health may impose a maximum fine of $6,000 per violation against hospitals cited for resident working hour violations. In previous cases, hospitals with repeated violations would face a maximum fine of $25,000 for a second offense and $50,000 for a third. Prior to the HCRA 2000 legislation, the maximum fine was $2,000 per violation.

Since St. John's Episcopal Hospital South Shore and Peninsula Hospital Center have been charged with violating the guidelines imposed by the State, they will now be required to submit a plan that will detail how they plan to correct the problems. They will then be subject to follow-up surveys to make sure the problems have been corrected, and that they are complying with the legislation.

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