Objective

To determine the extent of implementation of the four recommendations included in our initial audit report, Oversight of Nurse Hiring and Retention (Report 2017-N-2).

About the Program

The New York City Health and Hospitals Corporation (Health and Hospitals) is a public benefit corporation created by the New York City Health and Hospitals Corporation Act of 1969 to oversee the provision and delivery of comprehensive health care in New York City’s public hospitals and clinics. As the largest public health care system in the nation, Health and Hospitals provides essential inpatient, outpatient, and home-based services to more than 1 million New York City residents annually in more than 70 locations across the five boroughs, including 11 acute care hospitals, 6 diagnostics and treatment centers, and 5 nursing homes. As of December 20, 2019, Health and Hospitals employed 9,420 direct hire nurses throughout its health care system and as of December 23, 2019, 814 temporary nurses. As a condition of their hiring, Health and Hospitals requires that nurse candidates undergo various screenings (e.g., criminal history, verification of work eligibility) to ensure they are in compliance with relevant hiring policies and procedures, including fingerprinting.

Our initial audit report, issued July 16, 2018, found that, while Health and Hospitals generally complied with its policies for the screening of its direct hire and temporary nurses, it had not taken action to ensure that direct hire nurses who began before 2002 or any of its temporary nurses were fingerprinted. Tighter controls are warranted to ensure that all currently employed nurses, regardless of hire date, are fingerprinted so they can be properly monitored for potential criminal activity. We also identified numerous instances of deficient screening and monitoring.

Key Finding

Of the four recommendations presented in the initial report, we found two had been implemented and two had been partially implemented.

Key Recommendation

Officials are given 30 days after the issuance of the follow-up review to provide information on any actions that are planned to address the unresolved issues discussed in this review.