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No. Castle Forces Assisted Living Facility to Address EMT Non-Compliance

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The Bristal in Armonk was recently cited with a violation for non-compliance of its 2012 site plan approval that required an EMT on staff at all times. However, assisted living facility representatives said the state does not allow them to hire their own EMT.

The operators of The Bristal assisted living facility in Armonk must find a way to limit the volume of routine calls to local emergency volunteers after failing to adhere to a key condition for approval.

Last week, the North Castle Town Board approved a waiver for applicant HSRE-EB Armonk, LLC, the owner of the property at 90 Business Park Drive where The Bristal is located, to return to the Planning Bord to modify the site plan. In the Planning Board’s July 23, 2012, site plan approval for the 140-bed facility, The Bristal was to provide an EMT on site “at all times.”

The Building Department recently cited The Bristal with a violation for failing to comply with that condition. The matter is currently being adjudicated before the town’s Justice Court.

However, attorney Nicholas Cappadora, representing The Bristal, told the Town Board last week that staff has been unable to comply with the condition because the state Department of Health does not allow assisted living facilities to contract their own EMT. Non-medical tasks, such as housekeeping, food preparation and transportation, are among the services that can be outsourced.

Cappadora and The Bristal’s Chief Operating Officer Amy Silva-Magalhaes acknowledged that the Armonk Fire Department should only be contacted for its EMS services when there is a true emergency.

“So we request based on the need of our residents, but we are taking it very seriously,” Silva-Magalhaes said. “We have put in place protocols because we certainly don’t want to overburden our emergency response team. But, again, we do have to follow the course of treatment from the physicians of our residents that reside in our community.”

The Bristal contracts for its own transport services in non-emergency situations. However, in January, there were 14 calls to the department, 15 in February and 17 this month through last Wednesday, she said.

Supervisor Joseph Rende said he has heard from officials in the fire department that the number of calls for non-emergency, non-life-threatening calls ebbs and flows, but The Bristal must do everything in its power to avoid putting a strain on the volunteer first-responders. He said the volunteers have no issue responding to legitimate emergencies.

“There’s clearly a problem here, and it may not be through an EMT, but maybe we have to work together so that you can establish personnel that is there 24/7 that will evaluate each one of those situations and make that call whether or not it requires emergency response from us or just a transport,” Rende said.

Silva-Magalhaes said state regulations do not require 24/7 coverage by registered nurses or licensed practical nurses. Typically, The Bristal has three to five RNs and/or LPNs on hand for the 7 a.m. to 3 p.m. and 3 to 11 p.m. shifts, but not all the time during the overnight hours, she said.

Councilwoman Barbara DiGiacinto questioned whether the absence of around-the-clock nurses or licensed practical nurses on staff is adding to the number of calls to the fire department.

“I can imagine that if you had a call at night and you don’t have an RN or an LPN, if I were faced with a resident and I’m really not sure they should go to the hospital or not, I’m certainly going to err on the side of caution,” DiGiacinto said.

Councilman Matt Milim said he checked the Department of Health regulations and found that they are essentially silent on whether an assisted living facility can hire its own EMT. He questioned whether the board should vote for the waiver, wanting assurances that The Bristal will comply.

“This problem has been going on for years and years and years, and the reason why it’s coming to us now is because the building inspector finally has gotten so fed up that he issued a violation,” Milim said. “That’s the only reason why it’s being addressed as far as I can tell.”

However, Town Attorney Roland Baroni said that without the waiver to send the applicant to the Planning Board the matter would remain in limbo and await the ruling from the local court. The Town Board’s sole responsibility in the matter is to determine whether to send The Bristal to the Planning Board in hopes of resolving the issue, he explained.

The board unanimously approved the waiver, sending The Bristal back to the Planning Board to address the EMT situation.

The facility, which currently has 96 residents, opened in 2014.

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