Friday, April 13, 2007, 06:33 PM - Cal. Dept of Health ServicesThe California State Auditor issued a report today criticizing the California Department of Health Services for its handling of complaint investigations of nursing homes. Department of Health Services (“DHS”) is the state agency that investigates complaints of neglect and abuse on behalf of nursing home residents.
The State Auditor criticizing Department of Health Services is like Claude Rains, as Inspector Renault in the movie Casablanca, saying that “I am shocked, shocked to find out that there is illegal gambling” going on at Rick’s Casino. The problems with Department of Health Services are of long standing, and have been long ignored as well.
California law requires DHS to investigate complaints involving death, injury, abuse or unsanitary conditions within 24 hours to 10 days, depending on the severity of the complaint. (See Health & Safety Code § 1420(a)(1)). The DHS operating manual says that investigations should be completed within 45 days from the date a complaint is received. The 71-page audit, which looked at about 17,000 complaints lodged over a 21-month period ending April 2006, found that DHS failed to start an investigation within the required time limits in 51% of the cases, and that it failed to complete investigations as required by the DHS operating manual in 60% of the cases.
The audit also found instances in which the agency investigators did not take safety violations seriously enough, by issuing low-level citations, with paltry fines, to nursing homes for serious violations of safety regulations.
The audit also found that DHS has not established a website with licensing and citation information about each nursing home in the state, which was mandated by the legislature FIVE YEARS AGO.
The State Auditor’s office is just the latest in a series of reports that have criticized the Department of Health Services. State lawmakers ordered the audit after a report last year from the State Legislative Analyst’s Office found that DHS inspectors failed to detect problems during nursing-home inspections, failed to follow up on problems, ignored state standards and performed predictable inspections. Last year, the federal Government Accountability Office also issued a report saying that California’s inspectors often overlooked or downplayed serious safety violations.
The delay in DHS investigations has a profound impact on nursing home residents. The total number of complaints against nursing homes increased from about 8,000 in 2000 to 12,000 in 2005. Yet, at the same time, the portion of complaints that were substantiated by DHS investigators fell dramatically, from 41 percent to 16 percent. That is, in the period surveyed, DHS investigators found that they could not prove that the nursing home had done anything wrong in 84% of the cases. Yet, we know that nursing home care is, if anything, getting WORSE not better. The audit attributes the change in substantiated complaints to the agency’s slow response time, which makes it difficult for DHS investigators to determine what actually happened when they finally investigate.
Hats off to the Auditor for calling DHS on the carpet. The ball is now in Governor Schwarznegger’s and the Legislature’s court.
To read the State Auditor’s Report on Department of Health Services, click here.