“Complaint Workload Clean Up Project”-How Much Investigation Needed?

According to the March 3, 2014 story by Anna Gorman in the Kaiser Health News (in collaboration with the LA Daily News), L.A. County Officials Told Inspectors To Cut Short Nursing Home Probes, county inspectors were instructed to close certain cases without a complete investigation.  The project was dubbed “Complaint Workload Clean Up Project” and  involved the following:

According to the confidential documents, L.A. County public health supervisors … told inspectors to administratively close complaints submitted anonymously as “No Action Necessary.”

They instructed inspectors to close other cases by examining previous reports about the facility instead of thoroughly investigating the complaint at hand. If two other inspections done around the same time did not reveal problems similar to the new allegation, the complaint was to be determined “unsubstantiated.”

The county also told inspectors to administratively close cases reported directly by a nursing home if the facility had been in compliance with an earlier routine inspection.

The internal documents said, however, that inspectors were to fully investigate complaints that were high-profile, were part of a lawsuit or involved alleged abuse or neglect. 

According to the county’s chief of the health facilities inspection division quoted in the story, this occurred because of the state’s impetus to close cases. Although all investigations began, some  were not finished or documented, and he noted an insufficient number of staff to deal with the cases. 

The article looks at the number of open investigations statewide and references legislative hearings about the backlog.  The state’s department of public health has had issues before regarding the processing of complaints against nursing homes: “[a] 2005 lawsuit, a 2007 state audit, a 2011 report by the federal Office of the Inspector General and 2012 sanctions by [CMS] all have taken issue with the time it takes to resolve complaints.”   The article notes that the state’s department doesn’t condone the practice and has ordered the county to stop.  There is a separate inquiry undertaken by CMS.

A follow up story on March 5, 2014 notes that the county board of supervisors ordered an audit regarding the public health department’s oversight of nursing homes. The director of the Department of Public Health answered questions during the supervisors’ meeting.