LA County Nursing Home Inspections-Still Not Right

According to Kaiser Health News (KHN) Blog, Capsules, a recent audit shows that LA County’s public health officials still aren’t getting the nursing home inspections right. The audit, released in late August, was the latest in a series of actions regarding the complaint investigations for nursing homes in the county.  According to the article, the audit shows that

Los Angeles County public health officials inappropriately closed nursing home investigations and failed to follow state guidelines on prioritizing complaints … [and] even after nursing home inspectors found serious problems, their supervisors downgraded the severity of findings without any explanation or without discussing the changes with the inspectors as required.

The article summarizes the troubled history with the County’s record on handling inspections (the subject of prior blog posts) and notes that

[t]he most recent audit was based on a review of a small sample of cases — about 20 of the more than 3,044 that were open in March 2014 and 30 of the 1,124 cases that had been closed between July 2012 and April 2014. The audit found that five of the 30 cases were closed inappropriately without “conducting or completing the investigations…” [and] …supervisors downgraded inspectors’ findings in 12 of the 30 closed cases, meaning that the nursing home got a less serious citation or a smaller fine. In most of those cases, there was no documentation for the reason. 

Recommendations from the audit include “that the department’s inspectors, managers and doctors improve documentation and communication to ‘ensure the quality and integrity of their investigations.'” The County’s response?  “[I]t agreed that the documentation was “sometimes lacking” and that improvements were necessary… [and] several changes [were already made], including putting new people in charge of the division responsible for inspections and improving the tracking and prioritization of complaints.”  The County also responded, as it has previously “that the department is underfunded and ‘severely understaffed.’”

The audit includes attachments with explanations regarding the auditor’s recommendations, and the County’s detailed response. The audit report is available here.