Skilled Nursing Facilities often are charged with premature death of residents, questionable quality of care, fraud, waste and abuse. Such charges may be legitimate, but also can be from an overly protective family member or a disgruntled employee. The problem is, whatever the charge is whether legitimate or illegitimate, the cost is high and quality of care suffers. Los Angeles County auditors have found problems with the way the public health department investigates nursing home complaints involving issues of safety, neglect and other problems that could jeopardize the well-being of residents.
According to a Los Angeles County audit report, issued citations were downgraded by the public health department supervisors without notification to the county resulting in the impairment of quality and integrity of the investigations. However in defense of their downgrading of citations, the public health department sited its desperate need for more funding from the State for additional staff and resources. Also the public health officials claim they have implemented numerous operational and administrative changes that have improved the program.
Efforts to improve the program of the public health department, of course is a step in the right direction, but a “baby step” to an overwhelming problem. The county is responsible for 2500 health facilities, including nursing homes, acute-care hospitals and hospices. A previous county audit complete in April found a backlog of 945 nursing home investigations that had been open for more than two years! In many cases investigations were actually closed before they were completed. The consequence is that nursing homes throughout the county hardly ever face any consequences, even when the public health department detects neglect or abuse.
Skilled Nursing Facilities as well as all types of Healthcare facilities including Alzheimer, Assisted Living, Independent Living and Continuing Care Residential Community face the problem of complaints and citations. It “goes with the territory”. A dedicated, caring provider rolls with the punches and tries to improve their operation with their eye on the culture change in the industry, employing a person-centered, quality of care operation. In cases where reimbursement is delayed or even eliminated, the provider must have a cash reserve in order to survive. The increase in Skilled Nursing Bankruptcy filings reflects the absence of necessary funds to carry on when reimbursements are overdue or denied.
The U.S. Department of Health and Human Services and the Office of Inspector General recently published its Strategic Plan for 2014 to fight fraud, waste, and abuse, promote quality, safety and value, and secure the future, and advance excellence and innovation. Another step in the right direction, and furthermore, we always like to end our blogs with a positive thought.