Department of Human Services
An Audit Report on the Long-Term Care Regulatory Program at the Department of Human Services
Report Number 97-066
June 1997
Overall Conclusion
The Department of Human Services (Department) has generally complied with federal and state regulations in the conduct of surveys and complaint investigations. However, compliance with the inspection protocol does not ensure effective regulation, and more importantly, quality care in nursing facilities. Many factors have hindered the Department's ability to be effective in its regulatory role over nursing facilities, which has allowed substandard providers to exist.
Key Facts and Findings
As the Department reengineers the long-term care regulatory process, it should continually focus on improvements in the inspection process by clarifying criteria, terminology, and procedures. Additionally, the Department should establish measurable performance standards for nursing facilities and require all facilities to report performance measures on a regular basis.
Management should make continuous efforts to improve the enforcement function by evaluating the overall effectiveness of remedies on the quality of care in nursing facilities. The Department should fully utilize its authority to use a facility's and owner's history of noncompliance as a basis for imposing remedies. The Department should evaluate its current use of state licensing remedies and administrative penalties as enforcement tools.
Management and staff of the Department and the Office of the Attorney General should continue to improve communication through frequent correspondence and meetings to address past problems and to develop solutions. The Department should clarify the definition of violations that constitute a threat to resident health and safety, with input from the Office of the Attorney General.
Management should continue to evaluate methods for minimizing the risk of disclosure of unannounced inspections. Management should fully manage potential conflicts of interest identified by employees.
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