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State hires 19 new nursing home inspectors

The state’s public health commissioner announced Wednesday that she is shoring up the beleaguered ranks of nursing home inspectors, having hired 19 newcomers since July and actively pursuing 10 more, amid concerns about serious gaps in state oversight.

“We need to be fully staffed. We have had a lot of vacancies,” Dr. Monica Bharel, the health commissioner, told the Public Health Council, an appointed board of physicians, academics, and consumer advocates that sets health policy.

Bharel said her agency now has 77 nursing home inspectors. Even after it fills the 10 remaining vacancies, the health department aims to hire an additional seven program support staffers. Bharel did not explain how the cash-strapped department was able to hire so many new inspectors, but a spokesman later said the agency is using existing money to cover the cost.

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At the same time, Bharel said her agency this week overhauled its process for scrutinizing companies and executives seeking nursing home licenses.

The actions come as advocates question the state’s commitment to ensuring the health and safety of the thousands of elders and disabled residents living in 419 Massachusetts nursing homes.

A series of Boston Globe stories last year showed how an out-of-state chain had assembled a string of nursing homes with scant attention from regulators. That company, Synergy Health Centers, has been beset by reports of substandard care and short-staffing.

“These are good strides in the right direction, but there’s a lot more work that needs to be done here,” Janice Nigro, a Wakefield elder law attorney, said after Bharel’s presentation.

Nigro is among a group of attorneys trying to unearth information about a backlog of complaints filed against Massachusetts nursing homes. She said the attorneys often hear from clients who filed complaints with the health department but never heard back from anyone.

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That concern was echoed by Derek Brindisi, a member of the Public Health Council and assistant town manager in Plymouth.

“We get complaints at the local level,” Brindisi told Bharel. “We will direct them to the department [of public health] . . . but if they don’t hear anything, they reach back out to us and say, ‘What’s going on with this?’ ”

Bharel said her agency received 1,768 consumer complaints about nursing homes last year and an additional 9,947 reports filed by nursing homes about a wide range of problems in their facilities, from issues with food to more serious concerns. She said the complaints are “triaged through a two-tiered review process,” and that inspectors visit the nursing homes “when indicated.” Bharel said an undetermined number of complaints may be forwarded to the state attorney general’s office or the Executive Office of Elder Affairs.

Bharel did not detail how many of the 11,000-plus reports and complaints remain pending.

John Ford, an elder law attorney at Northeast Legal Aid in Lynn who listened to Bharel’s presentation, said his clients’ reports to state regulators about nursing homes seem to fall into a black hole.

“There ought to be a procedure, even if it’s a letter saying we’re in receipt of your complaint,” Ford said. “We ought to have some agreement on how to close this loop.”

The department appears to have such a process, sending out a letter within 10 business days after receiving a complaint, according to the department’s recently upgraded Internet web pages (www.mass.gov/dph/nursinghomes).

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The department’s pledge to beef up nursing home oversight includes collection of more information about the people and companies applying for nursing home licenses, Bharel said. That information includes details on the criminal and financial backgrounds of the executives running a nursing home’s affiliated realty property companies. The search covers records in Massachusetts and other states.

Affiliates are routinely established to shield nursing home companies from liability if they are sued. An affiliated company legally owns the nursing home property, which makes it harder for someone who is suing to get access to a nursing home’s money, according to attorneys who represent patients who have been harmed.

A recent Globe review of 2014 nursing home finances found the homes often report they are losing money even as they direct cash to these subsidiaries and to help pay executives’ six-figure salaries.

The state health department’s stepped up monitoring includes a new unit, the Supportive Planning and Operations Team, which will be launched July 1, according to Bharel, and which will conduct surprise inspections targeting problem facilities.

The inspections will be in addition to annual visits to each nursing home, she said.

That unit, dubbed the SPOT team, will focus on retraining management and staff at struggling nursing homes, Bharel said. The department is hoping to pay for this team with fines collected from nursing homes, but still needs federal approval for this financing plan, Bharel said.

Kay Lazar can be reached at Kay.Lazar@globe.com .