The state auditor is urging stricter oversight of nursing homes after a review found that Massachusetts health officials, who are responsible for monitoring the facilities, often failed to investigate high-priority allegations of abuse, neglect, and mistreatment in a timely manner.
Auditor Suzanne M. Bump concluded that the Department of Public Health regularly took about two months to launch an onsite investigation of serious concerns, even though regulations require it to respond within two weeks.
Auditors calculated that as many as 80 percent of the DPH’s most urgent cases were not prioritized or investigated within the required time frames, putting residents at increased risk of harm.
If the department “receives allegations that a client is mistreated, physically or financially, the agency must be more vigorous and timely in investigating these claims,” Bump said. “I urge DPH to enhance oversight of abuse investigations to ensure vulnerable residents are not taken advantage of.”
Nursing home advocates, who have long urged more robust oversight, applauded Bump for “shining a spotlight” on the issue of caring for such vulnerable residents.
“DPH is the first line of defense for ensuring nursing home residents receive quality care and are safe, especially in an atmosphere where the federal government is reducing options for enforcing regulatory protections,” said Arlene Germain, president of Massachusetts Advocates for Nursing Home Reform, a nonprofit patient advocacy group.
“Massachusetts must ensure that DPH has the resources and staffing for carrying out this critical role,” she said.
State public health officials said they disagreed with many of the auditors’ findings.
In a prepared statement, they said the department had increased staffing prior to the audit to respond to complaints.
By the end of last year, six months after the period covered in the audit, there was no longer a backlog in cases to be investigated, the statement said.
The statement said DPH also took steps to boost quality assurance at nursing homes to assure “residents receive safe, effective, and high-quality care.”
In its response to Bump, the DPH noted that it received more than 26,000 nursing home complaints during the two-year period auditors reviewed.
The department acknowledged it struggled with a backlog, but said it had identified and hired staff to address the issue and had cleared the backlog by December 2018.
Bump’s audit covers July 1, 2016, through June 30, 2018. The auditors reviewed 200 cases and determined 142 were not prioritized for onsite investigation within the required time frame of two working days. Additionally, 148 of these cases were not investigated within 10 working days, as required.
During the audit period, the DPH took an average of 41 working days to begin onsite investigations, Bump said.
In addition to required time frames not being followed for higher-priority cases, the audit found that the agency did not perform all required onsite surveys, did not refer some cases to the attorney general’s office as required, and did not have adequate case tracking and monitoring procedures.
The Massachusetts Senior Care Association, the nursing home industry’s trade association, declined to comment on the auditor’s report.