L.A. Officials Told Inspectors To Halt Nursing Home Investigations

Officials at the Los Angeles County Department of Public Health told inspectors to halt investigations of complaints at nursing homes as part of a project to reduce the backlog of such claims, according to interviews and a review of internal documents, Kaiser Health News/Sacramento Bee reports.

Background

Public health officials have said that there are more than 9,000 pending cases of health and safety complaints at nursing homes throughout California.

Under California law, an investigation must begin within 10 days of a complaint being filed or within 24 hours if the complaint alleges an impending threat of danger or serious harm.

Assembly Aging and Long-Term Care Committee Chair Mariko Yamada (D-Davis) recently proposed a bill (AB 1816) that would require the state to complete investigations within 40 days.

In addition, Yamada requested an audit of how the state DPH conducts investigations.

According to state officials, Los Angeles County is the only county allowed to do inspections on behalf of the state.

Details of Project

An effort -- known as the "Complaint Workload Clean Up Project" -- has been underway since at least summer 2012, according to internal email messages and memorandums sent by supervisors from LADPH.

According to the documents, public health officials -- including Ernest Poolean, chief of the health facilities inspection division for LADPH -- told inspectors to stop investigating cases that were anonymously submitted and file them under the status of "No Action Necessary."

In addition, inspectors were told to close investigations and deem them "unsubstantiated" if two investigations had been conducted around the same time and did not identify similar problems.

Poolean said the county DPH was forced to begin reducing the backlog this way because of pressure by the state to close cases. He also noted that many of the cases "may have sat on a desk for a long time" because of a shortage of inspectors.

However, the memorandums directed inspectors to fully investigate claims that:

• Involved alleged abuse or neglect;
• Were high-profile; or
• Were involved in a lawsuit.

Reaction

The California Department of Public Health said that it does not condone the project and that Los Angeles County officials should "immediately discontinue" reducing the backlog in such a manner.

In a statement, state DPH spokesperson Anita Gore said the initiative conflicts with state DPH policies and protocols. State officials said LADPH is the only county health department to take such an approach to reducing a claims backlog.

Meanwhile, CMS spokesperson Jack Cheevers said that agency will launch an investigation of the initiative.

Long-term care advocates also criticized the program.

Molly Davies, coordinator of the WISE & Healthy Aging Long-Term Care Ombudsman Program for Los Angeles County, said, "Abuse and neglect cases are not the only cases that lead to harm or death," adding, "There are other egregious types of complaints" (Gorman, Kaiser Health News/Sacramento Bee, 3/3).