Should State Surveyors Be Consultants or Enforcers To Nursing Homes?
Who stands firm and resolute when it comes to holding Skilled Nursing Facilities, psychiatric hospitals, home health agencies, hospice agencies, intermediate care facilities, dialysis clinics, and adult day health centers accountable when they violate the rules and California regulations protecting patients? Well, it turns out that California’s Health Facility Evaluator Nurses (HFENs) work in the trenches. As a group, they are overworked and underpaid, typically earning between $5,500 and $7,300 per month, by the California Department of Public Health. Among other things, it is their job to inspect, investigate, survey, and evaluate health facilities for conformity with licensing and certification requirements and compliance with State and Federal laws. When HFENs note deficiencies, they write reports, provide support for civil,monetary and administrative penalties.
Why is the State Enforcing Nursing Homes?
However, recently things are changing. The Center for Health Care Quality, a branch of the California Department of Public Health, issued an Executive Summary. It outlined a new “Quality and Safety” survey model that HFENs are expected to implement after the pandemic ends. Essentially, the Department of Public Health decided that there should be a new program whereby HFENs, who are already spending most of their time investigating complaints at Skilled Nursing Facilities and other healthcare facilities, will add recent week-long surveys to their already enormous workload and will focus on providing advice to a small number of SNFs. The problem is that there is already a backlog of more than 13,000 complaints, going back to 2014, that HFENs have yet to work through. By doubling the workload on HFENs, while at the same time taking away their ability to issue citations, the California Department of Public Health is setting HFENs up for failure. If HFENs are expected to spend half their time doing new surveys and “consulting,” they will spend that much less time investigating neglect, abuse, and the failure of long-term care facilities to care for nursing home patients.
We believe that HFENs want to do a good job and that the surveyors work hard to hold facilities accountable. When the Department of Public Health’s Executive Summary came out, many of these dedicated public servants came forward. They spoke with the Sacramento Bee to express concerns about the change in their duties and responsibilities. The shift, if implemented, would make surveyors “consultants” to specific nursing homes. After that, they would have no ability or authority to “enforce” the rules and regulations. This new plan is called “Adopt a SNF Model.”
The proposed shift is a disaster in the making for California’s at-risk nursing home population. In January, the legislature is expected to hold a hearing on this proposed shift.
If you believe, as we do, that the DPH proposal is misguided and likely to hurt elders in nursing homes, we urge you to contact your state representative and voice your concerns. Please tell them you oppose the new “Adopt a SNF” program, and that you support the State’s inspectors, who are our last line of defense against nursing home abuse and neglect.