The Federal Office of the Inspector General (OIG) for the Department of Health and Human Services again criticized the quality of California nursing home licensing inspections. The Inspector General’s office found that the California licensing inspections cannot be counted on to identify violations of state nursing home standards. The Centers for Medicare and Medicaid Services (CMS) relies on state inspections, including licensing surveys, as one way to ensure the quality of care provided in nursing homes. In California, the state agency that must perform surveys of nursing homes every two years to determine whether they meet the licensing requirements is the Department of Public Health. The Department of Public Health surveys are supposed to include reviewing employee qualifications, employee health examination records and units within nursing homes providing optional services, such as physical therapy.
The Inspector General’s office found that nursing homes did not always meet certain state requirements for employee health examinations and optional service units. The state’s survey inspections did not always identify that nursing homes were not meeting requirements for employee health examinations and optional service units. Based on the Inspector General’s sample surveys, health examinations of 30% of nursing home employees statewide were not conducted. Further, sampled nursing homes did not always follow their policies and procedures for health examinations or their policies and procedures were inadequate. The nursing homes and the state agency could not be sure that nursing home employees were free of any health conditions that might have created a hazard for Medicare and Medicaid beneficiaries. Further, they could not always demonstrate that optional service units at the nursing homes met state requirements for adequate policies and procedures, staff equipment and space.