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Report says Arizona still hasn't fixed the system for nursing home complaints

A new report found that Arizona health officials have failed to address recommendations that were made in 2019 to improve nursing home care. This latest follow-up also found other serious deficiencies.

In 2019, the independent Arizona Auditor General’s office issued a report which found the Department of Health Services failed to investigate complaints of abuse and neglect. The auditor general made five recommendations to make sure complaints are investigated. 

According to this latest report, DHS implemented zero out of five. 

"I am at a loss of how this how the system continues to fail our most vulnerable adults, especially those in a skilled nursing facilities," said Dana Kennedy, the state director of AARP Arizona

The report also found that DHS closed several high priority complaints without a required onsite investigation. And it quote, “improperly changed open, uninvestigated high-priority complaints to lower priorities,” upping the investigation time from 10 days to a year.

"How is it that a high priority case gets reclassified to not being a priority? How can how can a bedsore not be investigated for over a year? A bedsore happens because somebody is not properly cared for?

In a statement, Interim Director Don Herrington said the agency has “begun a thorough review to see what improvements are needed.”

Don Herrington's full statement

The health and welfare of residents is the highest priority of our Bureau of Long-Term Care. We recognize how much long-term care residents and their families depend on us, and we welcome any and all feedback on how we can do better.

At our request, the Arizona Auditor General has provided data behind its conclusions about complaints and self-reports that were closed without an investigation or reprioritized. We have begun a thorough review to see what improvements are needed. The Department takes very seriously any concerns about our oversight of long-term care facilities.

We are responding with specific ways the Department can better follow the Auditor General’s recommendations. These include:

  • Addressing staffing challenges in the ADHS Bureau of Long-Term Care, which continues recruiting for 15 open surveyor positions on top of about 20 surveyors currently on staff. This includes evaluating whether salaries align with neighboring states.
  • Developing and implementing a policy that clearly articulates the time-frame for investigating and closing complaints and self-reports.
  • Bolstering the number of staff trained to process complaints and self-reports.
  • Continuing to work with CMS to ensure that the Bureau of Long-Term Care is current with CMS requirements and updated policies.
  • Working with industry groups and partners to provide training and technical assistance.

The context here is important.
Amid the COVID-19 outbreak, and on instruction from the Centers for Medicare and Medicaid Services, the agency’s main focus shifted to infection control surveys for long-term care facilities with a goal of reducing the chances of outbreaks that could endanger residents. We take pride in ADHS exceeding the Centers for Medicare and Medicaid Services requirements for these infection control surveys, which staff conducted for all facilities and handled rapidly when outbreaks were reported. Meanwhile, the ADHS Bureau of Long-Term Care continued responding aggressively to complaints judged to involve immediate jeopardy to the health and well-being of residents.

The ADHS Bureau of Long-Term Care has been highly engaged with facilities during the period covered by this report, though we acknowledge that these efforts have not met the Auditor General’s 2019 recommendations amid the pandemic. Since July 1, 2019, the Bureau of Long-Term Care has made 1,000 visits to long-term care facilities, visiting each facility, on average, seven times.

We are focused on improving the Bureau of Long-Term Care’s response to complaints. All A-level (immediate jeopardy) and B-level (high-priority) complaints and self-reports received since Jan. 1, 2021, for long-term care facilities have been investigated within timeframes established by Department policy and the Centers for Medicare and Medicaid Services.

At ADHS, we strive to do better today and tomorrow than yesterday. When we fall short, our priority is to do better. We sincerely appreciate the Auditor General’s detailed review and recommendations for how we can do that. We are responding with specific, actionable, and measurable steps to enhance licensing and oversight of Arizona’s long-term care facilities."

Kathy Ritchie has 20 years of experience reporting and writing stories for national and local media outlets — nearly a decade of it has been spent in public media.