Auditor Calls on DPH to Enhance Oversight at Nursing Homes

Focusing on abuse and mistreatment...
State Auditor Suzanne M. Bump (Courtesy photo)

Boston, MA – In an audit released today, State Auditor Suzanne M. Bump is calling on the Department of Public Health (DPH) to enhance its oversight of abuse, neglect, and mistreatment of clients at state-licensed nursing homes. Bump’s audit found DPH’s Division of Health Care Facility Licensure and Certification (DHCFLC), the unit responsible for monitoring state health care facilities, did not prioritize and conduct investigations of cases of mistreatment within required timeframes, which could result in prolonged physical and financial harm to residents. The audit examined the period of July 1, 2016 through June 30, 2018.

The audit found problems with the timeliness of DPH’s process for both prioritizing and investigating allegations of abuse, neglect, mistreatment, or misappropriation of patient funds or property that were deemed a high priority. Auditors reviewed 200 cases and determined 142 were not prioritized for onsite investigation within the required timeframe of two working days. Additionally, 148 of these cases were not investigated within 10 working-days, as required. During the audit, DPH took an average of 41 working days to begin onsite investigations of these cases. Auditors calculated that approximately 65 to 80 percent of DPH’s high priority cases were not prioritized or investigated within required timeframes. The audit notes by not properly prioritizing and investigating these allegations in a timely manner, circumstances that could result in physical or financial harm to nursing home residents could exist for prolonged periods of time.

“The Department of Public Health has an obligation to protect the residents living in healthcare facilities it oversees. If it receives allegations that a client is mistreated, physically or financially, the agency must be more vigorous and timely in investigating these claims,” Bump said of the audit. “I urge DPH to enhance oversight of abuse investigations to ensure vulnerable residents are not taken advantage of.”

In addition to required timeframes not being followed for higher priority cases, the audit found DPH 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 in place. In its response to the audit, DPH cited numerous backlog issues for case intake due to a lack of resources and understaffing.

This past year, Bump’s office found similar issues related to reporting and documentation of abuse in audits of the Executive Office of Elder Affairs and Greater Springfield Senior Services, Inc.

The Department of Public Health’s Division of Health Care Facility Licensure and Certification is responsible for licensing healthcare facilities, including nursing homes and other Massachusetts facilities participating in the Medicare and Medicaid programs. It performs onsite investigations for intakes and complaints reported to DPH for facility noncompliance, quality of care, and resident harm. In fiscal year 2018, the unit received approximately $16.9 million in state funding.

The full report is available here.


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