A federal report released Monday said Kansas’ nursing home inspectors failed to follow up on about half the problems they found in 2014.
The report from the U.S. Department of Health and Human Services Office of Inspector General is part of a larger review of state agencies that inspect nursing homes that participate in Medicare and Medicaid.
In Kansas, that agency is the Kansas Department for Aging and Disability Services, or KDADS. Federal officials examined a random sample of 100 deficiencies directly related to resident health services that KDADS found at 79 nursing homes in 2014. They determined that the state had verified that nursing homes corrected the deficiencies in 48 cases.
In other cases, they said state inspectors only required that the nursing homes submit a plan to correct the problems and didn’t check to see if the plans worked.
“The state agency’s practice was to accept the nursing homes’ correction plans as confirmation of substantial compliance without obtaining the required evidence of correction for less serious deficiencies,” the report said.
Kansas Gov. Sam Brownback said he would look into the federal findings.
“I’ve got to review it more,” said Brownback, a Republican.
House Minority Leader Jim Ward, a Wichita Democrat and candidate for governor, said the report revealed significant problems that could mean a loss of federal funds if they aren’t fixed.
“It’s more than concerning,” Ward said. “It’s very, very frustrating that after seven years, (the Brownback administration) still can’t do the basic executive oversight.”
A shortage of inspectors was flagged as a possible source of the state’s failures. The report said that as of May 19, KDADS had 13 vacancies in its 61 surveyor positions, a rate of more than 20 percent. Those surveyors are tasked with inspecting 310 nursing homes.
KDADS spokeswoman Angela de Rocha said Monday that the state has since trimmed the number of vacancies to 12 and is continuing to hire.
"We realize that we have a problem with hiring, recruiting and retaining these surveyors," she said. "We know that's a problem. We've been working on it for years."
The federal review also showed that about 13 percent of the followup reviews that did occur had been accidentally deleted from the state’s database.
Federal officials also determined that Kansas inspectors were behind on their routine nursing home surveys, which are supposed to be conducted every 15 months. Only about half the nursing homes the feds reviewed were re-inspected within that time frame.
Mitzi McFatrich, the executive director of a nursing home resident advocacy group called Kansas Advocates for Better Care, said the report was “welcome” and KABC had urged the federal government to look into the nursing home inspection problems after the state failed to address them.
“That’s something we’ve been testifying to the Legislature about for a number of years now because it’s a big concern for us,” McFatrich said. “We think that puts residents at higher risk and for people that are already being harmed, they suffer that harm longer.”
The federal agency recommended that the state tighten its followup inspection requirements, update its policies to “ensure that survey system data is protected against unauthorized or unintended modification or loss” and develop a correction plan to make sure nursing homes get a routine inspection every 15 months.
The state responded by agreeing with the review’s findings and said it had made systemic changes to ensure that nursing homes will be required to show evidence they’ve addressed problems found in inspections. The state also said it had identified the data loss and fixed the system.
The state said it would monitor the 15-month routine inspections, but cited vacant inspector positions as an obstacle and said an analysis of competitive wages had convinced KDADs secretary Tim Keck that the executive branch and the Legislature need to re-evaluate next year how much they’re paying inspectors.
De Rocha said Keck has been working on a plan to increase the salaries that he will take to the Legislature in January.