Backlog of nursing home complaints, inspections linked to RN vacancies

State regulators have a backlog of about 200 complaints against nursing homes that need investigation, officials say.

A high number of job vacancies for nurse surveyors is a major cause of the complaint backlog, according to the state Department of Community Health.

The agency said the unaddressed nursing home complaints were not “immediate jeopardy’’ problems, when the health and safety of patients are judged to be at risk of serious harm. (Here’s a recent example of an immediate jeopardy case in Georgia.)

“If there is an immediate jeopardy [case], that gets a priority,’’ Frank Berry, commissioner of Community Health, said recently.

Berry

General complaints can range from a simple maintenance issue at a facility to a patient having a bedsore that hasn’t been addressed.

The agency also said that about 100 nursing homes will not be surveyed for recertification in time this year. “With the number of current vacancies and no funding budgeted for an outside vendor, we are projecting that we will fall short by approximately 100 surveys,” Community Health told GHN.

Other state agencies involved in health care have job vacancies as well.

The Division of Family and Children Services said recently that it’s seeking about 500 caseworkers and eligibility staff. Such workers help Georgians enroll in programs such as Medicaid and food stamps.

The Department of Public Health told GHN that in fiscal 2018, the agency had 945 RNs, but 150 RN vacancies. The vacancy number has been increasing, an agency spokeswoman said.

The nurse vacancies may be especially difficult to resolve. Georgia, like other states, is again facing a shortage of nurses for hospitals and other health care settings.

The Georgia Health Care Association, a group representing the nursing home industry, said that its facilities, too, face an RN shortage. The availability of nurses to meet the workforce needs of medical providers and the state is inadequate, said Tony Marshall, president and CEO of the organization. “Simply put, we have a supply-and-demand issue.”  Nursing homes have a bigger problem  in offering good compensation packages because of inadequate reimbursement by Medicaid, he added.

Marshall said that “fortunately, most [nursing home] complaints do not result in findings of adverse resident outcomes or deficient practice.”

It’s not the first time that Community Health has faced a significant backlog of nursing home complaints.

There was a backlog of 180 in early 2017, before the Legislature approved higher starting pay for nurses who investigate nursing home complaints, as well as raises for veteran RNs. Community Health that year also offered extra pay for RNs to do inspections on weekends to address a backlog of immediate jeopardy complaints.

Community Health has 18 RN surveyor vacancies currently, the same as in early 2017.

DCH said it has considered using an outside vendor to assist with the workload.

The federal interval for regulators to recertify nursing homes is 12.9 months on average, with no facilities surveyed beyond 15.9 months

“The concern about some surveys being late is that when surveys are delayed, residents may be subject to deficient practices at the facility for a longer time because the surveyors are not at the facility to identify the deficient practices and require that they be corrected,’’ said Melanie McNeil, the state’s long-term care ombudsman.

If the ombudsman’s representatives receive a complaint, they try to get the facility to resolve the problem. “The ombudsmen representatives are often successful in working things out for the resident,’’ McNeil said. “We also encourage residents and other complainants to try to resolve their issues directly with the facility.’’

But if the nursing home fails to correct the problem, the ombudsman’s representative refers it to Community Health, because the agency has enforcement powers.

“Sometimes our best efforts just are not enough,’’ McNeil said.

People wishing to complain about a nursing home situation can call 866-552-4464 then choose 5 for the ombudsman program. And they can also use the website www.georgiaombudsman.org

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