When nursing facilities receive Medicaid and Medicare funding, federal regulations require them to tell the state how they’ll correct deficiencies that are identified by inspectors. Then it’s the state’s responsibility to ensure that the necessary actions have been taken to address the problems. However, according to a federal review released this month, the Kansas Department for Aging and Disability Services has failed to “obtain the nursing homes’ evidence of correction for 52 percent of the deficiencies identified during surveys in CY 2014.”
The U.S. Department of Health and Human Services Office of the Inspector General conducted the review, which found that KDADS only verified the correction of 48 deficiencies out of a sample size of 100 at 79 nursing homes. The report also states that the “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.” This means KDADS officials weren’t showing up at the nursing homes to determine whether the problems had been fixed or even demanding basic evidence that would demonstrate compliance.
For example, after an inspector reported that a facility had failed to complete an accurate assessment of a resident’s dental health, KDADS accepted a corrective action plan without any reason to believe it had actually been implemented. After receiving the plan, KDADS sent the nursing home a letter that stated, “Your facility is found to be in substantial compliance based on your credible allegation of compliance and the submitted plan of correction.” In other words, “You said you improved, so you must have improved.”
Another example is even more troubling. On Aug. 14, 2014, an inspector reported that “the facility failed to protect … from abuse and mental anguish.” In its corrective action plan, the facility assured KDADS that it “will continue to ensure residents are free from verbal, sexual, physical and mental abuse, corporal punishment, and involuntary seclusion.” But the OIG claims that the agency “was unable to provide us with evidence of correction to show that any of the corrective actions … had actually taken place.” This was a “G-rated deficiency,” which is in the second-worst severity bracket.
Finally, the OIG found that KDADS had only conducted surveys at 38 of 73 nursing homes within 15 months of their previous inspections — a violation of federal requirements. It took one agency more than 18 months to conduct its mandatory review.
KDADS Secretary Tim Keck and spokeswoman Angela de Rocha say the agency is working to address these problems — one of which is the lack of inspectors. As Keck puts it, “We are acutely aware of this problem and are working on a plan to increase the surveyors’ salaries, which we will take to the Legislature in January.” According to the report, 13 out of 61 KDADS positions were vacant in May, and de Rocha says that ratio has changed to 12 out of 70.
Regardless of what KDADS is doing now, House Minority Leader Jim Ward was correct when he said the agency has failed to “perform basic oversight functions” and pointed out that “our most vulnerable elderly are at risk.” The OIG report demonstrates that there are significant concerns about how well the state is protecting our seniors, and this is something no Kansan should be willing to tolerate.
Members of The Capital-Journal’s editorial advisory board are Zach Ahrens, Matt Johnson, Ray Beers Jr., Laura Burton, Garry Cushinberry, Mike Hall, Jessica Lucas, Veronica Padilla and John Stauffer.