Helping hands, care for the elderly concept

"State auditors said that the primary responsibility for investigating allegations of abuse, neglect and exploitation of vulnerable adults in Arizona is with the Department of Economic Security."

State health officials are slow at investigating reports of abuse and neglect at long-term care facilities to the point where residents may be put at risk, according to a new audit.

The blistering report about the Arizona Department of Health Services found 14 of 33 complaints they examined were open for at least 229 days without an investigation.

State auditors cited one complaint, submitted by another state agency, which alleged that inadequate staffing levels caused a resident who was unable to feed or use the restroom, to be soaked in their own urine and have their clothes stained with dried food. 

That complaint, the report said, was not investigated for 851 days.

The report by the Auditor General’s Office also faulted the health department for classifying a third of “self-reports’’ by licensed long-term care facilities as needing no action. 

The auditors said makes no sense, noting facilities are required to report only items that are potential regulatory violations and that the department is required to determine if a violation actually occurred.

Auditors pointed to one self-report that was closed with a “no action necessary’’ conclusion on the same day it was reported.

That incident involved “allegations that a resident with ambulatory issues was being thrown around like a ‘rag doll’ by a staff member.’’

State Health Director Cara Christ disputed the findings, taking her own slap at the auditors for failing to “provide context’’ in terms of all of the roles of her agency.

“Long term care facilities represent less than 0.5 percent of total licensees under department regulation,’’ she said. 

Christ said the auditors less than 1 percent of all complaints received by her agency during the two-year period under evaluation.

“Rather than articulating how the department performs across this wide range of activities to protect public health and safety and investigating and resolving complaints within its jurisdiction, the audit findings focus on this very narrow non-representative sample,’’ she said.

Christ also said her agency evaluates facilities for the federal Centers for Medicare and Medicaid Services and “is currently in compliance with those requirements.’’

“The audit establishes expectations for the department beyond those that exist in its agreement with CMS or as currently established by the Legislature,’’ she wrote.

She also said the audit sets time frames without regard to available resources.

She agreed to do more to allocate new staff or reallocate existing staff to prioritize, investigate and resolve complaints about long-term care facilities.

She said her agency is assigning two additional staffers to handle complaints.

“The department believes an additional 44 staff and an additional $3.3 million appropriation and general fund allocation will be needed to timely adjudicate the nearly 2,500 complaints received annually,’’ she said.

State auditors said that the primary responsibility for investigating allegations of abuse, neglect and exploitation of vulnerable adults in Arizona is with the Department of Economic Security. 

But it is the role of the health department to review the facility’s practices, policies and procedures to determine if there are “appropriate safeguards in place to mitigate the likelihood of abuse occurring.’’

The auditors cited one case complaint by a nursing student at a long-term care facility who alleged residents were being subjected to abuse, neglect, unsanitary conditions and inappropriate qualify of care and treatment. Yet, that complaint had been open and univestigated for 299 days.

“The longer a complaint or self-report remains uninvestigated, the more likely potential problems or violations will remain unaddressed,’’ the report says.

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