Audit: Improved staffing levels needed at Pennsylvania nursing homes

The Department of Health (DOH) is addressing a troubling lack of oversight in state nursing homes after a report revealed deficiencies that negatively affected the quality of care.

On Tuesday, Pennsylvania Auditor General Eugene DePasquale unveiled the 91-page audit, identifying three major areas that needed to be improved: inadequate nurse staffing levels, improperly handling complaints, and inconsistent sanctions on underperforming facilities.

“The quality of care provided to 80,000 Pennsylvanians who live in nursing homes is directly related to adequate staffing,” DePasquale said. “The Department of Health has work to do in making sure these facilities are appropriately staffed."

The audit, which covered operations from January 2014 to October 2015, disclosed that the DOH had no policies in place to ensure nursing home residents were receiving the state-required minimum of 2.7 hours of daily care.

Ten percent of facilities could not prove reviews of staffing levels were conducted, 37 percent did not conduct reviews regularly and only half could provide documentation that adequate levels of staffing were met.

Furthermore, the DOH failed to discipline facilities on a consistent basis when deficiencies were discovered.

“DOH has considerable administrative discretion when pursuing sanctions, and we agree that not every instance of noncompliance may warrant a fine,” DePasquale said. “However, when a facility is not sanctioned but could have been, there needs to be an explanation.”

The audit also scolded the DOH for ignoring anonymous complaints that began in July 2012 under Governor Tom Corbett.

DePasquale noted that the policy violated federal requirements.

Last July, the DOH began acknowledging anonymous complaints and saw the number of complaints increase by 63 percent.

DePasquale lauded DOH Secretary Dr. Karen Murphy for requesting an independent audit after recognizing the need to improve operations.

"We have already launched a multifaceted, performance improvement initiative that addresses many of the audit recommendations and [we] are committed to continuing to accelerate the department’s efforts to make a positive impact on improving the lives of the more than 80,000 Pennsylvanians who rely on nursing homes to meet their long-term health care needs,” Murphy said.