Scathing audit says office charged with licensing care homes failing to ensure health, safety of patients

Scathing audit says office charged with licensing care homes failing to ensure health, safety of patients
(Image: Hawaii News Now) (Vorsino, Mary)

HONOLULU (HawaiiNewsNow) - The state Office of Health Care Assurance is required by law to oversee the health, safety and welfare of care home residents by licensing and inspecting care homes and holding them to standards.

But a blistering new state audit raises serious questions about how much oversight the office actually provides.

It says that Hawaii care homes are being licensed without inspections, and that there are no written guidelines for enforcement if a licensee doesn’t comply with care standards.

In fact, about half of the 214 care homes that the state Auditor’s Office sampled for the report were allowed to operate in 2017 with either an expired license or a license “hastily issued before all required steps” were complete.

That same year, eight care homes in the sample had 20 or more deficiencies but had still gotten their license renewals before they were resolved.

And in the last decade, OHCA hasn’t issued a single sanction against a care home or terminated a care home’s license.

“Relicensing a care home before the inspection process is completed or doing so without verifying compliance does not provide assurance. And failure to fully define and use enforcement authority do not provide assurance,” the state audit said.

“To the contrary, these circumstances, which we found to exist at OHCA, likely increase the risk to the health, safety, and welfare of care home residents.”

Additionally, the audit found that even serious deficiencies didn’t prompt a follow-up review. Those deficiencies included mislabeled medication, incorrect medication administration, blocked exits or improper supervision.

In a response to the audit, the state Health Department said while it is working to improve how the Office of Health Care Assurance operates, it does not believe patient safety is being put at risk.

“It is important to address this misperception at the outset of our response by emphatically stating that any risks to the safety, health and well-being of older adults in an adult residential care home are immediately investigated and appropriate action taken,” the department said.

The department also noted that over the past five years, it’s reported 277 cases of possible abuse or neglect of care home residents to Adult Protective Services.

The audit comes as the state tries to figure out how to meet the needs of a graying population.

Last year, more than 253,000 residents in the islands were over 65. There were more than 40,000 Hawaii residents, meanwhile, who were 85 or older. That’s up by about 10,000 from 2010.

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