The cornerstone of Georgia’s program to protect seniors in assisted living and personal care homes is a platoon of state employees that licenses and inspects facilities and investigates complaints of abuse and neglect.
But that team of 21 Department of Community Health inspectors has struggled to keep up with an expanding workload. The department’s top facility regulator acknowledged the strains in December 2018, saying the state needs more resources and inspectors to help enforce safety rules and protect vulnerable adults across a system of more than 2,600 state-licensed facilities, including some 400 assisted living and large personal care homes that cater to seniors. These inspectors also have to help investigative often-dangerous unlicensed homes, too.
Fast forward 14 months and the department has changed its tune even as the problems persist.
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Agency officials now won’t discuss the need for additional inspectors amid Gov. Brian Kemp’s proposed budget cuts across state government. In hearings before lawmakers in recent weeks, DCH Commissioner Frank W. Berry has been asked by lawmakers about breakdowns in care at the state’s senior care facilities and what his department needs to improve oversight. Each time, he has sidestepped questions about whether the agency needs additional resources.
State Sen. Nan Orrock, D-Atlanta, who sits on the Senate Appropriations Community Health subcommittee, was the latest lawmaker to press Berry for answers and ask what he needs to “turn this ship around.”
“The data is pretty staggering and these are people’s loved ones,” Orrock said. “Protecting the citizens of the state is the government’s responsibility.”
Berry tacitly acknowledged that his answer would leave some unsatisfied.
“I’m not prepared to come to you and ask for more staff if I can’t tell you definitively that I have to have more staff,” Berry told the subcommittee on Monday. “And so I know that may not be the answer that you were hoping for or looking for, but that’s my take on it right now.”
Berry’s position has concerned advocates for the elderly who this week will be talking with lawmakers as part of the annual Senior Week events at the state capitol. Hundreds of senior activists from across Georgia will visit their elected officials at the Gold Dome Wednesday and Thursday. High on their agenda is pressing the case for improving protections for residents of the senior care facilities.
An Atlanta Journal-Constitution investigation last fall revealed hundreds of cases of neglect and abuse had occurred in the state's assisted living and large personal care homes. A key finding was that the state's failed oversight system kept the public in the dark about the problems. DCH doesn'thave enough staff to conduct annual inspections, is hampered by outdated technology and has been slow to post reports on troubled homes, the AJC found.
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“Having more surveyors around the state who are able to respond is absolutely essential,” said Melanie McNeil, Georgia’s long term care ombudsman. “We don’t have that now. Harm happens when facilities aren’t held accountable in a timely way. Common sense tells you we need more surveyors available to handle this vulnerable population.”
Those concerns were echoed last week in a public hearing before the House Appropriations Health subcommittee. Advocates for the elderly urged lawmakers to fund improvements to the oversight system. The comments came as advocates have grown increasingly anxious that the state budget squeeze could undercut reform efforts necessary to protect seniors.
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One of those who testified was Kathy Floyd, executive director of the Georgia Council on Aging. Both McNeil and Floyd were among more than a dozen advocates and industry leaders present at the December 2018 meeting where DCH’s healthcare facility regulation chief Melanie Simon outlined the staffing shortages in a PowerPoint presentation.
Floyd recounted that meeting last week to lawmakers as she urged the legislature to fund more regulator positions so inspections can get completed in a timely fashion and the public can get access to critical information.
“They definitely needed more staff in order to regulate assisted living and personal care homes,” Floyd said.
DCH has struggled with a clear explanation for the change in its position about staffing. Berry had no answer after Monday’s senate committee meeting. A department spokesman followed up later Monday, explaining that the 2018 presentation was related to a statewide elder abuse task force initiative that has not spread as quickly as anticipated.
The agency spokesman said in an email statement that the department is focused on a “pressing need” to fill vacancies in the nursing home inspection program and has “emphasized” that in the FY 2020 budget. By contrast, all but one of the allotted 22 inspector positions in the inspection program that includes assisted living and personal care homes are filled. That program has about one staff position for every 95 licensed facilities.
