Objective

To determine the extent of implementation of the three recommendations included in our initial audit report Oversight of Resident Care-Related Medical Equipment in Nursing Homes (Report 2016-S-80).

About the Program

The objective of our initial audit report, issued on September 19, 2018, was to determine whether the Department of Health’s (Department) monitoring and inspection of nursing homes is sufficient to determine if nursing homes perform comprehensive inspections, testing, and maintenance of resident care-related medical equipment.

The Department oversees nursing homes in the State through its Division of Nursing Homes and Intermediate Care Facilities for Individuals with Intellectual Disabilities Surveillance (Division). The Division assesses and certifies nursing home compliance through Certification surveys. 

We found the Department completes Certification surveys in a timely manner and reports deficient practices to the public, as required. However, we identified gaps in the Division’s procedures that weaken its ability to effectively monitor nursing homes’ equipment inspection, testing, and maintenance programs. We also questioned whether the Department’s standard sample sizes were optimal for identifying equipment deficiencies at facilities with larger inventories or histories of poor survey results. Our audit also identified facilities that did not maintain some equipment according to manufacturer recommendations or lacked records of their maintenance. Additionally, 13 of 36 facilities visited could not provide documentation that generators had been exercised under load for four continuous hours every 36 months as required, and 4 facilities were not aware of the requirement.

Key Finding

• Department officials made progress in addressing the problems we identified in the initial audit. Of the initial report’s three audit recommendations, one was implemented, one was partially implemented, and one was not implemented.

Key Recommendation

• Officials are given 30 days after the issuance of the follow-up review to provide information on any actions that are planned to address the unresolved issues discussed in this review.