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Audit: Md. health officials failed to inspect hundreds of facilities

Maryland health officials failed to conduct required inspections for more than half of the state’s assisted-living facilities and nearly three-quarters of the facilities for the developmentally disabled, auditors found.

The findings — released Thursday by the state’s Office of Legislative Audits — refer to fiscal 2012, but auditors said the problems date back to at least 2004.

In 2012, Maryland’s Office of Health Care Quality, which is responsible for regulating health care facilities, did not perform inspections for 757, or 55 percent, of the 1,364 licensed assisted-living facilities in the state, according to the audit.

Additionally, the regulators only inspected 54 of 197 facilities that serve developmentally disabled individuals, auditors said.

Officials at the Office of Health Care Quality did not dispute the findings but said they are unable to comply with the requirements for inspections because the office is too short-staffed.

“OHCQ advised [auditors] that an increasing workload, combined with reductions in staff, have caused the delays in performing required inspections,” the audit reads.

According to the audit, the health care office estimated it would need about 68 additional surveyors in order to inspect all the facilities annually, as required.

Health care officials told auditors that they requested and received additional staff as part of their fiscal 2015 budget, but they did not disclose the number of additional workers.

Patrick Dooley, chief of staff and assistant secretary for regulatory affairs at the Maryland Department of Health and Mental Hygiene, confirmed Thursday that the office will hire more employees but could not immediately say how many.

The Office of Health Care Quality is an entity within the regulatory services unit of the health department.

In addition to increasing staff, Dooley said, the office is “taking a hard look” at the way employees conduct inspections to see if those surveys can be done more efficiently.

“Over the years, the things they’re supposed to review at these facilities continues to grow,” Dooley said. “They’ve just been adding one thing after another to the checklist. So they’re taking a step back and reviewing whether the things they’re looking at are really the most important things to look at.”

Health officials told auditors that earlier this year, staffers began using “targeted surveys” — which means some facilities need to be inspected more thoroughly than others, Dooley said.

“One size might not fit all,” Dooley said. “It might depend on how long they’ve been in business, whether they’ve had problems in the past. … If certain providers need additional follow-up, they should receive more attention, but if there are providers that have consistently had a good track record, do we really need to do a full review every year?”

Dooley said the state health department has been concerned about the problems with inspections for years, but he couldn’t say why nothing had been done over the past decade to address an issue auditors have been identifying since 2004.

“I can’t comment on what happened before, or why things got to be the way they did,” he said. “But now we’re really making an effort across the board to make it better. This is a work in progress.”