Report Attacks Oversight Of Homes For Elderly State Ombudsman Suggests Taking Responsibility Away From Department Of Health

If an elderly or disabled person gets poor care in a boarding home and someone complains, the state Department of Health is unlikely to take quick and decisive action, an ombudsman agency said Wednesday.

In fact, the agency’s oversight is so poor that jurisdiction over boarding homes should be shifted partly or fully back to the Department of Social and Health Services, the ombudsman said.

A report issued by the Washington State LongTerm Care Ombudsman criticized the department’s regulation of 400 boarding homes. Each home shelters between 10 and 60 people who need daily help with meals and medicines.

About 16,000 people live in boarding homes statewide. Another 8,000 people live in 2,100 adult family homes serving frail elderly or developmentally disabled people.

“These are our most vulnerable elderly and disabled citizens, people to whom we have a great obligation,” said ombudsman Kary Hyre.

His agency, funded by state, local and federal money and based in Federal Way, monitors enforcement of state laws designed to protect people in nursing homes, adult family homes and boarding homes. Although the giant DSHS oversees nursing homes and adult family homes, boarding homes were moved to the Department of Health in 1989.

The vast majority of long-term care homes provide good care, the ombudsman said.

But the report, based on investigative work by the ombudsman’s staff and volunteers, examined what happens when complaints are made about boarding homes and adult family homes.

Hyre said the state Legislature has worked hard to improve the quality of care for elderly and disabled residents, and DSHS has shown improvements within the past year.

“Unfortunately, the performance by the Department of Health is extremely disappointing and this report raises serious questions about (its) ability to protect residents,” he said.

The report recommends that oversight of boarding homes should be completely or partly moved back to DSHS.

“Our goal is that each concern is responded to rapidly and thoroughly so at the very least basic safety is assured and residents do not end up in the hospital or the morgue,” Hyre said.

Kathy Stout, director of facilities and services licensing for the Health Department, said Tuesday that her agency gives priority to complaints and responds to “immediate and serious complaints in a very short period of time.”

Stout said investigations might take longer because of a case’s complexity and the department’s small staff.

Jeff Crollard, author of the report, said the Health Department delayed investigations of abuse and neglect complaints against boarding homes “months and sometimes years” in a significant number of cases.

“Then when they did investigate, due to the passage of time, they were (often) unable to substantiate the complaint,” said Crollard, a lawyer with Columbia Legal Services who is legal counsel to the ombudsman program.

He also criticized the department for a conciliatory approach.

“Even when the problems were substantial, they would issue a consultation rather than a citation or penalty,” he said. For example, homes accused of neglect would rarely be cited for that, but would face a leser violation such as poor record keeping, he said.

Investigators for both DSHS and the health agency often failed to talk to the complainant, the resident or family members during their probe, he said.

The health department has one investigator for every 3,100 boarding-home residents, he said. By contrast, DSHS has one investigator for every 300 residents in adult family homes.

The report also recommends regulations requiring that complaints be responded to quickly depending on priority, that licensing inspectors interview residents and family members, and that substantiated complaints result in sanctions.

Judy Ostendorf of Spokane said four complaints were made about poor care or abuse of her mother at a boarding home. Investigations of the first three were delayed from eight months to one year, she said.

When probes began, she said, the health department said passage of time made the complaint impossible to verify, citing the home for a lesser violation instead.

She filed the last complaint herself, she said, but had to threaten agency staff with “going to the media” before an investigation was begun.