Health facility inspectors overworked, Idaho budget committee told

BOISE – The Idaho agency responsible for investigating complaints against hospitals and nursing homes has a backlog of 135 cases.

“We’re barely avoiding financial penalties for our ability to meet all federal performance standards,” Tamara Prisock, administrator of the Division of Licensing and Certification for the state Department of Health and Welfare, told legislative budget writers Tuesday. The agency is plagued by heavy turnover due to stress and an unmanageable workload, she said.

Gov. Butch Otter is recommending a modest budget boost to add four more health facility surveyors next year. Priscock said two patient deaths at Idaho assisted-living facilities in the past year spurred complaints. At one, in Idaho Falls, an elderly woman with dementia wandered away from the facility and died. The facility received a serious citation for insufficient supervision. The second case, from the Treasure Valley, is under investigation.

Senate Finance Chairman Dean Cameron, R-Rupert, said the budget request seems reasonable.

“I don’t have a better answer for it, so I think that’s the best answer at this point, is better training and add personnel,” he said.

The additional request will cost $72,500 in state funds next year to be paired with $274,700 in federal matching funds.

Sen. Dan Schmidt, a Moscow Democrat and physician, said he’ll support it. But he said he wonders if that’s enough.

Prisock detailed a backlog of 275 overdue surveys, 135 open complaints awaiting investigation and 11 facilities waiting for initial licensing or certification surveys. And that doesn’t count the 3,166 regular surveys due in calendar year 2015 or additional complaints that regularly come in, hundreds a year.

Turnover has plagued the division, Prisock said, with one worker leaving in 2011, six in 2012, 13 in 2013 and 11 in 2014. For the first three of those years, pay was the main reason the surveyors said they left; after lawmakers approved a pay adjustment last year, the primary reason cited in 2014 was workload and stress.

“Pay is no longer the primary reason surveyors leave the division,” Prisock said. “We must do more to address the workload.”

The division has 26 health facility surveyors for more than 500 facilities, and eight surveyors for 300 residential assisted-living facilities. It has nine surveyors qualified to survey the 2,200 certified family homes; and two to survey 140 developmental disabilities agencies.

“Although we continue to struggle with turnover, our productivity has increased,” Prisock told lawmakers. The division currently has five vacancies, and eight of its employees are eligible for retirement in 2015.

Rep. Marc Gibbs, R-Grace, the House Appropriations vice chair, asked Prisock if facilities are being faulted for things like wheelchairs facing the wrong way. “I get complaints that our inspections are much more stringent than in Utah,” he said.

She responded, “If we’re talking about Medicare and Medicaid certification, the requirements are the same across the nation.”

She said there’s no regulation on which way wheelchairs should face. But she said there could be some variations among states as to their approach.

The issue came up as legislative budget writers entered their second day of a week of budget hearings on divisions of the giant Department of Health and Welfare.