How Delaware is clearing its backlog in surveying long-term care facilities
Delaware has almost cleared a backlog in the state’s inspections of long-term care facilities, getting closer to a goal of surveying nursing homes and assisted living facilities on an annual basis.
The state Division of Health Care Quality Director Corinna Getchell testified Tuesday, Feb. 20 at the Joint Finance Committee meeting that outside contractors have helped reduce the backlog in annual surveys.
Of the 81 long-term care facilities that Delaware is responsible for surveying annually, there are only seven nursing homes that are now overdue for a survey and two are being handled currently, Gretchell said.
“With (contractors) assistance, the Division of Health Care Quality has been able to complete significantly more surveys and investigate more complaints and intakes,” she said. “The total number of nursing home and assisted living surveys completed represent double the annual surveys and 151 more intake investigations than in 2021.”
The state's backlog on complaints for nursing homes and assisted living facilities has reduced 40.5%, from 1,474 total complaints in March 2023 to 877 currently, according to the division.
Efforts to improve Delaware’s policing of long-term care facilities were prompted after a Delaware Online/The News Journal investigation last year found the state has failed to investigate complaints of abuse, neglect and falls at these facilities in the past decade. A congressional investigation into the issues nationwide confirmed Delaware Online’s reporting.
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Delaware’s struggle to police long-term care facilities
Delaware Online’s 2023 investigation found:
The Division of Health Care Quality, as of March 2023, had 1,474 complaints for nursing homes and assisted living facilities in its backlog. Data analyzed by The News Journal showed that since 2013, assisted living complaints overall had been investigated less than nursing homes.
From 2013 to 2021, an average of about 22% of the assisted living complaints filed were investigated by the state each year. Nursing home complaints, in comparison, had an average investigation rate of about 49% in that time period.
The state has chronically struggled with hiring and retaining staff to investigate these facilities, in part because of low salaries. The division has asked for additional funding in recent years but has been repeatedly denied by the governor’s office.
The congressional report found that many states, including Delaware, have a backlog of nursing home inspections because of a lack of federal funding, which has prevented states from having the necessary amount of inspectors.
FEDERAL REPORT: Delaware among states that struggle to provide nursing home oversight. What we know
This report did not focus on assisted living facilities because they do not fall under federal oversight.
Improving long-term care oversight
Gretchell said the division currently has seven vacant positions out of 70, which includes one investigator and six surveyors. The time to train and get an employee prepped to conduct surveys and investigations on their own can take up to a year, she said.
"It must be noted that the surveyor training process can take approximately one year," Gretchell said. "Therefore, even if new staff were hired, there will be a gap until these staff are qualified to survey independently."
The state has contracted with Healthcare Management Solutions to complete the surveys at a cost of $800,000.
“The contractors have also assisted in completion of (other surveys) and have trained staff in areas where (the Division of Health Care Quality) lacked training resources,” she said.
The Delaware General Assembly also approved increased Medicaid reimbursement rates for long-term care facilities, funds which have yet to be dispersed. State officials said they hope the funding will assist nursing homes and assisted living facilities with attracting and retaining staff through increased pay.
RELATED: Where are the inspectors? How a lack of nursing home oversight is endangering residents.
Delaware long-term care facilities are required to follow minimum staffing ratios under Eagle’s Law.
State lawmakers questioned whether the increased reimbursements would fund needed pay hikes for staff at nursing homes and assisted living facilities, which they said had been the hope when the rates were increased last year.
“There is no clear compliance component on this…so it would be difficult to enforce something that is not there,” Gretchell said.
Got a tip? Contact Amanda Fries at afries@delawareonline.com, or by calling or texting 302-598-5507. Follow her on X at @mandy_fries.
This article originally appeared on Delaware News Journal: How Delaware is clearing its long-term care survey backlog
