Feds say Missouri puts group home residents at risk with lack of regular background checks

The 2016 death of a man with developmental disabilities due to abuse and neglect prompted the U.S. Department of Health and Human Services too inspect Missouri's group homes, and a DHHS Office of the Inspector General report released Wednesday cites some continuing red flags.

Carl Lee DeBrodie, 31, was a resident of a Fulton group home when he was reported missing in April 2017. DeBrodie's body was later found entombed in concrete, with investigators believing he died some time in 2016. Sherry Paulo was sentenced to 17-and-a-half years in prison on federal charges after prosecutors deemed her the "most culpable" for DeBrodie's death.

From 2017: Police: Body in Missouri container likely of missing man

The Office of Inspector General audited 30 of the state's 218 individualized supported living providers in order to determine whether the Department of Mental Health's oversight of those providers ensured the health and safety of Medicaid recipients with developmental disabilities, and whether it had established infection control and prevention standards that prepared them for an emergency situation like the COVID-19 pandemic.

While the report found that the Missouri department ensured the health and safety of recipients with developmental disabilities, "improvements could be made."

No state requirement for post-hire background screening

After hiring, Missouri does not require providers to perform periodic background screenings of staff, so facilities that were audited had inconsistent policies. Nine of the 30 providers did not specify that periodic background screenings should happen at all, according to findings. Federal investigators found that one provider had five staff members that had not been screened in more than two years, even though the provider policy required annual screenings.

A lack of state-required background screenings after hiring could put vulnerable residents in danger, said the Inspector General's report: "There is an increased risk that some providers are not performing these screenings and that care is being provided by staff who have committed disqualifying crimes or adverse actions since the required screening they underwent when hired."

More: Cyrina couldn't roll over or lift her head as a toddler. A CPO program helped change that.

Some facilities lacked documentation of certification, training

The state completed 16 provider certification surveys after the providers' certification had already lapsed, and had trouble locating documentation of certification for five providers. The federal report said that without that documentation, potential health and safety issues may go unaddressed. The state said the lapse in certification was due to the COVID-19 pandemic and inability to conduct in-person certification surveys.

Of the 17 on-site inspections, six providers did not have documentation that staff completed required abuse and neglect training, which can result in "an increased risk that care is being provided by staff members who do not have adequate and up-to-date health- and safety-related training."

More: Justice Department opens investigation into whether Missouri is violating ADA

No state requirement for post-hire infection control training

The report also found that while the state had guidelines for training on infection control and prevention upon hire, there were no guidelines for refresher training, putting vulnerable residents at risk. That lack of refreshers creates "an increased risk that staff members who were hired prior to any policy updates will not be trained on the most current policies" or that long-time staff members may forget some or all policies from their initial training.

Susan Szuch is the health and public policy reporter for the Springfield News-Leader. Follow her on Twitter @szuchsm. Story idea? Email her at sszuch@gannett.com.

This article originally appeared on Springfield News-Leader: DHHS: 'Improvements could be made' to keep Missouri group homes safe