State inadequately investigates nursing home complaints, audit finds

The California Department of Public Health has failed to effectively investigate nursing home complaints, a state audit released Thursday found, with a total of 11,000 unresolved complaints in its system.

The department, which is responsible for monitoring more than 2,500 nursing homes, classified more than 40% of these complaints and incidents as having caused or being likely to cause harm to a resident. Yet the state auditor’s office found that the average number of days these complaints were open ranged from 14 to 1,042 days.

The Santa Rosa-Redwood Coast district office had 102 open complaints and incidents that posed a threat to a resident’s health or life. On average those incidents remained open for almost a year, according to the audit.

Auditors said the California Department of Public Health oversight for processing complaints was inadequate, adding that until recently it had not established a system to track unresolved complaints. The agency had also failed to set time frames for when a complaint should be closed.


Nearly 1,000 of these complaints were against certified nurse assistants and home health aides. On average they remained unresolved for eight months, and 22% of them were in the two most serious priority categories, the audit found.

The department was also inconsistent in the quality of its investigations, auditors said. The San Francisco district office closed complaints without supervisors reviewing them in four of the 10 investigations that were examined.

Among the audit’s recommendations are for the department to establish and implement a formal process for monitoring the progress of open complaints and incidents for all of its offices. The audit also recommended that health officials establish a specific time frame for completing their investigations.

The California Department of Public Health said it was in the process of developing policies and procedures for complaints against nurse assistants and home health aides. But the agency said it disagreed with establishing time frames for investigations.

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