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L.A. County orders audit of department over nursing home complaints

Supervisors criticize health officials over a report that complaints about nursing homes are not always thoroughly investigated. Officials say the inquiries are done, but the paperwork isn't always finished.

March 04, 2014|By Abby Sewell and Eryn Brown
  • L.A. County public health director Jonathan Fielding, shown in 2013, told county supervisors that all complaints about nursing home conditions are investigated, but final reports sometimes are not completed.
L.A. County public health director Jonathan Fielding, shown in 2013, told… (Al Seib / Los Angeles Times )

Los Angeles County supervisors ordered an audit Tuesday of how the county's Public Health Department investigates complaints about health and safety issues at nursing homes.

Members of the county board sharply criticized health officials over a report that complaints were not always thoroughly investigated.

An investigation by Kaiser Health News found that public health officials told inspectors to close certain cases without fully investigating them in an effort to reduce a backlog.

The report cited internal memorandums in which public health supervisors told inspectors to close complaints that were submitted anonymously. Other cases were to be closed by looking at previous reports on the facility in question, rather than conducting a full investigation of a new complaint, according to the report.

During their weekly meeting, county supervisors said they were caught off guard by the disclosures.

Supervisor Michael D. Antonovich noted that he successfully pushed for a publicly posted grading system for nursing homes, similar to that used for county restaurants. "These actions by the public health department make a mockery of that whole system," he said.

Public health officials said the department investigates all complaints about nursing home conditions, initiating an inquiry within 24 hours for serious cases and within 10 days for less urgent allegations. They acknowledged that final reports sometimes were not completed for cases where no violations are found, due to lack of staffing.

"We've done the actual work," department Director Dr. Jonathan Fielding told the board. "What we've not done is issued all the reports."

Fielding said he learned only Monday that the state was launching an audit of the county's investigation process. He said the department had already changed its procedures and now conducts more extensive investigations of each complaint.

In an interview after the meeting, Fielding and other officials said some internal communications were taken out of context in the report, but declined to provide copies of the documents involved. Cases stemming from anonymous complaints were to be closed only after an investigation concluded that they were unsubstantiated, department Deputy Chief Director Cynthia Harding said.

Anita Gore, a spokeswoman with the California Department of Public Health, said the county's complaint investigation process had not been properly approved by the state and conflicted with state protocols. The county was ordered to suspend the process, and state officials were investigating a sampling of cases to see if they were properly investigated and processed.

Gore said more than half of the state's 4,725 open cases involving nursing home complaints were in Los Angeles County.

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