Watchdog Agencies Release Initial Analysis of Skilled Nursing Homes

The Inspector General and Auditor-Controller Oct. 14, each released their initial reports detailing their ongoing investigation into skilled nursing homes. Supervisor Mark Ridley-Thomas called it a critical first step towards improving operations at these facilities, which have accounted for about 42% of Los Angeles County’s COVID-19 death toll.

Skilled nursing homes have been the epicenter of the pandemic in LA County, with about 16,000 infections and 2,500 deaths among patients and staff. In May, the Board of Supervisors approved Supervisor Ridley-Thomas and Chair Kathryn Barger’s motion directing LA County’s Inspector General to investigate skilled nursing homes for the first time. They also tasked LA County’s Auditor Controller with monitoring the facilities and creating a public dashboard showing their COVID-19 case totals, testing frequency, mitigation plan status, personal protective equipment supply and other information. The dashboard went live last month.

In his first interim report back to the Board, Inspector General Max Huntsman examined skilled nursing homes’ COVID-19 mitigation efforts and provided an overview of existing regulatory and oversight structures. He said subsequent reports will analyze the long-standing, complex issues that left many skilled nursing homes ill-prepared to prevent and control the rapid spread of COVID-19 and the systemic failures that have allowed substandard conditions to persist.

After posting the skilled nursing homes dashboard in September, Auditor Controller Arlene Barrera released her own first interim report, which pointed out the number of outstanding investigations into skilled nursing facilities. She noted that in addition to 5,407 open investigations, the Health Department’s or DPH, Health Facilities Inspection Division or HFID reported an additional 6,228 in-progress investigations related to other long-term care and short-term care health care facilities.

The Auditor Controller also confirmed that as of June 30th, HFID reported 10% of the 5,407 in-progress investigations had been prioritized at the level of “Immediate Jeopardy,” because the facility’s alleged non-compliance with one or more requirements has caused, or is likely to cause, serious injury, harm, impairment, or death to a resident.

Upcoming reports by the Inspector General and Auditor Controller are expected to include recommendations for addressing this backlog and for streamlining the process.