County To Appoint “Much Needed” Nursing Home Inspector

CALIFORNIA—On Tuesday, May 26, the Los Angeles County Board of Supervisors (BOS) unanimously voted to – for the first time ever – appoint an Inspector General to monitor skilled nursing facilities (SNFs).

Such nursing facilities allegedly account for 53 percent of all COVID-19-caused deaths in the county. As of Tuesday, there have been 5,311 SNF residents who contracted the virus, of which 1,028 have died. These statistics represent the 90.7 percent of Los Angeles county SNFs that reported their cases to the California Department of Health.

The motion to create the position was submitted by Supervisors Kathryn Barger and Mark Ridley-Thomas; view it here. It describes the role as a “much needed accountability measure.” 

“While some skilled nursing homes may be doing their best to respond to COVID-19, we’ve seen hundreds of deaths at these facilities, tragically exposing the urgent need for stronger oversight across the industry,” Ridley-Thomas said. “Now, more than ever, we must act to address any questionable operations and substandard conditions in the facilities that care for some of our most vulnerable residents – the elderly, the low-income, and the disabled.”

The key responsibility of the Inspector General will be to develop an in-depth report on SNFs in the county. According to the motion, the report should:

  • “provide an evaluation of SNFs within the County, and recommendations on operational and programmatic changes necessary to improve the County’s monitoring and oversight of these facilities.”
  • “include legislative and regulatory recommendations aimed at improving operations within these facilities.”
  • “be completed in consultation with the Auditor-Controller, directors of the health and social services departments of the County, County Counsel, and other appropriate department leaders.”

The Inspector General is meant to be appointed by July 1, 2020, and should hand in a proposal containing potential report content and a report-completion timeline by August 1, 2020. They must then provide “interim reports” every 60 days until they complete the final report.

“Skilled nursing facilities provide critical care and support for many of our most vulnerable populations,” Barger stated. “As the County fights the COVID-19 public health crisis, we must greatly improve our ability to assess and oversee these facilities to ensure the safety and well-being of all those who have been entrusted to their care.”

By approving the motion, the BOS also approved a proposal to appoint an Auditor-Controller to keep close watch of skilled nursing facilities.

The Auditor-Controller should:

  • “design a publicly available dashboard, consistent with State requirements, to be updated and posted on a weekly basis by the Department of Public Health (DPH).”
  • “assess DPH’s Facility Inspection Division’s (HFID) ability to monitor and ensure compliance with the COVID-19 Mitigation Plans.”
  • “work with the Chief Executive Officer, Director of the Department of Human Resources, County Counsel, and the Director of DPH to ensure there is the necessary staffing, expertise, training, enforcement protocols, and other functions required to support this monitoring and enforcement effort.”

The “dashboard” will ideally contain statistics regarding cumulative and current COVID-19 case numbers, monthly COVID-19 test numbers, the implementation status of each location’s COVID-19 Mitigation Plan, and other necessary data. All metrics will cover SNFs only.

In response to a Tweet by the BOS announcing the motion’s approval, Matt Pence commented: “53% of the deaths are in nursing homes, and this took 10 weeks?!?  While I believe that there are steps being taken in the right direction, this is a big fail.”

No prospective candidates for either position have been announced publicly thus far.