Wisconsin:Lawmakers OK audit of nursing-home regulation

[NRSKarenRN, BSN, RN]

News series on vulnerable population prompts study

By MARY ZAHN

of the Journal Sentinel staff

Last Updated: Oct. 3, 2001

http://www.jsonline.com/news/metro/oct01/audit04100301a.asp

A comprehensive audit of how effective the state is in regulating and overseeing assisted-living facilities and nursing homes was unanimously approved Wednesday by the bipartisan Joint Legislative Audit Committee.

The audit request was the result of a three-day Journal Sentinel series in August that reported on hundreds of vulnerable elderly and disabled people in assisted-living facilities who had been injured or put at risk - often by caregivers who were poorly trained or stretched too thin. The problem is compounded by too few state regulators and a confusing array of rules governing the homes.

In addition, the series reported that more than 10,000 of the state's disabled or elderly residents who want to stay in the community or live in an assisted-living facility have been forced to wait for months or even years for assistance that the state promises but fails to deliver. Finally, the nursing home industry - seen as the last option for people needing long-term care - is crumbling under the financial burdens caused by inadequate Medicaid payments.

"The hope is that the audit will show ways we can improve the system," said Peggy Krusick (D-Milwaukee), who in addition to asking for the audit is working on legislation to address specific issues raised in the series.

According to Krusick, areas to be covered in the audit include:

*Current state and federal regulations and whether they are effective.

*The effectiveness and role of state inspectors in identifying and correcting poor conditions.

*Whether financial penalties deter facilities from allowing poor conditions to develop or continue.

*Whether enforcement activities among the state Bureau of Quality Assurance regional offices - charged with regulating assisted living facilities and nursing homes - are consistent statewide.

"Concerns have been raised in recent months regarding the extent to which patient care and safety are ensured through the inspection process," Janice Mueller, state auditor, wrote in a Sept. 27 memo to the Joint Legislative Audit Committee. "Some legislators are concerned about alleged inconsistent application of nursing home regulations by survey teams. Other legislators have expressed concern about quality of care and patient safety in assisted living facilities as a result of a series of articles in the Milwaukee Journal Sentinel."

Mueller, who wrote the background memo at the request of the committee, said Wednesday that the audit would begin in November. She added that she did not expect it to be completed until next summer.

"There are 2,142 assisted living facilities and 465 nursing homes, so it will be a major task to try to independently assess the extent to which patient care and safety is ensured through the inspection process," Mueller said.

Appeared in the Milwaukee Journal Sentinel on Oct. 4, 2001

Check out the Special Report that triggered this audit:

Caring for Elderly, Disabled: Overwhelmed and Broken Down

http://www.jsonline.com/news/state/aug01/care26082501a.asp