- The Washington Times - Saturday, November 19, 2011

The Maryland agency responsible for inspecting health-care facilities failed last year to conduct annual, mandatory checks at more than half of the state’s assisted-living homes, according to a new audit.

The audit by the Office of Legislative Audits found Maryland's Office of Health Care Quality (OHCQ) failed in fiscal 2010 to perform inspections at 53 percent of the facilities and failed to inspect more than 75 percent of care providers for the developmentally disabled.

Inspection records at the agency — within Maryland’s Department of Health and Mental Hygiene — have been a problem for much of the past decade, and state health officials often blame the situation on heavy workloads and under-staffing, legislative auditor Bruce A. Myers said.

“If you’re not going to get more resources, maybe you have to make some changes,” he said.

The agency licenses and certifies all of the state’s health-care facilities and is required to inspect them at least annually to make sure they are compliant with state and federal regulations governing patient care, safety, living conditions and record keeping.

From July 2009 to June 2010, the state failed to inspect 725 of the state’s 1,367 licensed assisted-living facilities, which provide housing and support primarily for the elderly. The state also failed to inspect 154 of the state’s 201 care providers for the developmentally disabled, according to the report released this month.

Laura Howell, a health-care advocate and chairman of the Maryland Developmental Disabilities Coalition, said ensuring proper care at the facilities is especially important because many patients’ physical and mental limitations make them more vulnerable to abuse and neglect.

She said activists have lobbied heavily in recent years for OHCQ to receive more state funding, but the agency has continued to struggle despite sincere efforts to do its job. The agency employs about 190 workers but is understaffed by 92 positions, according to a response letter to the Office of Legislative Audits.

OHCQ really tries to maximize the resources that they have,” Ms. Howell said. “The reality is they don’t have the staff needed to do the workload they’re required to do. … But the underlying reality is that, of course, there should be accountability.”

Agency director Nancy B. Grimm said the agency has struggled to visit every care provider but has kept tabs on facilities by working in partnership with other agencies.

She said the state’s Department of Aging and the Developmental Disabilities Administration have been monitoring health-care facilities and that they and the facilities often report possible violations to OHCQ.

Despite under-staffing, Ms. Grimm said, all facilities receive some type of monitoring from one of the three agencies and that OHCQ steps in to inspect facilities when concerns are raised.

“We are very, very fortunate to have that collaborative approach,” she said. “[It] gives us another mechanism by which we can be notified, even if we’re not out there as often as we’d like to be.”

Ms. Grimm also said the agency is working to improve its efficiency and had several vacant positions unfrozen this month that are expected to be filled in coming months.