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Request to State Auditor

Dignity Alliance Massachusetts has sent a letter to State Auditor Suzanne Bump, asking for a follow up audit of nursing facilities. The letter is copied below, or download the DAMAuditor Letter on Nursing Home Complaints.docx.

We appreciate the work you and your office reported in September 2019 regarding the unconscionable delays in complaint investigations of nursing homes by the Department of Public Health.  We would encourage you to conduct a follow-up audit for the period beginning July 1, 2018 through June 30, 2020.   

When your office conducted the audit of nursing home complaints July 1, 2016 – June 30, 2018, the Department of Public Health announced that they were increasing the staffing for investigations.  An audit for the subsequent two-year period would determine if that increased staffing proved effective in addressing all complaints in a timely fashion.

We believe that the number of complaints in 2020 will show a dramatic increase as a result of the limited investigations which have occurred due to the Covid-19 pandemic restrictions.  Additionally, care delivery in nursing homes has suffered due to staffing shortages and pandemic related issues. The absence of the onsite presence of Department of Public Health surveyors and long-term care ombudsmen, not to mention family members, is of great concern, since there have been “no eyes and ears” to observe, monitor, and address problems.

In addition to determining whether the systemic delay of investigations continued following your earlier audit, it would be helpful to know if there is a current backlog of complaints not yet investigated as well as a backlog of complaints unresolved, or even unaddressed.

Dignity Alliance believes that this information is critical to addressing residents’ treatment in the Commonwealth and achieving transformative reform of long-term care. Based on knowledge and belief, Dignity members are concerned that there may be a backlog of hundreds of complaints.

It would be also be worthwhile for the report, from the onset of the Covid-19 pandemic to be cross-referenced with data on deaths, to determine if residents under age 65 or those who are racial minorities have been disproportionately affected by the virus and whether nursing homes have been making sufficient effort to get residents back into the community.

The overuse and misuse of anti-psychotics and other psychotropic medications are also serious concerns and worthy of an audit, including determining the number of related complaints. Such an inquiry would be useful in addressing this longstanding form of abuse.  Please see Attachment A for background and concerns.

In addition, please look into the extent to which there are nursing home residents who cannot provide written informed consent to their care and treatment and have no guardian or health care proxy agent to consent on their behalf.

We look forward to hearing from you regarding our suggestions for a follow-up audit of the processing of nursing home complaints by the Department of Public Health and other serious issues.”