December 31, 2004
The state auditor general is recommending the Legislature keep the small state agency that licenses nursing home administrators, even as a second audit this month confirms significant mismanagement could be placing vulnerable adults at risk.
The broad review by the Auditor General’s Office released Thursday found that the Board of Examiners of Nursing Care Institution Administrators and Assisted Living Facility Managers has lengthy delays in investigating complaints against administrators, forcing the state to dismiss dozens of cases even when other state investigators have found abuse or neglect of elderly residents.
The board also fails to properly answer public inquires about the handling of individual complaints and discipline of nursing home administrators, the auditor general’s report says, and the agency doesn’t follow state procedures on awarding contracts and protecting cash payments.
Still, the state can’t afford to abolish the board, the report says. Separate licensing for nursing home administrators is required by a 30-year-old federal law tied to Medicaid funding, and it screens out incompetent or unqualified managers.
A Tribune investigation earlier this year into the agency prompted Gov. Janet Napolitano to veto a bill that would have extended the agency’s life for another decade. Instead, lawmakers gave the agency until July 2005 to correct problems.
In the first public response to both the auditor general audit and a separate review by the state General Accounting Office, agency executive director Victoria Martin said her office is struggling to recover from years of mismanagement under prior directors.
She blamed a limited budget of $370,000 and five fulltime employee positions as reasons the agency won’t follow many of the auditor general’s recommendations to improve operations.
Martin did support raising licensing fees for the second time in two years. That would allow the agency to hire additional staff members to pursue more timely investigations.
But a former board member, who first drew attention to the agency’s problems, said the Legislature should shift licensing requirements to the state Department of Health Services.
That department already licenses nursing homes and assisted living centers, and could handle the additional responsibility of regulating top administrators as well, said Connie Thompson of Tempe.
"This board, even from their response, have shown they don’t have the ability to regulate themselves," Thompson said. "This board will continue to fail to protect the public’s health and safety if left unchecked."
The auditor general’s report said 33 other states follow federal law by having a major regulatory agency handle licensing with a citizen board providing oversight. But in regulating a variety of health care fields, Arizona has preferred to create independent boards that use their own staffs funded solely from licensing fees, the report says.