State audit report reveals delays with nursing home inspections in North Carolina

WILMINGTON, N.C. (WECT) -A 59-page report released by the North Carolina Office for the State Auditor revealed several issues with the oversight of nursing homes in the state from the Department of Health and Human Services Division of Health Services Regulation.

The report states the DHHS did not conduct timely inspections at 289 nursing homes from March 1, 2021, through Dec.1, 2023. There are 425 nursing homes across North Carolina. Federal regulations require nursing home inspections to be completed at least once every 15 months.

The State Auditor also states the Department of Health and Human Services did not complete investigations of complaints within the timeframe prescribed by state law, from Jan. 1, 2019, to Dec. 31, 2023. State law requires complaint investigations must be completed no later than 60 days after receiving the complaint.

According to the report, out of the 17,152 complaints that required investigations, 6,756 (39%) investigations were completed late.

“Because the Division’s inspections were late, nursing home residents were at risk of conditions that could have threatened their health and safety,” the report reads.

One example shared in the report is that inspectors found call bells from two residents that went unanswered for more than an hour: “One resident needed help pulling up her pants but was not provided assistance for more than an hour. The second resident waited between 45-60 minutes for a drink. The residents reported that the staff made them feel bad for asking for assistance.”

The report also states that the DHHS did not verify the correction of nursing home deficiencies found during inspections from Jan. 1, 2019, through June 30, 2022.

“In March 2022, the Division cites a nursing home for failing to prevent significant medication errors for 9 of 11 residents sampled during the inspection. Residents did not receive multiple medications including insulin for diabetes, heart medication for atrial fibrillation, pain medication for respiratory failure, anti-seizure medication to prevent seizures, and medication to prevent pulmonary embolism,” the audit reads.

In a response letter to the report, DHHS Chief Deputy Secretary of Health Mark Benton said the late inspections were due to COVID-19 and staffing shortages: “The NCDHHS team assigned to nursing home inspections and investigations has been understaffed and under-sourced for years. Without adequate staff, this team has struggled with both a 51% increase in complaints over the past 8 years and an increase in the severity of those complaints.”

Benton also stated that the administration’s last four recommended budgets included requests for additional staff, higher salaries, and improved benefits, but that the North Carolina General Assembly has not approved those requests.

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