Vermont improves long-term care home inspection process
Vermont has made major improvements on inspection of long-term care over the past year, according to the Office of the Vermont Auditor.
An audit released on Oct. 22 displayed a significant shift in tone from May 2023, when State Auditor Doug Hoffer released a report criticizing the Vermont Department of Disabilities, Aging and Independent Living, DAIL, for “substantial noncompliance with regulations.”
The 2023 audit contended that over seven years the department had failed to perform state-mandated annual inspections on long-term care homes, had no procedures in place to ensure safety violations were remedied and seldom made use of “enforcement tools” to respond to issues that were discovered.
“Put simply, our audit found that DAIL’s efforts to ensure Vermonters living in assisted living and residential care facilities are safe were not good enough,” Hoffer said in a press release. “As someone who has had family members in long-term care facilities, I know Vermonters count on the state to make sure our peace of mind about their safety is well-placed.”
Both audits focused solely on the oversight of assisted living and residential care facilities which are regulated by the state, and excluded nursing homes which are federally regulated.
What improvements have been made?
In his press release, Hoffer listed several of DAIL’s most “notable” improvements this year:
- Started inspecting facilities annually. The previous audit found that yearly inspections were not happening, and that some facilities hadn’t been inspected for several years.
- Started requiring all new facilities to be inspected after residents and staff move in. In the past, the state agency only performed walk-throughs before new facilities opened.
- Reinspected and issued new reports on facilities that previously had unfinished inspection reports and “statements of deficiencies.” Hoffer described such reports as “a key tool to hold facility management accountable for the well-being of the vulnerable Vermonters they house.”
- Began communicating regularly with facilities about the most common problems found during inspections, a practice Hoffer suggested might help care homes better “address systemic problems more proactively.”
“Protecting the most vulnerable Vermonters is one of our government’s most sacred duties,” Hoffer said in his press release. “My audit team did a great job identifying opportunities for DAIL to perform better, and credit to DAIL for stepping up.”
What still needs to be done?
Despite DAIL’s many successes within the past year, the state agency has yet to implement all the recommendations outlined in the 2023 audit, Hoffer wrote.
Most notably, DAIL has yet to begin posting evidence of enforcement actions on its website, the department arguing it will need to consult their legal department first.
“Vermonters deserve this information, presented simply and transparently, prior to placing loved ones in facilities that may have a history of failing to correct the problems DAIL uncovers,” Hoffer said in his press release.
Below is a list of the remaining actions the state agency needs to undertake according to the follow-up audit:
- Add protocol requiring facility inspections after changes in ownership.
- Use the same “limited” strategies to track tendencies and consistent problems at care homes with a few exceptions.
- Expand the definition of “failure to correct a deficiency” to include outstanding issues identified during licensure and complaint inspections. “Vulnerable adults are at risk whenever deficiencies are repeated no matter what type of inspection identified the deficiencies,” the follow-up audit said.
While DAIL still has work to do, Hoffer wrote he is “very pleased that they’ve made positive strides,” adding that he is “especially glad that they are now performing annual site inspections,” which are pertinent for “staying on top of the conditions of facilities” and ensuring “safety issues don’t go undetected for long periods of time.”
A third audit on the agency’s progress will be performed in 2026.
Megan Stewart is a government accountability reporter for the Burlington Free Press. Contact her at [email protected].
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