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Sarasota Herold-Tribune

Stop duplicative inspections

By NINA WILLINGHAM Guest Columnist
Published: Wednesday, March 18, 2009 at 1:00 a.m.

Reading the March 13 article "Nursing home bill opens rift," one could wonder if the newspaper has an understanding of the oversight process of our state's nursing homes, which provide care to our most vulnerable citizens. I am the senior executive director at Life Care Center of Sarasota, a skilled nursing facility, where ensuring care around the clock for our residents involves an entire team of dedicated, caring individuals who put quality first.

Nursing homes have weeklong annual inspections by a surveyor team composed of nurses, dietitians, social workers, life safety experts and physician consultants. The Agency for Health Care Administration conducts these surveys for the state of Florida and on behalf of the federal government. The nursing home signs a contract with the state and federal governments to provide quality care in exchange for public funding through Medicaid and Medicare. In addition, the Ombudsman Program, Adult Protective Services and the attorney general's Medicaid Fraud Office investigate concerns within a facility.

The proposed legislation by Sen. Michael Bennett and Rep. Ken Roberson makes no program or policy changes that affect the care provided for residents by nursing homes. It simply eliminates duplicative inspections at a time when the state is tightening its belt and resources are limited. Nursing homes have been demonized in the public as uncaring and greedy, yet, despite being inadequately funded for the past several years, we have continued to lead the nation with the highest ratio of staff to patient care.

Since 2001 Florida's nursing homes have hired more than 11,000 certified nursing assistants to help improve our quality care for residents. And, all along the way, the state's regulatory process has evolved into multiple agencies and teams initiating duplicative processes, which affect our daily operations and often disrupt the services and care we are trying to provide.

When a facility is visited three times within a month from the Department of Health, AHCA and a local ombudsman volunteer, all to inspect the temperature of our refrigerator, for example, staff gets pulled away from its daily duties. AHCA surveyors are trained and certified in the facility's physical plant requirements. Are the state's resources being used wisely if DOH follows behind to conduct the same inspection?

The ombudsman's role is to advocate on behalf of the resident. In the past these volunteers have worked effectively on behalf of residents and their families and made referrals to AHCA when there were facility-specific concerns that would be more appropriately addressed by AHCA.

Now Florida's ombudsman is proposing to focus on facility inspections or assessments, which are a duplication of AHCA's work. These volunteers are not trained as pharmacy or nursing reviewers or dietary consultants, yet their checklists for these "assessments" are facility inspections, rather than a tool to help the residents find practical solutions to their problems and complaints.

These bills would not weaken oversight or strip any responsibilities from AHCA in regulating our nursing homes. They would simply streamline our state government so our staff can go back to the business of what is most important -- providing the highest quality of care for our seniors. Nina Willingham is senior executive director of Life Care Center of Sarasota, a 120-bed skilled nursing facility in Sarasota.

This story appeared in print on page A9