In the wake of published reports that District inspectors routinely tell owners of nursing homes, group homes, clinics and other facilities when inspections will be held, the director of the city's inspection agency said yesterday she is considering changing its policy.
In a hearing before the D.C. Committee on Human Services on a bill to force the city to impose fines or receivership on badly run homes, Frances Bowie, director of the Service Facility Regulation Administration, said owners may no longer be warned when inspectors will arrive.
"As a result of the recent allegations of the quick-fixing on advance inspections, we are taking a look to see if unannounced inspections for all facilities" would be better, she said.
The Washington Post reported recently that many city-run and private facilities routinely are called by Bowie's employes and told when city inspections will take place. As a result, many facilities hire temporary nurses to increase its staff-patient ratio to the legal minimum and engage in unusual clean-ups of the premises and residents.
Councilwoman Polly Shackleton, who introduced the bill to require so-called "intermediate sanctions" against delinquent homes,criticized city officials for allowing unclean and dangerous conditions to continue in the homes for years.
She questioned why Bowie's agency has a months-long backlog of inspections to perform, yet only requested two more inspectors in next year's budget. Shackleton also noted that none of the $2.2 million for computer services that the city appropriated to the Department for Consumer and Regulatory Affairs (DCRA), which contains the agency, will be used for inspections.
Shackleton also criticized the agency's lack of attention to citizen complaints about poor care in nursing homes and group homes.
"We get calls from a large number of citizens who say they've called DCRA and told a backlog or other priorities prevent them from getting their complaint acted on."
Bowie said that "workload and shifting priorities" delay inspections and complaints. But she said the city acts within 24 hours of a serious complaint and within one month on other complaints.
The agency's own records, however, do not support this. Complaint files show that most were investigated months, even years, after the agency received them.
In response to questions, Bowie said her agency "is reviewing" conditions at Hope Village, which runs eight community residence facilities in Southeast Washington and has a long history of inspections that find poor sanitation, improper handling of drugs and overcrowding. Conditions at the facilities came to light in recent stories by The Washington Post and by WDVM-TV, Channel 9, which used hidden cameras to record drug use by residents.
"This has now been a couple of weeks" since the press exposure, Shackleton said to Bowie. "I wonder how much longer we will have to wait?"
Bowie said a report would be finished in two weeks, but did not clearly agree to give it to the council.
A wide range of groups, from the American Bar Association to the Hospital and Health Care Employees' Union, testified in support of the city imposing fines on homes that don't meet minimum health and safety standards and protecting residents from improper transfers.
"This legislation has been needed for years," said Anne Hart, a former health inspector and employe of Legal Counsel for the Elderly, an organization that gives free legal help to the elderly. "There have been persistent problems."
Beatrice Murphy Campbell, a member of the mayor's task force that recently rewrote the city's nursing home rules, said, "Let's stop standing around collecting salaries and stock market dividends from human conditions too intolerable to even contemplate without revulsion."
The City Council gave final approval recently to a DCRA bill that sets up a system of fines, but does not include the receivership or transfer protections in Shackleton's bill. John Fenton, counsel for the Committee on Human Services, said the two measures would probably be merged.
Some 27 states have the power to impose fines on poorly run homes, an important weapon because the lack of bed space in the District makes the city's current threat of closing homes an idle one, noted Nancy Coleman, a local representative of the American Bar Association.
"In the eight years I've been in the District, the same facilities continue to have the same problems," Coleman said. "The committee should consider escalating the fines for repeat violations."