The District government's practice of alerting some facilities in advance of health inspections will end Sept. 3, according to a newly written policy.
The Service Facility Regulation Administration, which is responsible for inspecting 1,061 health and social service facilities, including nursing homes, hospitals, dialysis centers, boarding homes and child care centers, no longer will announce visits in advance.
Residents and staff of city and privately run facilities of all types have told The Washington Post that city inspectors routinely would call ahead and arrange their inspections. As a result, premises were hastily cleaned, extra staff was hired temporarily, food was improved and residents received long-neglected personal care, The Post was told.
Frances Bowie, director of the D.C. agency, recently testified that only hospitals, clinics and community residence facilities were notified ahead of time and that it was done "for the convenience of the facilities." The facilities needed time to gather records and make sure all residents were available, she said.
Bowie testified before the D.C. City Council's Committee on Human Services, which is considering a bill to force improvements in city health inspections. City Council member Polly Shackelton (D-Ward-3), who sponsored the legislation, has criticized the city's announced inspections.
The policy is being changed, according to a statement by the D.C. Department of Consumer and Regulatory Affairs, "to make certain that inspectors will get the most accurate information possible about day to day conditions in the facilities."
Representatives of several unions, associations for the aged and legal aid groups in the District said the new policy could improve living conditions for the city's most vulnerable residents.
"It should make facilities stay up to standards on a more constant basis, instead of just when inspectors arrive," said Cheryl Fish, an employe of Legal Counsel for the Elderly, a group that assists senior citizens.
But researchers for the Institute of Medicine, a private think tank that is nearing completion of a two-year study of nursing home inspections in the United States, note that even unannounced inspections may not provide a true picture of conditions.
According to a draft of part of the report, researchers found that most inspections are no surprise because regulators schedule them approximately the same time each year. The institute recommends that regulators inspect homes between 9 and 15 months after an initial license is granted in order to find conditions as they commonly exist.