Following a national report released on May 11, which showed that only Nevada ranked worse than Michigan for living conditions for older adults, a new state auditor general report released last week revealed officials failed to visit in person, as required, long-term-care residences.
The timeline of the auditor general report of Michigan’s Long-Term-Care Ombudsman Program (MLTCOP) spans 31 months, meaning required visits were severely lacking prior to the COVID-19 outbreak in March 2020.
Among the report findings, not only did MLTCOP fail to visit most of the long-term-care facilities during the audit period, the percentage of facilities the ombudsmen did visit — four quarterly visits are required annually — ranged from 0 percent to 46 percent.
Part of the Michigan Department of Health and Human Services, according to the report, MLTCOP failed to:
- Establish investigation timeliness performance standards.
- Maintain sufficient documentation to support closing 27 percent of cases reviewed.
- Document the complaint intake date for 22 percent of cases reviewed.
- Document resident or guardian involvement or consent for 26 percent of cases reviewed.
Overall, the conclusion of the report was “not sufficient.” Included within its responsibilities, MLTCOP must provide residents of licensed long-term care (LTC) facilities such as nursing
homes, homes for the aged, and adult foster care facilities with access to ombudsman services through non-complaint related (quarterly) visits, complaint-related visits, virtual visits, and telephone calls.
The report states the Department of Health and Human Services needs to better monitor MLTCOP’s complaint investigation process to better serve and help protect the health, safety, welfare, and rights of the vulnerable individuals residing in LTC facilities.
Further, visitation restrictions placed on families and friends of LTC facility residents by health department epidemic orders were, for the most part, removed by April 2021; yet as mentioned in the department’s response and contrary to the SLTCO’s August 2020 announcement, MLTCOP ombudsmen were not instructed to resume their in-person visitations until March 2022.
In addition, the health department, in conjunction with MLTCOP, had not developed performance standards (targets) for its ombudsmen regarding how long it should take to complete complaint investigations, depending on the nature and potential risk of the complaint.
MLTCOP management’s identification of complaints open longer than 90 days is of little value for complaints relating to abuse, neglect, or eviction (involuntary discharge by an LTC facility), and the health department had not designed processes to monitor and evaluate the efficiency and effectiveness of MLTCOP’s handling of complaints.
“We consider this finding to be a material condition based on the significance of the exception rates, (the state’s Health and Aging Services Administration) and MLTCOP’s inability to evaluate the efficiency and effectiveness of all complaint investigations, and the potential safety risk to the vulnerable individuals residing in LTC facilities” the report notes.
The auditor general also cited MLTCOP’s failure to conduct all of the background checks of its ombudsmen to help protect vulnerable individuals residing in long-term-care facilities from potential abuse and exploitation. Background checks include establishing whether ombudsmen candidates have a criminal record or are on a national or state Sex Offender Registry.