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Health chief
urges flexibility
in inspections of
care homes

He says unannounced
visits would help keep
operators 'on their toes'

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By Treena Shapiro
Star-Bulletin

State Health Director Bruce Anderson said revising the state's rules on senior care homes may not prevent deaths like that of 79-year-old Chiyeko Tanouye, but they would allow the state more flexibility in setting standards for care home facilities.

A jury found Raquel Bermisa, the owner of a care home where Tanouye lived, guilty of manslaughter Friday for causing the elderly woman's death. Prosecutors said Tanouye died from complications from bed sores.

Anderson said the Health Department has been trying to revise "obsolete" rules so inspectors may drop by for random nonroutine inspections day or night, particularly in cases where they are investigating complaints.

Random visits would ensure care home operators are conforming with state standards, Anderson said. "That would keep them on their toes."

If operators are informed of an upcoming inspection, "they would correct any existing problems before we come," he said.

According to Anderson, inspections include examining the patients, determining the staff's qualifications and reviewing records. Bed sores like Tanouye's would be detected in this type of inspection, he said.

Perhaps 95 percent of care home operators are doing a great job, Anderson estimated, but he said, "We have had situations where care home operators have been neglecting those that they're caring for, and we certainly need the ability to check up on them day and night."

But some five-bed providers object to the department's being able to show up unannounced.

"They consider their care home a residence and feel it's an intrusion for us to inspect them," Anderson said. However, he stressed that these caregivers are running businesses and being paid to conform to certain standards.

Esther Ramos, administrator of Aiea Heights Rest Homes, said that at a larger care home center like her 23-bed home, unannounced inspections are no problem. "For us it doesn't really matter," she said. "We're always open; they don't have to announce it."

"It's a little bit harder for five-bed homes; they don't have the staffing; they don't have the owner there all the time, but here it's not a problem," Ramos said. "There's no pretension about anything because what goes on all the time is what you see."

The Health Department will be holding public hearings on the proposed rules changes in the coming months, Anderson said. In addition to unannounced inspections, the proposed rules will be altered to allow care home providers more flexibility in terms of staffing and building regulations.