Parties report progress
in care home inspections

Unannounced state inspections of adult residential care homes are working out well, say health and care home officials.

"Things are going well. We have no challenges," said Ron Gallegos, president of the Alliance of Residential Care Administrators and legislative representative for the Hawaii Coalition of Care Home Administrators. "We have a very good relationship with the (Health) department."

Dianne Okumura, chief of the Office of Health Care Assurance, said residents of the homes "like the opportunity to have someone come in and just talk to them and show they care abut them. The staff themselves feel very good about the visits. They feel they are getting a true picture of what's happening."

Care home operators fought a bill authorizing unannounced inspections for about five years before it passed in 2003. They argued that surprise visits would trample on their constitutional rights and disrupt their programs.

Agencies and organizations concerned about the health and safety of vulnerable residents in the homes strongly backed the inspections.

Okumura said inspectors made 391 unannounced visits from February through December last year and found 122 deficiencies at 33 homes.

Problems mostly involved documentation, physical environment -- such as someone blocking access in and out of the home -- and some medical administration issues, she said.

In some cases residents were left unattended, "so that got fixed right away," she said.

No penalties were necessary, she said.

From January through March this year, the inspectors made 59 unannounced visits and found no deficiencies, she said.

The office had 69 complaints last year and has had 18 so far this year -- a drop from 25 for the first quarter last year, she said.

"We're getting a number of complaints regarding lack of supervision of residents, some quality-of-care issues, neglect and unlicensed settings," she said.

Complaints are investigated within 24 to 48 hours, especially those concerning quality of care, Okumura said.

Meanwhile, she said, "We are still waiting for our draft rules to be approved by the governor. Once that goes into effect, we should see more improvement."

A task force was appointed in 1999 to draw up new rules for the care homes, and a draft was proposed in 2003. Changes have been made to address concerns, and the rules have been going back and forth between the Department of Health and the Governor's Office. They're now under review by the state attorney general's office.

AARP State Director Barbara Kim Stanton said the rules have not been updated since the mid-1980s, and "they are an important part of assuring quality care in care homes. They address things like an increase in staffing requirement and ongoing education and training, which we believe are essential to have high-quality level of care at care homes."

Gallegos said there are about 500 to 505 residential care homes with about 3,000 residents. According to a study a few years ago, 10,000 more adult residential care beds will be needed in Hawaii by 2015, he said.

The supply trend is going down instead of up, he said, noting operators of 25 homes retired last year because of age.

Most homes are full now, he said, and the operators are "grossly underpaid" for the type of care required, making an average of about $1.42 per hour for 24-hour care per resident.

They were hoping to get a raise from the Legislature this year, but a proposed increase of 7 cents an hour was reduced to 3 cents, Gallegos said.

That is the first raise for the operators in nine years, he said, while "even minimum wage got 50 cents (more)."