The federal agency that rates the quality or nursing homes in the Miami Valley is updating its five-star rating system to make it more accurate and more user-friendly. I-Team's Jim Otte reports that the system is designed to help families faced with tough decisions about where to put their loved ones.

Ohio nursing home inspectors have high turnover, miss deadlines

Ohio nursing home inspectors have high turnover and the Ohio Department of Health has failed for years to meet federal guidelines for timely regular inspections, according to a state audit.

The average time between nursing home inspections is supposed to be 12.9 months, but an audit of the Ohio Department of Health reviewed by the Dayton Daily News shows the department has failed to meet federal standards for annual nursing home inspections every year since at least 2011.

MAIN STORY: Staffing is a challenge for area nursing homes. Here’s what we know.

Ohio inspectors did, however, prioritize complaints and inspected within two days almost 100 percent of complaints of someone being harmed or at immediate risk of harm, which is the federal standard.

Ohio Department of Health said in a statement that it is making progress toward the federal guideline for the statewide average time between inspections to be 12.9 months or less. The agency’s statewide average time interval improved from 14.4 months in fiscal year 2015 to 13.7 months in 2017.

For 2018, the average time between surveys made more progress and was down to 13.5 months. 

Dr. Amy Acton, Ohio Department of Health director, told the House Finance Committee in late March that the state agency is currently seeking more funds in the next budget in order to hire additional long-term care inspectors and improve the frequency and quality of inspections.

Even though state inspectors are meeting standards for looking into complaints, it is important to have timely regular inspections because those inspections also catch problems that put residents at risk, said Brian Lee, former Florida ombudsman and head of a national nursing home resident advocacy group Families for Better Care.

“You still pick up those immediate jeopardies and actual harm incidents during the routine inspections,” Lee said.

Inspectors based in the field are on the road traveling to nursing homes and “the reality is that some new surveyors come to conclude that they don’t like such a work environment – and RNs in particular may have other job opportunities available to them,” Ohio Department of Health said in a statement.

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The health department is trying to address turnover by reducing its reliance on inspectors with RN backgrounds and hiring inspectors, when possible, with other backgrounds such as social work or dietetics.

More than 80 percent of inspectors have RN backgrounds — an in-demand degree — and inspectors with RN backgrounds are the primary driver of turnover.

The health department is also cross-training nursing home and long-term care inspectors and other department inspectors, such as those who survey Ohio’s ambulatory surgical facilities. Cross-training allows more work variety and flexibility, the department stated.

The audit showed that inspectors had 17 percent turnover in 2014, 23 percent turnover in 2015 and 18 percent turnover in 2016.

The average Ohio registered nurse makes $31.49 an hour, or $65,500 without overtime, according U.S. Bureau of Labor Statistics.

In 2016, the audit states that entry level RNs in Ohio made $24.90 an hour on average and RNs working as entry level state surveyors made $23.75 an hour.

For long term employees, however, it can be a lucrative job and after 13 years the pay rate is higher than average for nurses, the audit states.

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“Nursing across the board is at this point an in demand job and I think that the Department of Health is no different than any other industry that has to compete,” said Chip Wilkins, Dayton-area long-term care ombudsman.

Wilkins said, in his experience, nursing home inspectors look into complaints in a timely manner in the area.

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