Executive Summary

Issue 1: Greater Public Protection Could Be Achieved If The West Virginia Nurse Aide Abuse Registry Was Reviewed More Consistently and If It Was Required to Be Reviewed by Other Health Care Providers.

The Legislative Auditor found five nurse aides on the West Virginia Nurse Aide Abuse Registry that were working in nursing homes in direct violation of federal regulation several months or years after their names had been placed on the registry. While not in violation of state or federal regulations, 52 additional individuals on the abuse registry continued to work in other health care environments such as state hospitals, home health care services, behavioral health facilities, children's services, county senior services, assisted living facilities and ambulance transport services. Work as care-givers presents a proven risk to vulnerable populations such as the frail elderly, disabled adults and children. The Legislative Auditor surveyed 14 states, and found that seven of those surveyed prohibit nurse aides on the abuse registry from continued employment in health care settings other than nursing homes.

The Department of Health and Human Resources' Office of Facility Licensure and Certification (OHFLAC) also has a responsibility to create policies and procedures that will mitigate the problem of re-employment of proven abusers. Other states keep abusers away from vulnerable populations by limiting the types of health care settings where uncertified nurse aides can be employed. Changes in state statutes could achieve this goal. Another need all states are experiencing is the need for a national registry of nurse aide abusers. DHHR should explore how to establish such a national registry.

Issue 2: Complaint Response Times for Legally Unlicensed Health Care Facilities Are Improving But Further Improvement Is Needed to Increase Public Protection.

The Office of Health Facility Licensure and Certification (OHFLAC) is responsible for oversight of all health care facilities, including Legally Unlicensed Health Care Homes. Unlike all other types of long term care or assisted living facilities, legally unlicensed facilities do not receive annual inspections from OHFLAC. The only time OHFLAC inspectors visit legally unlicensed facilities is in response to a complaint allegation. The Legislative Auditor found that OHFLAC's complaint response time has improved; however, further improvement is needed in order to assure public protection.

Other areas of concern are the manner in which priority codes are assigned to complaints and the lack of management information. OHFLAC was unaware of how late its response times were until they were informed by the Legislative Auditor. As the nature of complaints are serious, it is in the public's interest for OHFLAC to continue improving the response times so that they are in compliance with their own policy.