Report 2014-111 Recommendation 15 Responses

Report 2014-111: California Department of Public Health: It Has Not Effectively Managed Investigations of Complaints Related to Long-Term Health Care Facilities (Release Date: October 2014)

Recommendation #15 To: Public Health, Department of

To improve oversight of its district offices' complaint and ERI investigation process, Public Health should increase its monitoring of the district offices' compliance with federal and state laws as well as with its policies. For example, Public Health could accomplish this by directing its regional managers to spend more time at the district offices to enforce district office compliance with policies, or by directing its quality improvement section to review a random sample of investigations for quality and adherence to policy. Public Health should further establish a formal process to review periodically LA County's compliance with the terms of its contract, including compliance with the terms for investigating complaints.

6-Month Agency Response

CDPH Branch Chiefs have increased their visits to district offices, and increased regional meetings to ensure compliance with policies and procedures related to complaint and ERI closure. During these visits, the Branch Chiefs discuss complaint and ERI investigation monitoring with district office administrative, supervisory, and management staff.

CDPH has implemented a monitoring unit in LA County that consists of a former District Office Manager (retired annuitant), a Health Facility Evaluator Supervisor, and 2 Health Facility Evaluator Nurses. This unit ensures LA County's compliance with the terms of its contract, including compliance with the terms for investigating complaints. In addition, weekly calls occur between L&C Headquarters and LA County officials to monitor workload progress and provide guidance and direction as needed.

CDPH continues to review complaints and ERI for appropriate prioritization level, investigative process, and adherence to regulatory requirements and policy.

California State Auditor's Assessment of 6-Month Status: Fully Implemented

60-Day Agency Response

Beginning in September 2014, CDPH Branch Chiefs initiated visits to each district office to ensure compliance with policies and procedures including those related to complaint and ERI closure and will continue this during their quarterly visits. During these visits, the Branch Chiefs discuss complaint and ERI investigation monitoring with district office administrative, supervisory, and management staff.

CDPH has developed criteria for reviewing complaint and ERI prioritization and quality of investigations. Beginning May 2014, CDPH has used these criteria to conduct monthly reviews of a sample of complaint and ERI investigations in LA County. CDPH prepares a quarterly report of these reviews. These reviews will continue in LA County until April 2015. By April 2015, CDPH will add criteria for reviewing plans of correction and supervisory review to the LA County monthly reviews. By October 2015, CDPH will use the criteria to monthly review a sample of the investigations in district offices statewide.

California State Auditor's Assessment of 60-Day Status: Pending

All Recommendations in 2014-111

Agency responses received are posted verbatim.