Report 2006-106 Recommendations and Responses in 2012-041

Report 2006-106: Department of Health Services: Its Licensing and Certification Division Is Struggling to Meet State and Federal Oversight Requirements for Skilled Nursing Facilities

Department Number of Years Reported As Not Fully Implemented Total Recommendations to Department Not Implemented After One Year Not Implemented as of Most Recent Response
Department of Health Services 5 9 5 0

Recommendation To: Health Services, Department of

To ensure that district offices consistently investigate complaints and include all relevant documentation in the complaint files, Health Services should clarify its policies and procedures, provide training as necessary, and periodically monitor district office performance to ensure compliance. At a minimum, Health Services should clarify its 45 working-day policy for closing complaints by establishing target timeframes for facility evaluators, supervisors, and support staff to complete key stages in the complaint process.

Response

Effective May 1, 2012, the California Department of Public Health, Licensing and Certification Division (L&C), adopted a policy to align its complaint investigation process with the Centers for Medicare and Medicaid Services. L&C developed policies and procedures using the federal complaint investigation process and provided training to all staff including managers, supervisors, surveyors, and administrative support staff. During the training phase, all District Offices received directions and guidance on how to carry out the federal complaint investigation process and the timeframes for completing investigations. The federal complaint investigation process that L&C adopted sets the standard for all complaints to be investigated and closed within 60 days from when the investigation was initiated. L&C established a monitoring and evaluation system that ensures collective accountability among L&C staff from the field to headquarters in implementing the process and a more timely completion of the investigation.

  • California State Auditor's Assessment of Status: Fully Implemented
  • Completion Date: September 2012
  • Response Date: September 2012

Recommendation To: Health Services, Department of

To fill its authorized positions and manage its federal and state workloads, Health Services should consider working with the Department of Personnel Administration to adjust the salaries of its staff to make them more competitive with those of other state agencies seeking similarly qualified candidates. In addition, Health Services may want to consider hiring qualified candidates who are not registered nurses.

Response

CDPH has partnered with the Department of Personnel Administration (DPA) on the Health Facilities Evaluator reclassification project that aligns the pay structure of surveyors, supervisors, and managers to make them more competitive with other state agencies seeking similarly qualified candidates. The project has aggressive timelines and is moving towards completion. CDPH and DPA completed review of the reclassification package, which involved extensive field interviews and data/salary analysis in preparation for State Personnel Board (SPB) action in fall 2012. In preparation for SPB's action, CDPH and DPA are reaching out to labor relations to affirm the proposed changes affecting the bargaining units. If SPB approves the project in its entirety, we anticipate implementing the realignment of the pay structure in spring 2013.

  • California State Auditor's Assessment of Status: Fully Implemented
  • Completion Date: September 2012
  • Response Date: September 2012

Current Status of Recommendations

All Recommendations in 2012-041