Lansing — The state agency responsible for inspecting adult foster care facilities and senior citizen group homes failed to notify authorities in the Michigan Department of Health and Human Services of patient neglect and abuse complaints, according to a state audit released Tuesday.
A report by Auditor General Doug Ringler says the state’s adult foster care licensing division did not report abuse allegations to the Adult Protective Services division within the department in 12 of 48 cases — 25 percent — that auditors sampled between Oct. 1, 2010, and Feb. 12, 2014.
“Although licensing policy requires staff to report all allegations of abuse, neglect and/or exploitation to APS, the division stated that staff did not consistently follow this policy because they believed that they should establish reasonable cause before making referrals to APS and that staff had varying interpretations of the facts that should warrant referral to APS,” state auditors wrote in their report.
The Adult Foster Care and Homes for the Aged Licensing Division also failed to ensure the facilities it regulates conduct background checks of all employees, according to the audit.
The audit’s findings prompted concern in the mental health community.
“We are going to review the entire audit report, but the audit summary is troubling,” said Linda Burghardt, president and CEO of the Mental Health Association in Michigan. “Many of our constituents reside in licensed AFC homes, and it appears that the DHHS licensing process has a number of flaws and needs immediate improvement.”
People with physical, mental or developmental disabilities who do not require round-the-clock nursing care may live in state-licensed adult foster care homes. Residents 60 years or older requiring supervised personal care live in state-regulated homes for the aged.
State auditors randomly selected 44 adult foster care facilities employing 1,574 workers and found six facilities had not conducted background checks on 12 employees.
“One of these employees had a conviction for a disqualifying offense that occurred prior to the employee’s date of hire,” state auditors said. “The licensee had employed this individual for over two years.”
State law prevents adult foster care facilities from employing people with felony convictions for abuse, neglect, cruelty, torture, criminal sexual conduct, prescription drug diversion or felonious use of a dangerous weapon.
State auditors notified the Department Health and Human Services of the conviction in May 2014, and the department informed the unnamed facility on July 3, 2014, that the employee was ineligible to work there, according to the audit.
Five of the adult foster care facilities and group homes for individuals over age 60 took an average of 217 days after employees were hired to conduct criminal background checks, according to the audit.
None of the residential facilities was named in the audit.
In response to the auditors’ finding, the Department of Licensing and Regulatory Affairs said it now requires inspectors to pull “one employee file for verification of criminal background check” during periodic and annual inspections.
State auditors also found the licensing division did not complete complaints against adult foster care facilities and homes within the required 30-day and 60-day time frames.
A sample of 76 complaint investigations between Oct. 1 and Feb. 12, 2014, showed 33 percent were not completed within the required time frame, with the average complaint taking an extra three weeks to be investigated, according to the audit.
“We determined that four of the 25 late investigations resulted in license violations, including fictitious medication logs, improper facility heating source and improper medication dispensing,” state auditors wrote.
Auditors also scrutinized the timeliness of annual on-site inspections of the residential facilities.
A random sample of 20 inspections of homes found 17 of them — 85 percent — were conducted an average three months late.
Officials at the licensing agency told auditors that annual inspections “may not have occurred timely because conducting complaint investigations and original licensing inspections were higher priorities,” according to the audit.