Mass. Official Calls for Improvements in Nursing Home Abuse, Neglect Investigations

A top official in Massachusetts called on the state’s health department to improve its nursing home investigation efforts after an audit revealed significant delays in processing inspections of potentially deficient properties.

The Massachusetts Department of Public Health’s investigative unit failed to conduct on-site inspections of nursing homes within the mandated 10-day timeframe in 148 of 200 cases, according to the results of a probe launched by the office of state auditor Suzanne Bump.

Bump’s investigation focused on complaints classified as “non-immediate jeopardy high,” or the potential issues that fall below the most pressing “immediate jeopardy” episodes but still require swift attention — including allegations of harm, or situations that could potentially lead to harm if the situation is not rectified quickly.


The Centers for Medicare & Medicaid Services (CMS) requires states to prioritize investigations into such allegations within two working days, and formally inspect the property within 10 working days. During the audit period, which stretched from June 2016 to June 2018, DPH employees took an average of 41 working days to conduct such inspections; based on the sample data, Bump’s office determined that up to nearly 80% of the more than 1,500 total “non-immediate jeopardy high” investigations took longer than 10 days to begin.

“The Department of Public Health has an obligation to protect the residents living in health care facilities it oversees. If it receives allegations that a client is mistreated, physically or financially, the agency must be more vigorous and timely in investigating these claims,” Bump said of the audit. “I urge DPH to enhance oversight of abuse investigations to ensure vulnerable residents are not taken advantage of.”

DPH officials responded by acknowledging a staffing shortage at the time of the audit.


“To address the backlog, in 2018, additional staff were hired in the Complaint Unit,” the agency said in a statement responding to the state auditor’s report. “As of December 2018, due to hiring additional staff, there is no longer a backlog of intake cases.”

CMS has identified improvement of state-level enforcement agencies as a key part of its recent initiative to bolster nursing home quality and safety, asking Congress for additional funding for survey agencies and exploring ways to change the frequency of regular inspections.