Vermont has improved long-term care inspection process, state auditor finds

By ERIN PETENKO

VTDigger

Published: 11-10-2024 8:00 PM

The Vermont agency responsible for long-term care facilities has improved its inspection process, a year after the state auditor’s office published a report that uncovered multiple failures.

State Auditor Doug Hoffer released a follow-up report Tuesday outlining those improvements, while highlighting a few remaining categories where the Department of Disabilities, Aging and Independent Living still hasn’t met last year’s recommendations.

Hoffer said he was pleased the department adopted a number of his office’s recommendations.

“Protecting the most vulnerable Vermonters is one of our government’s most sacred duties,” he said in a press release. “My audit team did a great job identifying opportunities for (the department) to perform better, and credit to (the department) for stepping up.”

In its initial report, the auditors found the department had not inspected some long-term care facilities for years, which was in violation of state statute. It also found the department failed to follow up on severe deficiencies uncovered during some of its inspections, including resident deaths, for months after the initial inspection.

The follow-up report found the department developed a system to track its annual inspections and has inspected the facilities that had gone the longest without an inspection.

Carol Scott, the department’s long-term care manager, said via email that the new system includes an electronic tracking tool that she monitors daily. Scott also leads the department’s newly created State Long Term Care Survey and Certification Team, composed of three nurse surveyors, which focuses solely on overseeing regulatory compliance.

According to the auditor report, the department also created new procedures to inspect newly opened facilities after residents move in, and has begun sharing information about frequent deficiencies with other facilities to help address systemic issues in the industry.

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However, the department has not implemented a suggestion to expand its definition of repeated deficiencies to those uncovered during licensure and complaint inspections, which the initial report claimed was a loophole in the process.

Scott wrote that expanding the definitions would be outside the department’s jurisdiction because it would make assumptions about facilities that fall outside of state regulations.

The report also noted the department has not followed the auditor’s recommendations to make its enforcement actions public on its website. Scott said the department needed legal consultation to determine whether it could post enforcement actions.

The auditor’s office typically follows up with initial reports one year later and three years later to see what has changed. Hoffer said he welcomed the opportunity to share positive news.

“They perceive the auditor’s office as the guys who are going to tell you what doesn’t work,” he said in an interview, so this report is a chance to show Vermonters what does.

He said the initial audit became personal to him after his father died in 2023.

“I became aware of this whole assisted living world, which was new to me until my father needed that kind of care,” Hoffer said.

“It’s a big deal, and it’s just one of those things where Vermonters, as is true for folks in every other state in this country, rely on the state to ensure that the places that are licensed to receive and provide services to vulnerable older Vermonters are taking care of business,” he said.