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Editorial: Care homes need closer oversight

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The revocation of a license for an elder-care facility is a thankfully rare occurrence, according to the state Health Department. Even so, the way it played out at Dignity Senior Living at Oceanside serves as a cautionary tale for such facilities and for state regulators, who must factor in and address the potential shock to the residents and their families.

And the shock to dozens of residents at the Hauula residential complex was substantial, most of them informed abruptly that they would need to vacate in nine days.

Fortunately, the department’s Office of Health Care Assurance ultimately gave a reprieve to the more than 60 residents who lived at the facility, who now have until May 31 to relocate.

This was the outcome of a settlement between the office and Dignity, signed May 6 by state officials and Albert Chen, the facility’s administrator and Dignity CEO. After the end of the month, according to the consent order, Oceanside would be considered unlicensed, resulting in penalties of $1,000 per day.

There is little disputing the cause of the revocation, only the way the termination played out from the perspective of residents and families. Handling of notification about the ongoing problems, uncovered during a series of inspections in 2020, must improve. John McDermott, the ombudsman for long-term care, said he was unaware of the issue until called by the media in April.

The Department of Health (DOH) sent the letter to Chen on April 12, revoking the state license; residents received a copy of that on April 21, McDermott said.

Meanwhile, the report documenting 149 separate deficiencies, the basis for revoking the license, still hadn’t been posted online, he said, which means anyone researching the facility as a potential residence would not know about the serious problems.

Janice Okubo, DOH spokeswoman, said the revocation letter was sent after the state’s Adult Protective Services office “issued a finding of neglect against the facility, not individual employees.”

This capped a litany of violations noted in inspections on Aug. 14, Sept. 24 and Dec. 28. The 300-page report included numerous examples of residents missing prescribed medications, insufficient oversight of a resident after multiple falls and two suicide attempts, staff lacking proper training providing wound treatment, and inadequate employee familiarity with the facility’s abuse and neglect policy.

The list went on and on. Why few people were in the loop about these discrepancies is a shortcoming that should be corrected.

“Nursing homes, by federal law, must post their annual inspections in a conspicuous location but there are no federal laws for assisted living facilities since they don’t receive any federal funds,” McDermott said in an email to the Honolulu Star-Advertiser.

Chapter 90 of the Hawaii Administrative Rules does indicate that assisted-living residents can request a copy, he added, but few would know to do so. McDermott rightly proposed amending rules to require inspections to be posted as they are for nursing homes.

Okubo said the state does not take over management of a privately owned facility. That, she added, distinguishes this case from the state’s Hawaii Health Systems Corp. assuming operation of the Yukio Okutsu State Veterans Home in Hilo during the coronavirus outbreak in September, she added.

Granted. But there’s no disputing that this case should have set off alarm bells sooner, and among more of the facility’s stakeholders.

The group directly affected was small, but the incident surely resonated statewide. Finding and keeping quality elder care is a universal concern, and nobody wants to see a repeat of the unsettling Oceanside story.

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