Supervisors Want Inspector General for Skilled Nursing Facilities

LA County Supervisor Kathryn Barger and Mark Ridley-Thomas will ask the Board to appoint an inspector general to oversee skilled nursing facilities, which account for more than half of all county deaths from the Coronavirus.

About 90 percent of Pasadena’s deaths linked to the virus have come from an outbreak in the city’s skilled nursing facilities.

Vice Mayor Tyron Hampton and Councilman Victor Gordo have called on the city to investigate the health department’s response to the outbreak in these facilities.

“Skilled nursing facilities provide critical care and support for many of our most vulnerable populations,” Barger said. “As the County fights the COVID-19 public health crisis, we must greatly improve our ability to assess and oversee these facilities to ensure the safety and well-being of all those who have been entrusted to their care.”

Skilled nursing facilities, which serve thousands of residents who tend to be older and medically fragile, have become the epicenter of LA County’s Coronavirus pandemic. As of May 18, 4,794 residents and 2,918 staff from these facilities have tested positive for the virus. Across LA County, 52 percent of all deaths from COVID-19 have been in institutional settings, particularly in skilled nursing facilities.

The motion also calls for bringing in the Auditor-Controller to ensure closer monitoring of skilled nursing facilities immediately. The inspector general would be tasked with developing recommendations on how to strengthen oversight for skilled nursing facilities, and how to improve their operations long-term, according to a statement.

Many skilled nursing homes get low marks for quality of care, patient satisfaction, and employee pay, the statement noted.

The Board of Supervisors will vote on the motion at Tuesday’s meeting.

“While some skilled nursing homes may be doing their best to respond to COVID-19, we’ve seen hundreds of deaths at these facilities, tragically exposing the urgent need for stronger oversight across the industry,” Ridley-Thomas said. “Now, more than ever, we must act to address any questionable operations and substandard conditions in the facilities that care for some of our most vulnerable residents — the elderly, the low-income and the disabled.”

LA County Department of Health Services director, Dr. Christina Ghaly, said that “It is our collective responsibility to protect and support the most vulnerable among us. Prioritizing the health and safety of those in our county’s skilled nursing facilities is the right thing to do and will also help protect the availability of hospital resources for all those who need them.”

The Ridley-Thomas/Barger motion says it is “critical that LA County learn the lessons of this crisis; identify the internal and external factors that have contributed to inadequate conditions within skilled nursing facilities; and provide oversight, accountability and resources as needed.”

They described the proposed inspector general as a “much-needed accountability measure” appointed to conduct an exhaustive review of LA County’s capacity to regulate skilled nursing facilities, recommend structural and operational changes, and outline a plan for ensuring adequate and sustainable oversight. They also plan to task the inspector general with recommending regulatory and policy improvements at the local, state and federal levels to enhance quality of care, ensuring adequate infection control measures, and supporting healthcare workers.

To increase transparency, the Ridley-Thomas/Barger motion also called for directing the LA County Auditor-Controller to take the lead in designing a publicly accessible dashboard with information about COVID-19 case totals, testing frequency, mitigation plan status, and other information. The motion seeks to find ways to enhance LA County’s ability to assess the adequacy of mitigation plans and to oversee their implementation.

Skilled nursing facilities have also received close attention from LA City government. Under an emergency order issued Friday by Mayor Eric Garcetti, skilled nursing facilities in Los Angeles will be required to provide diagnostic testing for COVID-19 for their employees, residents and contractors.

Nursing facilities, senior living homes and other facilities that care for people 65 and older have been potential “death traps,” Garcetti said.

He said the facilities can request assistance with testing from the city’s Emergency Operations Center if they’re unable to obtain it themselves. The tests will be required to be administered at least once a month.