Volunteer Inspectors Oppose Bill's Cuts (3/05/09 Florida Times-Union) By Deirdre Conner

Nursing home inspectors are speaking out about proposed legislation that could loosen inspection regulations for long-term care centers.

A bill introduced in the state Senate could end annual inspections of nursing homes and assisted living facilities conducted by Florida's Long-Term Care Ombudsmen program.

The state advocacy agency sends a small, paid staff and a cadre of volunteers to inspect the centers and investigate complaints filed by residents or their relatives about living conditions.

But under Senate bill 1562, the mostly volunteer ombudsmen would no longer do those routine assessments; instead, they would only be authorized to handle complaints.

The health care industry says it would end redundant inspections by multiple agencies. Right now, nursing homes and similar centers are regulated by the Agency for Health Care Administration, the Department of Health and the state fire marshal.

"By eliminating those duplicative inspections ... it allows staff to focus their time and effort providing that quality of care," said Kristen Knapp, spokeswoman for the Florida Health Care Association.

The ombudsmen worry that to eliminate their annual assessments would overburden regulatory agencies and jeopardize the well-being of the state's frail elders.

Chuck Cardwell, a Jacksonville resident and ombudsman volunteer, said he's concerned about the residents for whom he advocates, both in routine reviews, which take about an hour to an hour and a half, and in investigations.

"We're sort of their last line of defense," said Cardwell, a retired law enforcement officer who got involved in the program after reading about it in the Times-Union last year. "I can't stress how necessary it is."

The yearly drop-in inspection is an avenue to reach out to residents, whose interests are the sole focus, said Brian Lee, the state's chief ombudsman.

"A lot of the residents we're looking out for can't communicate for themselves," Lee said. "I'm sure it's tiresome when you have one agency after another coming in, but from the residents' perspective, it's another safety net to prevent abuse and neglect."

Lee said the agency is currently working on new rules for the assessments that make them more resident-focused, and less similar to the AHCA inspection. And, he said, AHCA only checks assisted living facilities once every two years. Local ombudsmen make visits at least once a year.
The ombudsman program estimates its 413 volunteers - who dedicate around 20 hours or more a month to visiting facilities and talking to residents and their families - save taxpayers $1.7 million a year.

In addition to the yearly reviews, they investigate complaints that range from food quality to unfair evictions to medication problems. Sometimes they refer problems to state regulators for follow-up, but often they are resolved on the spot without having to get state workers involved.

Knapp said the association is just trying to look for ways to help the state save money in a time of severe cuts. Eliminating the assessment will give ombudsmen more time to address complaints, she said.

But Mary Domask, one of the 23 local ombudsmen, said her investigations are often initiated during the in-person resident interviews required as part of the yearly assessments.

"Sometimes when you sit down with someone face to face, they'll share something they wouldn't with someone with an inspector's badge," she said