State health officials are pulling overtime to resume posting inspection reports for long-term care facilities online as required by law, but so far it’s only for certain types of homes and there are no guarantees how long the agency will keep up with it.

The Department of Health’s Office of Health Care Assurance, which is responsible for the vast majority of the care homes regulated by the state, had stopped putting the reports online after an initial upload in March of about 80 inspections.

Keith Ridley, who heads the office, said he lacked the resources necessary to fulfill the state mandate, which required the reports to be posted on the department’s website starting Jan. 1.

Department of Health. Office of Health Care Assurance State Licensing office. 601 Kamokila. Kapolei. nathan story. 20 oct 2015. photograph Cory Lum/CIvil Beat
The Health Department’s Office of Health Care Assurance state licensing office in Kapolei. Cory Lum/Civil Beat

The Legislative Kupuna Caucus, citing Civil Beat’s ongoing coverage of the issue, sent Gov. David Ige a letter Oct. 20 calling on him to get the agency to comply with the law.

Sen. Suzanne Chun Oakland, Sen. Les Ihara and Rep. Gregg Takayama said in the letter that they want the department to post current inspection reports within the five days mandated by the law while working to shrink the backlog.

They said waiting up to two weeks for the agency to respond to a written request for the inspection reports, redact confidential information and charge for the records is unacceptable and costly for the family and the state.

The reports started going up again last week, said Health Department spokeswoman Janice Okubo, but not for all types of care homes.

The Office of Health Care Assurance had posted 186 inspection reports as of Thursday, and Ridley estimates a backlog of 500.

Ridley said his office is doing its best to post the reports from earlier in the year while also posting recent reports.

“Since this work cannot be absorbed or caught up on with our current limited staff, we will post reports as time permits but we will post on a more regular interval,” he said. “We cannot predict how many reports or how often the reports will be posted.”

Okubo said the office is continuing to look for someone to fill a “temporary 89-day hire office assistant position” to work on posting the records.

“In the meantime, we are using overtime for an existing staff member to conduct the work,” she said.

Still No ARCH Reports Online

The Office of Health Care Assurance oversees roughly 1,700 facilities whose inspections are supposed to be posted online.

There are seven types, ranging from skilled nursing facilities that house dozens of elderly residents who need a high level of care on down to community care foster family homes, which offer up to three beds for residents who need varying degrees of care, from help preparing meals to a nursing-home level.

One type of facility — adult residential care homes — has not had a single report posted online, despite assurance from state officials last March that they would do so soon.

There are almost 500 ARCH facilities throughout Hawaii, with most providing care for up to five elderly residents.

ARCH operators strongly opposed legislation requiring the inspection reports to be posted online, saying there were privacy concerns and that the public wouldn’t know how to understand the contents of the report.

The Legislature passed the bill despite their objections in 2013, giving the Health Department an 18-month lead time to figure out how to start posting the reports.

There was funding for two years for two positions to do the online posting, but the department did not hire anyone in that time frame and the appropriation was not renewed in the current budget cycle.

Lawmakers have said they are open to providing funds next session, which starts in January, but don’t want the department to wait until then to comply with the law.

In explaining why the inspection reports are being posted for some types of facilities but not for others, Ridley said certain types of providers have a consistent history of not including personal or confidential information on the inspection reports, which lets his office post those more quickly.

“Nevertheless, those reports still require a review to ensure that no personal or confidential information is on the report prior to being posted,” he said. “So, at a minimum, the activity to segregate and review the reports and to scan the reports must still be done.”

The Kupuna Caucus, pointing to others states as examples, said the agency should adjust the form it uses for the inspections to eliminate the need for any redactions — something the federal government does in its surveys of nursing homes.

Meanwhile, the department’s Developmental Disabilities Division, which oversees roughly 300 homes that each care for up to two people with intellectual or developmental disabilities, has been able to meet the online posting requirement with existing resources.

The division had posted 226 reports on its website as of Thursday.

Read past Civil Beat coverage about the posting of care home inspection reports and other elderly issues here.

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