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State tosses complaints against Arizona AL managers.

An Arizona board responsible for handling complaints about assisted living (AL) facilities threw out more than 86 percent of the cases citing poor management during a three-year period. The reason: untimely investigations, according to a state audit report.

In fiscal years 2003 and 2004 the Arizona State Board of Examiners of Nursing Care Institution Administrators (NCIA) and Assisted Living Facility Managers dismissed 53 of 61 cases received during fiscal years 1999 to 2002, according to the Arizona Office of the Auditor General in Phoenix.

"Many of these cases were dismissed because so much time had passed that the manager's or administrator's credentials had expired, or no further investigation could be conducted because necessary information and access to witnesses were no longer available," said Auditor General Debra Davenport. "As a result, the board's ability to protect the public was decreased."

The board of examiners has the authority to certify assisted living facility managers in conjunction with the Department of Health Services, which licenses the facilities, according to the Auditor General's office. When a complaint is filed against an AL facility director, manager or administrator, the board must determine what disciplinary action, if any, should be taken against that person.

The board continues to have problems handling cases in a timely manner, according to Davenport. More than 100 of 126 complaints received in fiscal years 2003 and 2004 were unresolved as of July 2004, with at least one-fourth of those open for 260 to 680 days. "These lengthy processing times are a concern because information needed to adjudicate complaints may become harder to obtain as time passes," she said. "(This allows), administrators and managers named in the complaints are able to continue to practice unchecked."

A typical case: A complaint received in September 1999 alleged that the manager of an assisted living facility abused and neglected residents. The Board of Examiners did not consider the complaint until November 2003, two years after the administrator's license had expired, according to the report.

The Auditor General's report attributed the untimely follow-ups in part to high turnover among the board's investigative staff: the agency had five different investigators in fiscal years 2003 and 2004. There's also a lack of adequate staff at the examiners' office, which consists of two part-time investigators. A third full-time position was changed to a business manager who does not handle the cases, according to the report.

Secondly, the NCIA board lacks necessary investigation policies and procedures, including time frames for each step in the investigation process. The board also inadequately monitors the investigation process and lacks an accurate database to help it do so, according to the report.

The report recommended that the NCIA board consider contracting a third investigator or return the business manager position to that of an investigator. It should also develop policies and procedures for prioritizing complaints and establishing time frames for completion, then monitor progress with monthly reports.

The report also noted that the state needs to revise existing law to allow the Examiners' Board to discipline administrators and managers whose licenses have expired.

Victoria Martin, executive director of the Board of Examiners of Nursing Care Institution Administrators and Assisted Living Facility Managers in Phoenix, said her association agrees with most of the Auditor General's findings and will try to implement them in some fashion.

The exception, she said, is the implementation of complaint time frames. "We don't have adequate investigative staff," Martin said, "and we need to maintain the flexibility to address the most serious complaint cases as they arise rather than try to meet arbitrary time frames on all complaint cases."

Lindsey Norris, executive director of the Arizona Association of Homes & Housing for the Aging in Phoenix, said she was surprised to hear how bad the situation was with the NCIA Board.

Her association supports continued investigation by the state, Norris said, "in order to improve the operations of the board and get it running properly," she said.
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Title Annotation:THE NEWS; Arizona State Board of Examiners of Nursing Care Institution Administrators and Assisted Living Facility Managers
Author:Naditz, Alan
Publication:Contemporary Long Term Care
Geographic Code:1U8AZ
Date:Mar 1, 2005
Previous Article:Annual LTC costs top $72,000 in new survey.
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