Audit: Grand Rapids Home for Veterans improving


GRAND RAPIDS, Mich. (WOOD) — The Grand Rapids Home for Veterans has improved since a scathing audit about 16 months ago, according to a new report released by the Office of the Auditor General.

>>PDF: Office of the Auditor General’s August 2017 report

In a follow-up review, the inspector said the veterans home has at least partially complied with changes needed in five key areas.

VETERANS HOME STAFFING

The agency said the contractor that staffs the veterans home has partially complied with improving staffing levels, meeting the federal requirement for hours of skilled nursing care from the beginning of December 2016 to the end of January 2017.

The auditor’s report said although the new contractors did not meet the home’s daily goal of 115 CENA staff, staffing levels improved significantly since the February 2016 audit.

However, the auditor general’s office said there were 37 days the contractors did not provide enough CENA supervisors.

In response to the findings, the Michigan Veterans Affairs Agency said the auditor general’s numbers were based on staffing contracts that were established before the home determined those those levels were “greater than actually needed.”

Since the MVAA is only billed for the exact number of staff its contractors provide, the agency said it’s working to “determine a more effective and cost efficient level” and will then change its staffing contracts.

“We understand that the OAG has to measure compliance with the contracts as they were written during the audit period, but the fact is that the Home experienced excellent outcomes with the number of supervisors provided,” the MVAA stated.

As of Feb. 10, the Grand Rapids Home for Veterans housed 350 veterans and employed 535 state and contract employees, according to the report.

RESIDENT CHECKS

The veterans home earned a “substantially complied” rating from the auditor general when it came to resident checks.

The auditor general said surveillance video from September 2016 to January 2017 showed caregivers made 97.3 percent of required checks – not the 100 percent caregivers had documented conducting.

“Once we brought this to the Home’s attention, it terminated or re-educated the applicable staff,” the auditor general’s report read.

The auditor general said four caregivers were responsible for the 14 falsified checks.

As for missed fall alarms, the auditor general said the home for veterans had transitioned to an alarm-free facility two months after the February 2016 audit, so it couldn’t check fall alarm responses. However, the auditor general’s office said it reviewed fall reports and determined there was “no significant difference” in the average monthly number reported.

The auditor general also noted the veterans home ended its contract with the previous agency it used for staffing, so there was no need to “pursue appropriate corrective action” with the contractor for the “irregularities” highlighted in the February 2016 audit.

RESIDENT PRESCRIPTIONS

The Grand Rapids Home for Veterans significantly improved its timeliness in filling resident prescriptions, according to the follow-up report.

The February 2016 audit concluded the home refilled 35 percent of non-narcotic prescriptions more than five days late and about 4 percent of non-narcotic prescriptions more than five days early.

The auditor general’s office found between Sept. 1, 2016 and Feb. 16, 2017, the home was more than five days late on just 2.4 percent of non-narcotic prescriptions, and less than one percent of non-narcotic prescriptions were more than five days early.

As for better controls on prescriptions, the report concluded the home had established roles for pharmacy staff on ordering, receiving, dispensing and disposing of non-narcotic drugs. The only suggestion from the auditor general’s office was that the veterans home add four more non-narcotic prescriptions to its list of seven non-narcotic drugs at highest risk for theft and abuse that a software program now tracks.

INVESTIGATING COMPLAINTS

The Grand Rapids Home for Veterans improved the most with how it handled resident complaints, according to the auditor general’s follow-up report.

In February 2016, the agency said the veterans home did not properly investigate, resolve and track resident complaints in a timely manner, or forward complaints to an outside department to review.

This time around, the auditor general’s office found the home had forwarded all verified complaints to an independent reviewer and immediately reported all complaints of alleged abuse and neglect to the appropriate manager or agency. The auditor general’s office also found all substantiated abuse and neglect complaints were reported to the U.S. Department of Veterans Affairs within 24 hours.

The follow-up report also concluded that the home tracked all reviewed complaints in a log and changed the time it required a response to complaints from 10 days to 72 hours. The veterans home resolved 92 percent of complaints within that 72-hour window. As for the lone complaint not answered in that time span, the Grand Rapids Home for Veterans re-educated staff involved to prevent it from happening again, according to the report.