OIG Report – Washington State Failed to Ensure that Nursing Homes Complied with Federal Requirements for Life Safety, Emergency Preparedness, and Infection Control

In the fall of 2022, twenty Washington skilled nursing facilities had unexpected visits from auditors representing the Office of Inspector General (OIG). These surprise visits to ten percent of Washington facilities were a result of the OIG’s oversight activities to ensure that our state survey agency (SA), Residential Care Services (RCS) and State Fire Marshals were ensuring facility compliance with the federal life safety code, emergency preparedness, and infection control standards/requirements.

In doing so, the OIG auditors sampled facilities based on “risk factors” determined through deficiencies reported in the federal database from January 2020 through the first week of July 2022. During these on-site visits, the auditors evaluated the facility for life safety violations, reviewed the facilities emergency preparedness and communications plans, and reviewed the policies, procedures, and documentation related to infection control. They did this review in comparison with the Federal requirements for nursing homes and determined non-compliance to be a violation or deficiency.

According to the recently released OIG report, Washington State did NOT ensure that nursing homes complied with the Federal requirements. The auditors state they identified deficiencies in all twenty facilities, totaling a whopping 525 violations. The report goes into greater detail regarding the authority, audit process, and violations, however the outcome of deficiency determinations is listed below:

The report determined that as a result of the state agency not holding facilities accountable, residents, staff, and visitors of the twenty nursing homes sampled are at an increased risk of injury, significant illness, or death during a fire or other emergency, or in the event of an infectious disease outbreak. Further determinations from the OIG revealed that Washington State did not ensure that nursing facility management was educated about life safety and emergency preparedness training resources and that the frequent turnover of facility management and staff were factors in them not being aware of the Federal requirements.

The OIG has recommended that DSHS, specifically RCS complete the following as a result:

RCS’s response and plan submitted to the OIG is included in the report. As a result of this report, the SNFs in Washington should expect an increased focus from surveyors, complaint investigators, and the State Fire Marshal regarding life safety code, emergency preparedness, and infection prevention and control. It is vitally important that facility leadership takes an active role to ensure education, training, and resources are provided to facility staff in these areas.

WHCA is also working to develop educational offerings in 2024 to help facilities meet this need. The Washington State Fire Marshal’s office will be offering an educational session during our upcoming Virtual Winter Conference on January 30, as well as multiple sessions regarding infection prevention and control on the following dates, January 31, and February 1.