A backlog of annual inspections at Oklahoma's nursing homes and skilled nursing facilities exceeds the numbers that mounted nationwide during a yearlong hiatus prompted by the novel coronavirus pandemic.  

A CNHI investigation found 51% of U.S. nursing homes and long-term care facilities eligible for Medicare and Medicaid reimbursements have operated at least 18 months without annual recertification inspections. Nearly 63% of Oklahoma's licensed care providers are at least 18 months delinquent on the required annual inspections.

Data compiled by Centers for Medicare and Medicaid Services show a number of facilities in the state with histories of fines or serious deficiencies have yet to be recertified. The federal agency suspended the recertification process — and rigorous annual inspections it requires — in March 2020 in an effort to control COVID-19 infection, which had a disproportionate impact on the elderly population. 

The American Health Care Association, which represents more than 14,000 nursing homes and long-term care facilities, along with LeadingAge, presented proposals to address problems exposed by COVID-19. The organizations said the pandemic exacerbated systemic issues such as workforce shortages, aging facilities and underfunded government reimbursements for services.

“The pandemic has been an unprecedented tragedy with long term care facilities being at the epicenter of the crisis,” said Debbie Meade, chair of the board of directors of AHCA. “We have seen long-standing challenges exacerbated among our facilities and without serious reform, we risk more crises in the future."

As those challenges get sorted out, LaTrina Frazier, the Department of Health assistant deputy commissioner of protective health services, told CNHI Oklahoma that state inspectors used COVID-19 infection control surveys as a tool to assess facilities during the pandemic. Until recertification is completed state inspectors have used infection control surveys and complaint inspections to ensure resident safety. 

Those surveys, according to CMS data, have yielded findings of some health deficiencies at some area facilities. 

Records show no deficiencies were found during three of the four infection control inspections conducted from June 2020 through March at Brentwood Extended Care & Rehab LLC. An inspection dated Feb. 3 cites two deficiencies with a level of harm that was minimal and the potential to impact few residents.

Brentwood officials did not respond to inquiries about those findings or how it navigated the yearlong pandemic and related issues. 

CMS records show the facility, which according to CMS records was subject to fines totaling $70,289 in 2018, has had no complaints during the past three years that resulted with a citation. It is one of two facilities in Muskogee with one-star rating by CMS. 

Seven infection control inspections conducted since July at The Springs Skilled Nursing and Therapy, which CMS ranks as a one-star facility, revealed 21 health deficiencies. Two inspections based on complaints during the past year, records show, resulted with two citations. 

CMS bases its overall rating on a nursing home's performance in three areas: health inspections, staffing and quality of resident care measures. Information about the nursing homes the agency certifies along with scores for those measures online are available at www.medicare.gov/care-compare.

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