The state agency responsible for protecting vulnerable adults failed to provide adequate oversight over 20 adult day centers, which contributed to numerous health and safety violations.
The problems were disclosed in a federal audit released this week by the Office of Inspector General for the federal Department of Health and Human Services. Federal inspectors made unannounced visits to the adult day centers in early 2017 and found that all 20 of the centers reviewed failed to comply with state licensing requirements.
Overall, the agency found 200 violations of health, safety and administrative requirements at the adult day centers, which primarily serve seniors and adults with disabilities, according to the inspector general’s audit report.
The violations ranged in severity from peeling paint and loose plaster to hazardous chemicals and a knife left out in the open and easily accessible to clients. The federal inspectors found 81 instances of noncompliance with health and safety requirements, as well as multiple violations of state record-keeping and background study requirements. The federal audit was focused on adult day centers that serve older Minnesotans enrolled in Medicaid’s “Elderly Waiver” program, which helps low-income seniors live more independently by paying for certain services, such as those provided in the day centers.
The federal agency determined the problems stemmed from low staffing levels at the Minnesota Department of Human Services (DHS), which licenses 195 adult day centers in cities and towns across the state, from Mankato to Hermantown.
A staff shortage prevented the agency from performing routine inspections of the centers, including re-licensing visits every two years, the report said.
The audit comes as DHS, the state’s largest agency, faces widening questions over its oversight of state-licensed programs that serve tens of thousands of vulnerable Minnesotans, including children, seniors and people with disabilities.
Last month, the Minnesota Legislative Auditor, a nonpartisan arm of the state Legislature, launched an investigation into allegations that some child care providers are defrauding the state’s publicly funded child-subsidy program.
Legislators called for the investigation following a television news report suggesting widespread fraud in the Child Care Assistance Program, or CCAP, which subsidizes the child-care expenses of nearly 30,000 low-income children per month.
In response to this week’s audit report, DHS Inspector General Carolyn Ham called the violations identified in the report “very concerning.” Since the audit, her office has taken action to hold the centers accountable, by conducting licensing inspections at the 20 day centers.
As a result of those inspections, two of the day programs have been closed and a dozen of the centers have received correction orders.
Ham noted, however, that the federal audit was focused exclusively on adult day centers that already had a history of health and safety problems. As a result, she said, “We do not believe the level of violations found is representative of all of Minnesota’s adult day centers.”
Roberta Opheim, the state ombudsman for mental health and developmental disabilities, said the federal audit report raises broader concerns about the state’s oversight of adult day centers, which offer social activities, meals and a range of other activities to thousands of older adults across the state.
“It’s clear that DHS licensing is not doing a thorough enough job” inspecting adult day centers, Opheim said. “This is a vulnerable population, and we have rules in place, and if those rules aren’t followed, what risk does that put on the vulnerable individual?”