Health Care Quality division reports jump in facility complaints and surveys; advocates and lawmakers press for permanent staffing and implementation funds

The state's Division of Health Care Quality (DHQ) reported a marked increase in survey and complaint activity for long-term care and licensed facilities during a budget briefing to the Joint Finance Committee.

DHQ officials told the committee that in fiscal year 2024 the Office of Long Term Care Residents Protections completed 494 surveys (including 321 annual surveys, 93 complaint surveys and 38 follow-ups) and that investigators handled roughly 1,033 complaints for nursing homes and assisted living facilities. The division said the Office of Health Facilities Licensing and Certification completed 81 acute and continuing-care surveys and investigated 443 complaints; overall complaint investigations and more serious deficiencies have increased, the director said.

DHQ said it has used contracted surveyors to help manage the workload and that contract surveyors completed 10 annual nursing home surveys and investigated 112 nursing home complaints since the current fiscal year began. The division reported higher caseloads to its investigative unit: 3,313 reports of alleged abuse, neglect, mistreatment or financial exploitation were logged in FY24, a 27 percent increase over the previous year.

Why it matters: advocates and some lawmakers said the workload and the rise in serious complaints show the division needs stable, recurring funding and staff to meet statutory obligations; DHQ said it welcomed additional funding to assist with facility surveys.

Budget and staffing details disclosed to the committee: - DHQ's FY26 governor's recommended budget: $6,387,500 in general funds; $1,616,100 in appropriated special funds spending authority; $2,465,700 in non-appropriated special funds; total $10,469,300. - The FY26 package includes $23,000 in general funds for anticipated inflationary contracted surveyor vendor costs and $32,500 in appropriated special funds spending authority tied to a newly required program. - DHQ is implementing a new background check center system and a new licensure system that will integrate with the incident reporting system; target implementation was stated as fall 2025.

Public comment and advocacy: dozens of public commenters asked lawmakers to fund full implementation of dementia- and disclosure-related laws (identified in testimony as SB 150 and SB 151), to staff DHQ to complete surveys and follow-up investigations, and to ensure civil monetary penalty funds are used to improve resident care. Witnesses cited a January balance for the civil monetary penalty accounts (public testimony reported federal fund balances of $242,900 and state funds of $72,500 as of January) and urged that penalties be used to prevent future harm, including workforce development and education programs.

Committee questions and follow-up requests: lawmakers asked the division whether it tracks substantiated versus unsubstantiated complaints and whether the division records whether incidents are caused by contracted staff or facility employees; DHQ said it does begin to record when issues involve temporary staffing agencies and that the division tracks incidents by facility to detect patterns. Lawmakers also asked for a historical accounting of civil monetary penalty collections and uses and for a five-year summary of state civil money account balances, collections and expenditures.

Ending: DHQ officials said they are tracking patterns by facility, using contract surveyors to meet demand, and developing IT improvements to better integrate incident data. Advocates urged more recurring staff and funding to turn new statutes into enforceable rules and to address quality gaps in long-term care.