Health Facilities Commission seeks licensure-system funding, additional staff as complaints and recertification backlog rise

Logan Grant, executive director of the Health Facilities Commission, told the House Finance, Ways, and Means Committee that the commission received $4 million in nonrecurring funds for a new licensure system and funding for accounting positions to aid reporting to CMS, but that several higher-priority staffing requests were not included in the governor’s proposed budget.

Grant said the $4 million would replace the commission’s current piggyback use of the Department of Health’s system with a licensure system tailored to the commission’s regulatory needs. He also said accounting positions funded through the governor’s office will be housed in the Department of Finance and Administration’s Division of Accounts to help the commission draw down federal funds.

Grant outlined several unfunded requests: four positions to form a high-priority complaint unit that would centralize surveyors who investigate urgent complaints and help reduce disruption to delayed recertification surveys; additional staff for Certificate of Need (CON) reform implementation funded through the CON program’s dedicated funds; extra licensure administrative staff, plans reviewers and life-safety inspectors; more legal support (litigation attorneys currently handling about 60 cases each); and an infection-prevention specialist to advise on outbreaks and provider training.

The commission reported a spike in complaints beginning in late 2022, which Grant attributed to changes in Chapter 5 of the State Operations Manual from the Centers for Medicare & Medicaid Services. He said complaint intake increased substantially — he described a roughly 54.2% increase since 2022 — and pointed to 6,216 complaints triaged in 2024. Grant said that although increases reflect reporting requirements and not necessarily a decline in quality of care, the added workload has reduced the commission’s ability to keep up with recertification surveys.

On CON reform, Grant said implementation will begin Dec. 1 for NICUs, burn units and PET/MRI units, and that technical advisory groups developed quality measures for those services. The commission is contracting a neonatologist to develop surveyor tools for NICU reverification; Grant said reverification is new and cost estimates are still being developed. On burn units, the advisory group recommended facilities obtain American Burn Association accreditation within five years of licensure; Grant said there are three burn units in the state and that accreditation processes can take time because they require operating experience, staffing and outcomes data.

Committee members asked whether the commission can fulfill increased inspection requirements without more staff. Grant said the commission is ‘‘very strained’’ and noted federal funding for the commission has been capped for about a decade; he said the commission had not received an increase in federal funding and described the federal cap amount verbally during questioning.

Why it matters: The commission’s staffing and system requests are tied to its ability to investigate urgent complaints, perform required recertifications and implement new CON-related standards for specialized services. Lawmakers asked for additional data on projected reverification costs and on the commission’s most common complaint types.