Medical Facility State Inspector Shortfalls An Urgent Matter for the Governor and General Assembly

by James C. Sherlock

Virginians are blessed to have a person running the Department of Health Office of Licensure and Inspection (OLC) who may be the best public servant in the Commonwealth. She desperately needs help to do the work she is assigned in order to protect us.

Kim Beazley, the Director of that Office, has been quoted at length by me before. On November 30th, 2020 I published Ms. Beazley’s response to a series of FOIA requests to get an update on a 2017 Office of the State Inspector General report that found major shortfalls in the staffing levels of the OLC.

Ms. Beazley’s answers showed that nothing had changed in three years.

The shortfalls were based upon laws and budgets that purposely reduced the authorized staff significantly below that sufficient to meet its statutory inspection requirements.

This year I submitted another series of FOIA requests to get an update, this time on nursing homes oversight. I publish Ms. Beazley’s response in its entirety below. Still, nothing has changed.

I honestly do not know why the Governor and General Assembly have refused to  staff the Office of Licensure and Inspections properly. I darkly suspect it has something to do with campaign donations from the wide range of medical facilities subject to inspection, but that is impossible to prove.

The temporary fixes Ms. Beazley describes that hire contractors with federal COVID money to fill the gaps are not a long-term solution. The use of contractors for inspection also denies OLC the corporate knowledge required to get to know the inspected organizations and recognize trends.

Regardless of the reason why the Commonwealth has consciously ignored the shortfalls for years, we need the new Governor and General Assembly to make the budget and law changes to fix the problem.

Ms. Beazley’s remarkable response dated December 29, 2021 at 7:29 PM is here.

Remember, the OLC administers four state licensing programs: Hospitals, Nursing Homes, Home Care Organizations (HCOs), and Hospices and Hospice Facilities.

The OLC is also the state survey agency for the U.S. Centers for Medicare and Medicaid Services as well evaluating laboratories that perform diagnostic testing on human specimens (including physicians offices, hospitals, and nursing homes) under the Clinical Laboratory Improvement Amendments of 1988 (CLIA) Program.

In addition to regulatory compliance inspections and surveys, the OLC is responsible for actively supervising the Cooperative Agreement on behalf of the State Health Commissioner and for investigating consumer complaints regarding the quality of health care services received.

These inspections are conducted by medical facilities inspectors who are health care professionals such as physicians, registered nurses, dietitians, social workers and laboratory medical technologists. The training and development of providers and OLC staff on these matters is conducted and coordinated by the Training Unit.

If only OLC had enough of those inspectors. Not only is the agency limited by statute and budget, but they must compete for professionals in markets in which they are in short supply. The pay and benefits of inspectors will need to be raised to competitive levels.

As I said, Kimberly Beazley is a remarkable public servant. Consider especially her reply to my request at 7:29 PM on the day before New Years eve. With her responses in November 2020 and at the end of 2021 as references, the laws to fix the problems she documents virtually write themselves.

All Virginians need this issue addressed by our new Governor and General Assembly. Our safety depends on it.

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9 responses to “Medical Facility State Inspector Shortfalls An Urgent Matter for the Governor and General Assembly”

  1. Dick Hall-Sizemore Avatar
    Dick Hall-Sizemore

    There is some help pending in the budget bill introduced by Governor Northam:

    3 new positions to supplement the state hospital state licensure program

    1 position for the Office of Licensure and Certification

    1. Embarrassing response to the need! In Jim Sherlock’s November 2020 post, he cited: “OLC’s current authorized staffing is 127 positions, with current actual
      staffing being 105 (95 FTEs and 10 wage positions) and current vacancies
      being 22 (20 FTEs and 2 wage positions).”

      1. Dick Hall-Sizemore Avatar
        Dick Hall-Sizemore

        The key is keeping down the vacancy rate. In November 2020, the FTE vacancy rate was about 17 percent, which is too high. I suspect it was that high due to a hiring freeze imposed because of the budget uncertainties related to COVID. Before passing judgment, it would be good to know the current vacancy rate. Currently, VDH is advertising for 4 positions in OLC–2 supervisors, 1 inspector, and 1 office services specialist.

        1. James C. Sherlock Avatar
          James C. Sherlock

          Dick, if the vacancy rate was zero, OLC would not have nearly enough inspectors to fulfill its statutory inspection requirements. I documented that in my previous post linked in the article. This is a very longstanding problem. The facility payments for inspections that contribute to OLC budget have not changed in 40 years.

      2. James C. Sherlock Avatar
        James C. Sherlock

        Carol, Ms. Beazley’s response is rich in important information. I thought it too rich to provide as a quotation in the text. Read the entire response.

        1. Everyone should read it. It is close to a miracle that they accomplished as much as they did in 2021.

          “In the last year, OLC has not received additional state funding or additional FTEs for the purpose of conducting federal surveys or state inspections; however, OLC did receive $1.5 million in CARES Act funding. OLC used this entire
          allotment to hire contract surveyors to assist with nursing home recertification
          surveys primarily. This has increased OLC’s capability to perform federal
          certification surveys, but not state licensure inspections. OLC also notes that CARES Act funding is a time-limited source of funding, so OLC anticipates its capability to recede to pre-pandemic levels once that funding lapses.”

          @Dick Hall-Sizemore:
          Adding funding for one position without addressing the long-standing budget short-changing that prevents filling vacancies at competitive salaries is scandalous.

          How do you answer Jim’s statement that “The shortfalls were based upon laws and budgets that purposely reduced the authorized staff significantly below that sufficient to meet its statutory inspection requirements.”?

    2. James C. Sherlock Avatar
      James C. Sherlock


  2. Thank you for continuing to keep the OLC issues in the public eye and acknowledging the efforts of Ms. Beazley. Here’s hoping the new Commonwealth Transformation Officer becomes aware of the OLC situation and addresses it.

  3. vicnicholls Avatar

    Have you talked to Karen Greenhalgh, the 85th district I believe?

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