Faced with having to make a quick decision about her mother’s long-term care, Wendy Silverthorne turned to the Internet to do some research.
Silverthorne, 56, a social worker in Washington state, sought complaint histories for several Oahu care homes she was considering for her 78-year-old mother, a Kailua resident whose health had deteriorated and who no longer could care for herself, even with the help of her 80-year-old husband.
Silverthorne’s research proved fruitless.
Unlike the majority of states, Hawaii does not place its state inspection results for long-term care facilities online. To get such information, Silverthorne would have to write to the Department of Health, pay for copies of the requested reports and wait at least 10 days to get them. Sometimes the wait can be much longer.
"I felt sick to my stomach," Silverthorne told the Star-Advertiser in a phone interview. "I couldn’t get access to information that would help in making an informed decision about my mother."
Silverthorne was among those who last week voiced support for Senate and House bills that would plug that information gap.
Supporters of Senate Bill 358 and House Bill 120, which would require inspection reports to be placed online by January 2015, say such information should be readily available, just as it is in at least 27 states that provide access via the Internet.
As Hawaii’s elder population continues to grow at a rapid rate and as more families consider community-based residential facilties for loved ones needing assistance, consumers should have prompt access to as much qualitative information as possible, proponents say.
That access becomes even more critical when families are given only a day or two to find a suitable place for a loved one being discharged from a hospital and when vacant beds are few at local nursing homes.
But the care home industry, which successfully lobbied to defeat a similar bill in 2009, is putting up a fight again.
Operators of such facilities say making inspection information available online would violate their privacy rights, create misleading impressions about the quality of their services and add to already burdensome regulations.
"The overregulation and extraordinary oversight of this industry has beaten it in the ground and driven many legitimate operators out of business while driving up the costs of operations to the state," Esther Pascual, president of the United Group of Home Operators, wrote in testimony to the Senate committees on Health and Human Services considering SB 358 last week.
The panels advanced the bill with amendments.
Norma Tenorio, a nurse who with her physician husband owns and operates three Oahu care homes, also opposes the bill.
She told the Star-Advertiser that the state in its most recent inspection of her facilities found only minor deficiencies, such as a wheelchair blocking a sidewalk. Still, the inspection report covered 12 pages, she added.
"It has no relationship to real caregiving," Tenorio said. "But if people see those 12 pages, they’re not even going to look at us."
If a consumer comes to one of her homes and asks to see the latest inspection report, Tenorio said, she provides it but at least is able to offer more context.
While consumers, thanks to federal regulations, can find plenty of quality-of-care information online about nursing homes, nothing similar is available for state-licensed long-term care facilities, including adult care and community care foster family homes. Hawaii has more than 1,000 of the last two types of facilities, scattered in neighborhoods around the state.
If Hawaii were to provide online access to inspection reports, it would become part of a growing trend nationally.
In 2010, 17 states maintained websites where people could view inspection results, according to John McDermott, Hawaii’s long-term care ombudsman, who has been pushing for similar access here. At least 10 more states have since joined that group.
Hawaii’s current system is unacceptable because information is not provided when it is most needed and because the delays can result in added costs to families and the state, McDermott said in his testimony to legislators.
"We need to move into the 21st century," he said.
The 2009 push to provide online access to inspection reports failed largely because of the care home industry’s lobbying efforts in the House.
The Senate passed the bill unanimously that year, but the measure didn’t even survive its first hearing in the House.
This time around, advocates again are expecting a tough fight in the House, even though HB 120 passed its first test last week, gaining approval from that chamber’s committees on Health and Human Services.
Louise Kim McCoy, a spokeswoman for Gov. Neil Abercrombie, said the administration supports the measures and is asking the Legislature to appropriate $46,000 for new computer equipment and website and database development, plus funds for a full-time position for staff support.
Preparing for when the Department of Health assumes oversight responsibility for all long-term care facilities in July 2014, the administration is developing a new, automated inspection tool that will be used across all licensed home-care settings, according to McCoy.
"The results of the inspections will be easily uploaded to a dedicated website to ensure transparency, consumer education and consumer protection," McCoy said in a written statement.
Robyn Grant, director of public policy and advocacy for the National Consumer Voice for Quality Long-Term Care, a Washington, D.C.-based group, said the posting of inspection reports can lead to improved services.
"It really does hold the facilities accountable because they know they will be compared to competitors," Grant said.
She downplayed concerns that the postings could be misleading.
"That’s not giving consumers enough credit to be able to read these reports and understand them," Grant said.
Silverthorne, the Washington resident who tried to find Hawaii inspection reports online, said her family won’t benefit from the proposed legislation because her mother now is in a Kaneohe nursing home.
But she and her brother, who also lives on the mainland, are supporting the proposal because they believe it will help many other families, she added.
"We feel this is so important."
