About half of Hawaii’s care homes operated without a license or with a “hastily issued” permit, sometimes without even being inspected in 2017, according to a scathing audit of the state Department of Health.

The DOH’s Office of Health Care Assurance failed to complete annual inspections to “ensure the health, safety and welfare” of care home residents and reissued licenses sometimes without even visiting a facility, the state Auditor said today following an investigation of 214 of the 493 licensed care homes.

Of those sampled, 116 care homes — or 54 percent — were relicensed before the inspection process was completed. At least eight had 20 or more deficiencies, but were relicensed anyways, the report said.

“Most of the time, OHCA simply renewed a care home’s license,” said State Auditor Les Kondo in the report, adding that there were no annual relicensing inspections for six care homes in 2017 and 22 in 2016. “That means that OHCA relicenses many care homes before completing its relicensing process. We found that OHCA’s primary objective is to support the continued operations of those care homes, not to ensure the health, safety, and welfare of the facilities’ residents as mandated by statute.”

The audit also noted that the DOH did not cite a single care home operator or terminate a care home license from 2007 to 2017, even for those with substantial or repeat deficiencies. It also had no written enforcement guidelines for operators who did not comply with the quality of care standards.

In a written response DOH Director Bruce Anderson said that the department has corrected deficiencies since the investigation and inspections are now “more timely and up-to-date.” The report does not reflect conditions today, he added.

“Our first and foremost obligation as a regulatory agency is to ensure residential care homes comply with all applicable laws and provide quality care in a safe environment,” he said. “The need for residential care is anticipated to increase as Hawaii’s population ages. After reading the audit, many families may erroneously conclude that adult residential care homes may be unsafe for their loved ones. … Any risks to the safety, health and wellbeing of older adults in an adult residential care home are immediately investigated and appropriate action taken.”

Audit of the Office of Health Care Assurance’s Adult Residential Care Homes Program by Honolulu Star-Advertiser on Scribd