Officials of the Hillsborough County, Fla., state's attorney's office plan to put nursing homes on the spot.
"Operation Spot Check," launched earlier this month in the county, is an expansion of a program begun three years ago across the state in Fort Lauderdale by local and state regulators to randomly inspect Florida nursing homes operating in that area. The inspections are triggered by previous abuse and quality-of-care complaints.
The goal is deterrence, not to find wrongdoing, said Craig Clenendin, Hillsborough County's co-chief of special prosecutions and coordinator of the program.
"This is a prevention tool," Clenendin said. "It motivates operators to always be in compliance."
The spot-check inspection teams will include social workers, fire marshals, building and code enforcement officials, and representatives from the state's Medicaid Fraud Control Unit and the state's attorney's office.
The Florida Agency for Health Care Administration, which regulates nursing homes and conducts scheduled health inspections, had been criticized for giving advance inspection notice to homes, which allowed some problem facilities to be on their best behavior during reviews, only to deteriorate later.
"The success of Operation Spot Check depends upon the element of surprise," Clenendin said.
He said a surprise inspection team in Fort Lauderdale arrived at a nursing home one weekend and found not a single staff member within the facility.
The program has not yet conducted any surprise inspections among Hillsborough County's 32 nursing homes and 265 adult-living facilities but has implemented security precautions to avoid leaks that could eliminate the element of surprise. Only one team member knows which facility will be inspected next.
Mark Schlein, assistant attorney general and the director of Florida's Medicaid Fraud Control Unit, said the program is intended to augment, not replace nursing home inspections. "All of these are quality-of-care issues," Schlein said. "An inoperative air-conditioning unit can be a matter of a life and death to elderly patients in the Florida heat. We take a team approach. That allows us to do more than any one agency can do."
Schlein said that while inspections remain the turf of the FAHCA, there was no territorial war over Operation Spot Check.
"I think (the FAHCA) recognized that as a result of real-world resource constraints they can't do as much as they'd like to," he said. "They've signed on willingly."