The other day, I found myself getting very frustrated with a particular sector of the clients we service. You see, we provide service to the healthcare industry. We are project managers in the construction arena serving acute care hospitals as well as long term care providers, independent living, assisted living, and skilled nursing facilities.
My focus in this narrative is on the Skilled Nursing Facilities (SNF) for two reasons. First, they are regulated by the State of California unlike the independent and assisted living facilities who deal with their local municipalities. We seem to have government getting into our spaces and faces more and more with each passing day. Second, SNFs lack the attention they deserve both from external sources as well as their internal representation. These facilities take care of our elderly. The revenue and reimbursement it takes to properly address this population, though it may be debated, amounts to a lot of money.
However, herein lies the problem, the SNF facilities have a habit of undertaking construction work without the benefit of a building permit. Time passes, months and even years. Then, they get visited by an agency responsible for some level of certification concerning their operation.
The California Department of Health (CDPH), one of the agencies, visits the site whereupon they do a survey; this occurs annually. I am not sure, but I think CDPH huddles in advance of sending their teams out in order to determine their focus in a given year.
Currently, it seems to be kitchen hoods and the fire suppression systems that accompany them, but it can be a multitude of issues.
Now understand, I am not advocating anything short of doing the work correctly. But, when an agency comes out and cites conditions that have been in operation for over 5 years without a permit, you have to ask yourself, “Why does this happen?” I am suggesting that it may be a combination of a lack of education as well as a lack of responsibility on the part of both the facility and the responsible agencies.
Now, the corrective action for the facility is to back into the process by engaging an architect and an inspector, securing plans, getting a permit, testing the system, and securing approval through the Office of Statewide Health Planning and Development (OSHPD). The cost associated with this can exceed $5k-10K very easily. There are over 2,000 SNFs in California and many, if not most, were built in the 1960’s so the building inventory in the State is well over 50-years-old. We talk about helping our elderly, this is one area where help is truly needed.
I feel better just sharing this. Well, time to go help another facility with their citation.