A review of the California Board of Registered Nursing's enforcement program detected a backlog of more than 180 complaints not yet assigned to one of the board's investigators, suggesting some active frontline caregivers could be putting patients at risk.
During its review, the California State Auditor found of the 40 complaints made between Jan. 1, 2013 and June 30, 2016, the nursing board failed to address 31 of them within the 18-month goal set by the California Department of Consumer Affairs. These types of delays have contributed to the current backlog. Of the 180 cases yet to be disseminated to investigators, 140 were pending investigation for more than 10 days. Among these pending cases, approximately 70 involved allegations categorized as urgent or high-priority. Such allegations may include criminal activity and patient death or harm. The average length of pending status for these urgent violations was nearly 80 days.
"Further, [Board of Registered Nursing] lacks accurate data to assess the timeliness of its complaint resolution process as the system it uses for enforcement activities lacks adequate controls to ensure BRN staff members accurately enter information into the system regarding complaint status," wrote Elaine Howle, State Auditor, in a letter to California legislators on the findings. "As a result, we found errors when attempting to calculate the length of each stage in the complaint resolution process, and had to remove nearly 4,800, or 17 percent, of the complaints from our analysis due to these errors."
The nursing board oversees 420,000 licensed nurses and investigates more than 7,000 complaints annually. Bonnie Castillo, RN, associate executive director of the California Nurses Association, told The Sacramento Bee the CNA was still reviewing the audit's findings. Ms. Castillo cited staffing problems as an underlying factor in the issue, referencing the ratio of one board member for every 3,000 nurses. Conversely, for the state medical board that ratio is one to 900.
"We know staffing is everything, for efficiency and to ensure the public is adequately protected. And that is really way too few staff," Ms. Castillo told the Bee.
Michael Deangelo Jackson, the nursing board's president, did not dispute the audit's general findings. In a letter to Ms. Howle, he said the board was in the process of making changes, according to the Bee.
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