Board's failure to resolve complaints endangers patient safety

In a recent government meeting, significant concerns were raised regarding the Arizona Board of Nursing's complaint handling processes, following a performance audit and subsequent follow-up review. The initial audit, conducted in September 2021, highlighted critical deficiencies in the board's ability to resolve complaints in a timely manner, with many cases exceeding the mandated 180-day resolution period.

During the follow-up review, it was revealed that approximately 75% of over 2,000 public complaints closed between March 2022 and March 2023 did not meet this timeline. Alarmingly, some complaints took over three years to resolve, including serious allegations of unprofessional conduct and patient safety risks. For instance, a high-risk complaint involving sexual harassment was substantiated only after more than three years of investigation.

The board has implemented seven out of eleven recommendations from the initial audit, but three remain unaddressed, alongside four new recommendations stemming from the follow-up review. These include improving the timeliness of complaint investigations and enhancing documentation practices. The board's current staffing levels and resource allocation have been cited as contributing factors to these ongoing issues, with over 1,800 open complaints reported as of August 2023.

Despite a fiscal year 2023 ending fund balance of nearly $12.7 million, the board has not been authorized to utilize these funds for hiring additional investigative staff, which is crucial for improving complaint resolution times. The board has requested eight additional staff positions for fiscal year 2025, but any potential impact from these hires will not be felt until mid-2024.

Further complicating matters, the board has closed 200 public complaints without recording closure dates, hindering the assessment of their timeliness. Additionally, some complaints alleging unprofessional conduct were not initially investigated, raising concerns about the board's triage policies.

The board's next sunset review is scheduled for October 1, 2025, during which further assessments of its complaint handling processes will take place. The Joint Legislative Audit Committee (JLAC) has directed that the next review will focus on the board's implementation of all outstanding recommendations, including those identified in the recent follow-up.