Nevada’s Department of Health and Human Services sent an action plan to the governor on Monday after a legislative audit last week revealed filthy and unsafe conditions at community homes for the mentally ill almost two years after department officials had purportedly taken steps to address them.

Since Thursday morning, the department has inspected 142 so-called community-based living arrangement homes and confirmed the welfare and safety of every client, HHS Director Richard Whitley said in a Monday statement. However, several providers were placed on 10- and 30-day corrective action plans by inspectors with the Bureau of Health Care Quality and Compliance who accompanied the regular case workers on the site visits.

Whitley, in a statement, reiterated his commitment to “correcting all deficiencies identified by the audit.” He launched an internal investigation into how squalid conditions persisted at the homes when he thought staff with the Division of Public and Behavioral Health had implemented steps to address them in March 2016 in the wake of a Reno Gazette-Journal story.

Sen. Ben Kieckhefer, R-Reno, who visited one of the homes in Sparks with inspectors Monday morning, said that he was “impressed” by the Health Care Quality and Compliance inspectors’ attention to detail. Under existing department policy, case workers are responsible for conducting monthly environmental reviews of the home.

“I think it highlighted the fact that we have a structural program in terms of who is performing these inspections and what sort of chain of command there is and who answers to who,” Kieckhefer said.

The Republican senator, who sits on the legislative committee that heard the audit last week and called the state of the homes a “failure,” said he asked the department if he could come visit during one of the inspections to get a better sense of what was happening on the ground. He said the home wasn’t “one of the worst by any stretch of the imagination” though and had gone through several inspections already.

The seven-day action plan sent to the governor will address where state staff failed to address conditions in the home, including failure to properly certify the homes, conduct timely inspections, observe the problems, properly report findings and properly sanction providers. The department will, in those seven days, determine if homes are safe for consumers, investigate case worker reports and compare to the re-inspection reports, investigate supervisory comments and compare the monthly reports from caseworkers to the legislative auditors’ report.

The department will submit its initial review of data and information with preliminary results by Tuesday with a root cause analysis due on Friday. Deputy director Julie Kotchevar is overseeing the investigation and has been appointed interim Department of Public and Behavioral Health administrator after former administrator Amy Roukie resigned on Friday.

In the next 30 days, the department will develop policies and procedures to ensure regular inspections are happening and corrective items are noted and then regularly checked up on to make sure they are fixed. They will also develop procedures for imposing sanctions on providers who operate the community homes for repeatedly failing to meet standards, as well as policies about children living in the homes and language proficiency and physical requirements for on-site provider staff.

There are a rolling set of deadlines for the various parts of the 30-day action plan, from early to late February. The last corrective action, due Feb. 23, is to develop policies and procedures to ensure provider certifications are performed consistently and in a timely fashion in compliance with a new law that went into effect on July 1.

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