Lillington, N.C. — Harnett County leaders want the authority to inspect all elderly-care facilities, including state-monitored nursing homes, but critics point out deficiencies at rest homes inspected by the county.

Harnett commissioners said that county inspectors could more easily take care of commonly heard complaints – such as lack of care and unhealthy conditions – than state inspectors.

"There's a lot of times we get complaints about different things that we can go in there and visually see, and there's nothing we can do about it," Commissioner Tim McNeill said.

County social service workers inspect Harnett's 15 rest homes and family-care homes, which are assisted-living residences with around-the-clock care. Federal law permits only state inspectors to evaluate the county's four nursing homes, which accept Medicare and Medicaid and can provide a higher level of medical for residents with severe health problems.

Some of those nursing homes, though, have repeatedly been cited for violations by federal and state inspectors. For example, Harnett Manor, a one-star facility, has been noted for violations such as "not controlling the fly population," "showers beds and potty chairs stored dirty" and "feces present."

"These people need a voice and someone to take care of them, and we don't feel like it's being adequately done," McNeill said. "We feel like the county, at the local level, can do a better job of it."

County-inspected rest homes have their own documented problems. In February, Carrie C. Evans, 85, who had dementia, walked out of Primrose Villa, fell into a ravine three blocks away and died of a severe head injury.

A week before Evans' death, county inspectors were at Primrose.

Former Primrose employee, Tina Bartolo, said that both state and county inspectors, in general, provide "no supervision at all."

"They just go in and sit at a desk. They don't check nothing," Bartolo said.

Jeff Nunn, administrator of Harnett Manor, said that state inspectors are stricter than county inspectors and that he doesn't think more county inspections would be productive.

North Carolina has 106 state inspectors and 435 nursing homes. That gives each inspector a caseload of roughly four facilities. Inspectors review those nursing homes at least once every 15 months.

Harnett County leaders said that local inspectors could do reviews every two months and, in the meantime, respond to complaints immediately. "You inspect that day, and you see what is going on that day," McNeill said.

McNeill said that the county can't change what happened to Evens, but he believes that putting more inspectors in adult-care homes might keep other senior citizens from harm.

"If you are there more, you are apt to catch more," he said.

State officials refused to comment on whether they would welcome Harnett County's bid for greater inspection authority.

Anyone with concerns about neglect or abuse at an elderly-care facility can submit a complaint to the state Department of Health and Human Services online, by calling 919-855-4500 or toll-free 1-800-624-3004, by faxing 919-715-7724 or by mailing Complaint Intake Unit, 2711 Mail Service Center, Raleigh, NC 27699-2711.