Maryland health officials have revoked 157 nursing assistants' certificates after learning that a state employee awarded the medical documents to people who didn't apply or didn't meet minimum standards.

The Department of Health and Mental Hygiene's inspector general concluded in 2009 that an employee fraudulently issued 19 nursing certificates, but the new findings show more than eight times as many faulty certificates had been issued. The employee has been fired.

A new audit also found that 53 percent of Maryland's 1,367 licensed assisted-living facilities and 76 percent of the state's 201 centers for the disabled were not inspected during fiscal year 2010. The Office of Health Care Quality says staff reductions it would be unable to meet the legally required standards without additional workers.