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CANHR Zoom Town Hall
COVID-19 Vaccinations in Long Term Care Facilities

On January 15th CANHR hosted a Zoom town hall for California residents of long term care and their families, friends, and advocates to discuss the COVID-19 vaccine rollout in nursing homes and other long term care facilities.

Speakers included Dr. Jonathan Evans, Mike Dark and KJ Page. Dr. Evans is the former President of the American Medical Directors Association and addressed the clinical side of the vaccine, including safety and effectiveness. Mike Dark is a staff attorney for CANHR and a member of the California Vaccine Community Advisory Committee. KJ Page is the Administrator of Chaparral House in Berkeley, and spoke about what the rollout of the vaccine at an actual Long Term Care facility has been like.



COVID-19 Vaccinations in Long Term Care Facilities

CANHR Fights Illegal Discharge to Reunite Couple
Married 50 Years

When Bill and Beverly Borden entered the skilled nursing facility housed in Tahoe Forest District Hospital in Truckee, they and their family thought the couple of more than fifty years had found a home to spend the rest of their lives together.

In April of 2020, in the midst of the COVID pandemic, the facility dumped Bill Borden in a hospital emergency room and refused to readmit him to return to his wife. The couple and their family were devastated, and they reached out for help to their ombudsman and to CANHR.

CANHR immediately filed a complaint with the California Department of Public Health, and successfully represented the Bordens at a hearing before the Department of Health Care Services. Although the agency ordered that Bill be immediately readmitted, the facility ignored the ruling and the State did not enforce the hearing decision. Capitalizing on the State’s inaction, the facility filed for a civil restraining order to prevent Bill's return. CANHR represented the Bordens in the superior court hearing on that motion, again resulting in a resounding defeat for the facility.

With the facility refusing to readmit Bill and obey the DHCS order, and the State refusing to enforce its own order, CANHR sought the assistance of the federal Centers for Medicare and Medicaid Services (CMS), arguing that the CMS should decline to provide Medicare reimbursement to the facility because its refusal to readmit Bill meant the facility was not complying with its contract with the federal regulator. These arguments were successful, and faced with a meaningful penalty for flouting federal law on October 17 the facility finally readmitted Bill, ending the longest separation the couple had experienced in their marriage.

As soon as Bill's short quarantine is over, he and Beverly will again be together, at home.

Residents and their families experiencing unlawful discharges and wrongful refusals to readmit should contact CANHR for advocacy and advice.

click to read more

CANHR's COVID-19 Coronavirus
News & Resources 

In an effort to keep you all better informed, we have created a website, specifically for COVID-19 information, news and resources related to Long Term Care. For the duration of this crisis, we are posting frequent updates there.

Home Equity Protection Program (HEPP)
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Join our campaign to restore reasonable visitation to residents in long term care facilities.
Hollywood Premier Dumps Resident For NOT Having COVID-19


Violation of the Month Archive

New Developments

  • CANHR Files Lawsuit Against CMS Over Weakened Nursing Home Enforcement
    On January 18, CANHR and the Consumer Voice for Quality Long Term Care sued the Centers for Medicare and Medicaid Services over a 2017 policy directive that pushes nursing home enforcers into smaller "per instance" fines instead of "per diem" fines that hold facilities accountable for each day of their wrongdoing.  The directive has been particularly loathsome during the COVID-19 pandemic, a time when strong enforcement of our nursing home care standards has never been more important.  Read AARP's press release about the lawsuit here.  CANHR is being represented by AARP Foundation and Constantine Cannon LLP.
    (posted January 19, 2021)
  • Spectrum Institute to Co-Host Free Town Hall on California's Conservatorship System - February 1 at 11:00.
    The Spectrum Institute and some other organizations will be hosting a town hall meeting on February 1 at 11:00 to review the problems in California's conservatorship system and discuss possible reform efforts.
    Download flyer with more information HERE.
    (posted January 19, 2021)
  • New Study Examines COVID-19 Cases and Deaths in California’s Nursing Homes
    On December 1, the California Health Care Foundation released a new report – COVID-19 in California’s Nursing Homes: Factors Associated with Cases and Deaths – that was prepared by a team of researchers from UCSF, Cal Hospital Compare and IBM Watson Health. Early in the pandemic, the study found that low staffing levels and for-profit ownership were major factors triggering outbreaks and deaths in California nursing homes. For-profit nursing homes had COVID-19 case rates five to six times higher than those of nonprofit and government-run nursing homes while facilities with RN staffing greater than 0.8 hours per resident day had 50 percent fewer COVID cases than nursing homes that staffed below that level. As the pandemic spread, demographic factors including age and race were found to be significant risk factors. For example, nursing homes with higher percentages of Latino residents were found to have larger outbreaks than those with smaller populations of Latino residents. The report contains a series of important recommendations on staffing, ownership oversight, health equity promotion, facility size and design, transparency and public reporting of data.

    Read the Los Angeles Times article on the report: As virus again surges in California, race is a defining factor in nursing facilities, research shows
    Read the San Francisco Chronicle article on the report: Coronavirus cases and deaths soared in nursing homes across California. Here’s why
    (posted December 3, 2020)

  • Can Long Term Care Facility Residents Go Home for the Holidays During the Pandemic?
    In addition to the over 90,000 reported deaths due to COVID-19 in the nation’s nursing homes since March, the Associated Press is reporting findings that more than 40,000 additional residents died prematurely due to other causes. Those “excess deaths” were identified through an analysis conducted by Stephen Kaye, a professor at the Institute on Health and Aging at the University of California, San Francisco. The November 18 AP article – Not just COVID: Nursing home neglect deaths surge in shadows – describes a tandem wave of horrific deaths in nursing homes due to extreme neglect and isolation. The analysis found that for every two COVID-19 victims in nursing homes, there is another who died prematurely of other causes.

    California officials have turned a blind eye toward this wave of deadly neglect by suspending regular inspections that evaluate the quality of care in nursing homes. The federal Centers for Medicare and Medicaid Services (CMS) gave the California Department of Public Health (CDPH) authority to restore full inspections more than three months ago, yet it still hasn’t done so, opting instead to divert inspectors to narrowly focused infection control surveys that its own inspectors have harshly criticized for ignoring neglect. Alarmingly, CDPH’s actions are helping to cover up neglect rather than to detect and stop it.

    Not surprisingly, the AP’s investigation points to understaffing as a primary cause of the neglect. Here too, the CDPH is aiding negligent nursing home operators and exposing residents to neglect by rubber-stamping hundreds of operators’ requests to waive California’s minimum staffing standards during the pandemic. CDPH has granted such waivers to over 300 skilled nursing facilities, including to some of the worst performing nursing homes in the state.

    click to read more
    (posted December 2, 2020)
  • California Department of Public Health Moving Forward with Divisive Plan to Turn Inspectors into Consultants to Nursing Home Operators
    On November 20, 2020, the California Department of Public Health (CDPH) wrote CANHR rejecting CANHR’s call to withdraw its misguided plan to turn nursing home inspectors into consultants to nursing homes. After spending the summer touting the benefits of a consultative role for inspectors, CDPH now disingenuously claims that its new survey model will not be consultative. Its actual plan and revised duty statement for inspectors show otherwise. The highly controversial duty statement is the subject of an Unfair Practice Charge filed on August 28 by SEIU Local 1000, the union representing RN inspectors, against CDPH.
    (posted December 2, 2020)
  • Can Long Term Care Facility Residents Go Home for the Holidays During the Pandemic?
    While recognizing they have a right to do so, public authorities are recommending that residents not leave facilities to gather together with loved ones during the public health emergency. In recent days, the Centers for Medicare and Medicaid Services (CMS), the California Department of Public Health (CDPH) and the California Department of Social Services (CDSS) have all issued alerts discouraging residents from participating in in-person family gatherings during the holidays.

    What happens to those who leave? Authorities are urging them to minimize risks and are recommending various precautions to limit exposure to the virus. Although residents have the right to return following a holiday gathering, authorities have directed nursing homes and assisted living facilities to screen and monitor residents carefully, to test them when indicated, and, when appropriate, to quarantine returning residents for 14 days. CANHR recommends residents and their representatives speak to facility management - in advance - about any plans they have for holiday outings and seek information, preferably in writing, about the facility's protocols for returning to the facility.

    On November 19, the Center for Medicare Advocacy updated its annual alert – Home for the Holidays: Leaving the Nursing Home During a Medicare-Covered Stay – to address the recent CMS guidance to residents, families and facilities on family holiday gatherings during the pandemic.

    Read the November 18, 2020 CMS alert to Nursing Home Residents and Their Families on Holiday Gathering and Outings.
    Read the November 20, 2020 CDPH All Facility Letter 20-86.1 to Long Term Care Facilities on COVID-19 Infection Control Recommendations during Holiday Celebrations
    Read the November 20, 2020 CDSS Provider Information Notice 20-42-ASC on COVID-19 Infection Control Guidance for Celebrations and Outings

    click to read more
    (posted November 23, 2020)
  • Nursing Home Complaints Undermined by CDPH Website Change
    What happened? Due to a change in the way CDPH formats its on-line complaint form, people who file complaints against health facilities, including nursing homes, no longer see fields in which they can input their contact information. Therefore, complaints are being received as anonymous.

    Why does this change matter? If a complainant does not enter their contact information, the results of the complaint will not be communicated to the complainant. In addition, the investigator assigned to the complaint will not be able to gather any additional information from the complainant. Both of these problems will increase the likelihood that complaints are not fully investigated.

    What can I do? If you have filed a complaint in 2020 and have not received a letter officially opening the investigation, re-file your complaint asap.

    Can I still file complaints on-line? Yes, just be sure to enter your (the complainant's) information in the "complainant information (optional)" box on the complaint website - unless of course you wish to remain anonymous. To file a complaint, go to
    and enter the facility name. To open the complainant information input fields, click on the arrow in the "complainant information (optional)" box. A picture of the box is below.

    When will this problem be corrected? We don't know. CDPH is aware of the problem and has agreed to update the website to resolve it.

    click to read more
    (posted November 23, 2020)
  • Voting during COVID-19 For Nursing Facility and Assisted Living Residents
    There’s a big election coming up in November. If you live in an assisted living or nursing facility, you should be aware that you do not lose your right to vote just because you move into long-term care. However, you might face a number of practical barriers to exercising your right to vote, and many of these barriers will be exacerbated in the context of COVID-19.
    CLICK HERE for guidance for residents planning to exercise their right to vote this November.
    (posted October 2, 2020)
  • Los Angeles County Inspector General Issues First Report on Nursing Home Investigation
    On October 14, the Inspector General appointed to investigate the crisis in Los Angeles County nursing homes released the first interim instalment of what will be a multi-part report. Even this first report makes it clear that the County's Department of Public Health, which contracts with the State to provide oversight and inspection of Los Angeles facilities, has badly failed the County's long term care residents.

    The report states that almost half of the 5,407 current nursing home complaints concerning County residents have remained open for over three years, and that 547 investigations involving residents in immediate jeopardy are unresolved. The report also raises questions regarding the County DPH's designation of dozens of poorly performing nursing homes as facilities dedicated to COVID treatment. While the initial report draws needed attention to the County's dysfunctional oversight, it remains to be seen if the continuing investigation will identify and address the horrific conditions that have endangered nursing home residents in the County for decades.

    click to read more
    (posted October 16, 2020)
  • CANHR Fights California Department of Public Health Plan to Transform Nursing Home Inspectors into Advisors to Operators
    On October 5, CANHR wrote the California Department of Public Health (CDPH) urging it to withdraw its deceptively named nursing home oversight plan – Quality and Safety State SNF Survey Model – that would divert its inspector workforce by requiring inspectors to conduct collaborative monitoring visits at skilled nursing facilities. CANHR’s letter also urges CDPH to rescind a new duty statement for nursing home inspectors that requires inspectors to spend 30 percent of their time advising and assisting nursing home operators on regulatory matters. The highly controversial duty statement is the subject of an Unfair Practice Charge filed on August 28 by SEIU Local 1000, the union representing RN inspectors, against CDPH.
    (posted October 15, 2020)
  • Office of Inspector General Reports States Are Still Not Investigating Nursing Home Complaints in a Timely Manner
    The latest in a long line of investigations on failed oversight of nursing homes found that many states are consistently failing to meet federal performance standards for investigating high priority complaints. The findings are detailed in a September 2020 report by the federal HHS Office of Inspector General: States Continued to Fall Short in Meeting Required Timeframes for Investigating Nursing Home Complaints: 2016-2018.
    (posted October 15, 2020)
  • KPBS Reviews Abuse and Big Profits in El Cajon Nursing Home
    A recent two-part series from KPBS examined abuse, poor care, and big profits at Avocado Post Acute, a nursing home in El Cajon. The first story focused on an alleged sexual assault perpetrated by a certified nursing assistant (CNA) against a resident. The resident reported the incident to multiple staff members within hours after it happened but the facility management did not respond timely or appropriately. The CNA accused of the assault was initially permitted to return to work and may have committed sexual misconduct at different nursing homes before and after the alleged incident at Avocado Post Acute. The second story reported that Avocado has a very poor track record for regulatory compliance and has significantly understaffed its facility, causing harm to residents while reaping big profits for the owners.

    For the alleged sexual assault and failure to appropriately report the allegations to the authorities, Avocado Post Acute received two minor federal deficiencies deemed "no harm." No state citation was issued despite a law making the failure to report alleged abuse within 24 hours an automatic Class B citation.
    (posted October 13, 2020)
  • Looking for something no longer here? View our "New Developments" archives

Need a Speaker?

If you would like to invite CANHR to a support group meeting, resource fair, or other event in your community, please complete a speaker request form online.
Note: Due to limited number of staff, CANHR may not be able to accommodate all requests outside of the Bay Area and Greater Los Angeles Area.