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During the past year, residents of long-term care facilities and their family members faced the unimaginable. COVID-19 took the lives of over 13,000 nursing home and assisted living facility residents and staff in California and turned bad facilities into some of the most dangerous places in the state. Unable to visit residents, family members watched their loved ones deteriorate from isolation, lack of adequate staff and lack of adequate care.

Throughout this terrible year, CANHR remained open and worked tirelessly to assist the thousands of residents, family members, social workers, and ombudsmen, law enforcement and state legislators who called our hotline or emailed their concerns.

Please read our complete letter HERE and stories of our consumer advocacy during the pandemic HERE.

Join our struggle. Please donate generously. With your donation, we can continue our advocacy for all long term care residents.

EVENTS

CANHR Zoom Town Hall:
The Current State of Visitation Rights
in Long Term Care Facilities

Thank you to our guest speakers from the Essential Caregivers Coalition.

CANHR Job Opening: Staff Attorney

CANHR has an opening for the position of Staff Attorney. To read more details and see the instructions for applying, please visit THIS PAGE. You can also download the PDF VERSION of all the relevant information.

Support H.R. 3733: New Federal Legislation to
Protect Resident Visitation in Future Pandemics

On June 30, Congressmembers Claudia Tenney and John Larson introduced H.R. 3733, a bipartisan bill that would guarantee nursing home residents' right to critical in-person support from up to two essential caregivers, even during a pandemic.  The essential caregivers are designated by the resident or the resident's representative and would have up to 12 hours of access to the resident each day.  If the bill becomes law, it would be a powerful rebuke to CMS and the states that adopted and maintained dangerous and overreaching bans on visitation during the COVID-19 pandemic.  CANHR encourages everyone to contact their Congressmember and urge them to support H.R. 3733. Graphic courtesy of the Essential Caregiver Movement.

CANHR's COVID-19 Coronavirus
News & Resources 

In an effort to keep you all better informed, we have created a website, https://canhrnews.com/ 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)
funded by the State Bar of CA to prevent financial mortgage scams and more... Please read our FREE BOOKLET of Reverse Mortgage information.

 

#VisitationSavesLives
Join our campaign to restore reasonable visitation to residents in long term care facilities.
 
Hollywood Premier Dumps Resident For NOT Having COVID-19

Read More...


Violation of the Month Archive

New Developments

  • Podcast: How to Advocate for a Loved One Labeled "A Bad Fit."
    CANHR Staff Attorney Tony Chicotel is featured on a new podcast from the National Consumer Voice for Quality Long-Term Care discussing long term care facility residents who are labeled "a bad fit." Residents and their advocates often feel shame and impotence about dementia-related behaviors and are hesitant to address the failures in care that cause such behaviors.  In the podcast, Tony talks about raising expectations for dementia care and exercising residents' rights to care that maximizes their comfort and quality of life.  The podcast is part of a series to help people pursue good long term care.
    (posted August 4, 2021)
  • New State Vaccination Rule for Nursing Homes and Assisted Living Facilities
    The State of California has taken an important step to safeguard the wellbeing of residents of long term care by mandating that virtually all facilities providing care in congregate settings take steps to ensure that their workers are vaccinated.

    In an order issued July 26, the State mandates that hospitals, skilled nursing facilities, and adult and senior care facilities verify the vaccination status of all employees, and that they require that all unvaccinated employees submit to testing twice weekly in skilled nursing and intermediate care facilities and once weekly in assisted living facilities. Vaccinated, asymptomatic employees need not be tested under the rule. The deadline for compliance is August 23.

    The new rule has been issued just as the new Delta variant of the Covid-19 virus, now widespread throughout the U.S., has been identified by the CDC as both much more transmissible and potentially more virulent than previously thought
    (posted July 30, 2021)
  • How Many Staff Members are Vaccinated at Your Nursing Home?
    It may be fewer than you would expect.

    According to federal data as of July 11, 2021, less than 80 percent of current nursing home staff in California were vaccinated. However, variation from facility to facility was extreme, ranging from 0 to 100 percent. While 827 California nursing homes reported that 75 percent or more of staff are vaccinated, over 350 facilities fall below that rate. More than one hundred California nursing facilities reported that less than half of their staff is vaccinated or reported no data.

    The vaccination rate data is posted on the Centers for Medicare & Medicaid Services (CMS) COVID-19 Nursing Home Data webpage and is updated weekly.

    Whenever possible, CANHR recommends that people looking for nursing homes avoid facilities where less than 75 percent of staff are currently vaccinated. All other things being equal, give preference to facilities where all, or nearly all, of staff and residents are vaccinated.
    (posted July 29, 2021)
  • CMS Restores Tougher Penalties for Nursing Home Violations
    After a lawsuit filed in January 18, 2021 by California Advocates for Nursing Home Reform (CANHR) and the National Consumer Voice for Quality Long-Term Care (Consumer Voice) challenging CMS’s 2017 policy limiting the types of civil money penalties (CMPs) that can be imposed against nursing facilities, CMS has reversed course and announced plans to impose much stiffer penalties for nursing facility violations. READ FULL PRESS RELEASE (PDF) You can read more about the topic in this New York Times article.
    (posted July 28, 2021)
  • CANHR Joins Disability Rights Organizations Supporting Britney Spears' Right to Counsel of Her Choice
    CANHR has joined with 26 other disability rights organizations to submit an amicus brief in the Britney Spears conservatorship case, arguing in support of Ms. Spears' right to have a lawyer of her own choosing. Amazingly, California law is not totally clear about the rights of conservatees or proposed conservatees to select their own attorney. Courts sometimes refuse to allow attorneys selected by conservatees to serve their clients, instead imposing a more "amenable" court-appointed attorney to serve. Thanks to the ACLU for leading this effort to support conservatee rights.
    (posted July 13, 2021)
  • Avoid Long Term Care Facilities with Restrictive Visitation Policies
    Despite plummeting rates of COVID infections and deaths in nursing homes and the lifting of public health-oriented restrictions, long term care facilities throughout the state are still limiting visits from families and friends to a measly 30 minutes per week.  Other facilities, in stark contrast, are permitting extensive daily visitation.  The wide range of visitation policies among facilities has been enabled by the State’s continued waiver of laws that normally require broad visitation access for residents.
      
    Potential residents and their loved ones are strongly encouraged to speak with the managers of facilities they are considering and ask for written copies of their visitation policies.  Facilities that are not willing to share their policies in writing or those that have restrictive policies should be avoided.

    Some facilities are not going to allow more visitation until it starts costing them customers.

    Please see our updated How to Choose a Nursing Home fact sheet for more information.
    (posted July 2, 2021)

  • Office of Inspector General Finds Deaths of Nursing Home Residents Soared by 32 Percent in 2020
    A June 2021 report by the HHS Office of Inspector General found a horrific increase in the death rate of nursing home residents in 2020 beyond deaths caused by Covid-19. The report – COVID-19 Had a Devastating Impact on Medicare Beneficiaries in Nursing Homes During 2020 – reveals that deaths of Medicare beneficiaries in nursing homes during 2020 increased by 169,291 from the previous year. It also found that beneficiaries in nursing homes who were Black, Hispanic, Asian or on Medicaid were more likely to get COVID-19 and to die from it than others. The report concluded that understanding the pandemic’s effects on nursing home residents is necessary to prevent future tragedies.
    (posted June 25, 2021)
  • Advocates Propose Framework for Legislative and Administrative Changes to Benefit Nursing Homes Residents
    A coalition of organizations that advocate for nursing home residents, including CANHR, have proposed a Framework for Nursing Home Reform Post COVID-19. The Framework for federal reform includes multiple proposals under six broad areas – (1) staffing and workforce; (2) regulation and enforcement; (3) ownership and management standards, transparency, and accountability for quality; (4) government payment systems, financial transparency, and accountability; (5) structural changes in the long-term care delivery system; and (6) nursing home redesign and rebuilding. Each proposal requires either legislative change by Congress or administrative action that the Centers for Medicare & Medicaid Services (CMS) could take under its current statutory authority.
    (posted June 25, 2021)
  • LAist Reports Medicare and Medi-Cal Paid Nearly a Half-Billion Dollars to Nursing Home Chain Whose Owner Who Was Denied a License Due to Dangerously Poor Care
    Illustrating why bad actors are in the nursing home business, KPCC reported on June 16, 2021 that nursing homes connected to ReNew Health and its CEO, Crystal Solorzano, received more than $428 million in Medicare and Medi-Cal payments between 2016 and 2019. The story – Despite Multiple Citations for Deficient Care, Government Sent More Than $400M to Troubled Nursing Home Chain – reports that government money flowed to the chain despite violations that put residents’ lives at risk and despite regulators attempts to block Solorzano from acquiring additional nursing homes. According to LAist, “the same government agencies that found those facilities were dirty, understaffed and provided deficient care are also their biggest source of revenue.” The story is part of the ongoing ‘Unprotected’ series examining California’s failures on nursing home oversight, which began with KPCC/LAist’s in-depth investigation of Solorzano’s nursing home chain: Immediate Jeopardy: Death and Neglect Inside A Troubled California Nursing Home Chain.
    (posted June 25, 2021)
  • Sufficient Staffing is the Prescription to Prevent Dangerous Nursing Home Conditions Exposed by the Pandemic
    What policies can best protect nursing home residents now and in the future from the overwhelming infection and death rates seen during the pandemic? That question is the subject of a thought-provoking June 2021 commentary by Professor Charlene Harrington of UCSF and other nursing home experts that was published by the HSOA Journal of Gerontology and Geriatric Medicine: Time to Ensure Sufficient Nursing Home Staffing and Eliminate Inequities in Care.
    (posted June 15, 2021)
  • Advocacy Organizations Call For Restoration of Visitation Rights in Nursing Homes
    Frustrated with visitation policies that are stuck in pre-vaccine 2020, CANHR and several other nursing home resident advocacy organizations called on CMS to restore visitation rights in U.S. nursing homes. Many facilities across the country continue to limit visitation access for residents to 30 minutes per week, leading to extended isolation, deprivation of care, and harm to residents.
    (posted June 14, 2021)
  • News Series Points Out Huge Problems in California Conservatorship System
    ABC 10 in Sacramento recently released a five-episode series on California’s flawed conservatorship system called “The Price of Care.”  The investigative report exposes broad problems in the way conservatorships are granted and monitored while featuring individual stories in which conservatees were placed in long term care facilities, separated from family members, and charged enormous sums by professionals who profit from the system.  While many of the conservatorship criticisms and themes featured in the series will not be new to those familiar with CANHR’s work, the series comes at a pivotal time in state reform efforts.  Two bills in Sacramento, AB 1194 (Low) and SB 724 (Allen), would make important positive changes to the conservatorship process and are discussed in the fifth episode.  ABC 10’s reporting is another example of recent media coverage of conservatorship problems that is contributing to a groundswell in demand for reform.
    (posted June 1, 2021)
  • State and Counties Sue Mariner Nursing Home Chain for Fraud, Understaffing, and Resident Dumping
    A lawsuit filed by the California Attorney General and a group of District Attorneys throughout the state alleges that Mariner Health Care Inc., which runs 19 nursing homes in California, systemically broke laws and harmed patients "all to generate increased profits at the expense of resident care." 

    The Mariner action follows a civil lawsuit filed against one of its facilities and a similar lawsuit filed by the AG and District Attorneys against the Brookdale nursing home chain. The complaint against Mariner alleges the chain:

    • failed to maintain sufficient staffing to meet the state minimums and the needs of its residents leading to poor wound care, pressure ulcers, lice, scabies, and sexual assaults;
    • illegally dumped residents with Medi-Cal coverage in favor of more highly reimbursed residents with Medicare coverage; and
    • falsified resident information reported to the government to fraudulently obtain a higher federal 5-star rating.

    The Mariner and Brookdale lawsuits represent a new approach to nursing home enforcement in California, led by consumer advocates in the Attorney General's office and in District Attorneys' and City Attorneys' offices around the state. These resident champions are thankfully filling some of the void left by the weak enforcement efforts of our state Department of Public Health.

    click to read more
    (posted May 12, 2021)
  • Federal Antipsychotic Quality Measure is Unreliable
    A recent report from the Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services concludes that antipsychotic drug data used by the Centers for Medicare and Medicaid Services (CMS) is inaccurate, hampered by fraud, and gives a misleading impression of chemical restraint use in nursing homes.

    Since 2012, CMS has used data that is self-reported by nursing homes to compile an antipsychotic drug "quality measure." The idea of the quality measure is to report the percentage of residents receiving an antipsychotic drug at least once a week, excluding "appropriate" drug uses, which includes treating dementia, Huntington's disease, and Tourette's syndrome. The self-reported data purports to show that inappropriate antipsychotic use has declined by 41% since 2011. 

    The OIG report criticizes CMS for relying exclusively on facility self-reported data. Facilities often misreport data, either by error or for their own self-interest, i.e., to make themselves look good. OIG cross-checked self-reported facility data with residents' Medicare prescription drug claims and found two significant accuracy problems. The first accuracy problem is that many residents (over 12,000!) received an antipsychotic drug according to their Medicare claims but the facility did not report the drug use to CMS. The second accuracy problem is that many residents (over 29,000!) were reported to have schizophrenia but their Medicare claims indicated they did not. In other words, nursing homes are hiding their antipsychotic drug use by making up phony schizophrenia diagnoses. Much of the concerns about CMS's antipsychotic quality measure was previously covered by CANHR.

    The recommendations made by the OIG were sensible: CMS should obtain more data about antipsychotic use, like drug brand, dosage, and duration of use, to get a more complete picture of antipsychotics in nursing homes. The OIG also recommended CMS supplement facilities' self-reported data with data from other sources, such as the Medicare claims data.

    CMS's response to the OIG findings were tone deaf. While acknowledging the wisdom of improving the accuracy of the data, CMS touted the same unreliable data to brag about the reduction in nursing home antipsychotic drug rates. When it comes to reducing antipsychotic drug use in nursing homes, CMS is trumpeting success that it knows has not really been achieved. Despite all of CMS's self-reported efforts, 20% of all nursing home residents still receive an antipsychotic drug and the vast majority of those residents are receiving them inappropriately.

    click to read more
    (posted May 10, 2021)
  • The Consequences of Regulatory Failure: 132,000 Dead Nursing Home Residents
    A new article in the Georgetown Law Review, “Nursing Homes, COVID-19, and the Consequences of Regulatory Failure,” by Syracuse Professor Nina Kohn attempts to explain why COVID-19 was so devastating to nursing homes in 2020. In the article, Professor Kohn condemns the idea that the enormous number of COVID-19 infections and deaths in nursing homes was “inevitable” or “largely outside of [facilities'] control.” She goes on to summarize:

    [T]he nursing-home-as-victim narrative belies the deliberate policy choices and regulatory failures that have shaped long-term care in the U.S. and enabled nursing homes to make choices that have long endangered the health and welfare of their residents. . . . The skyrocketing death rates in nursing homes are not merely the result of glitches in the public health response to COVID-19, but rather a predictable consequence of the failure to enforce federal regulations, gaps in regulatory requirements for facilities, and policies that steered vulnerable, older adults into these institutions in the first place.  

    Professor Kohn critiques the nation’s slow rollout to address the massive vulnerability of nursing home residents to COVID-19: routine testing of staff and residents was not required until six months after the pandemic hit, PPE was not provided to nursing homes, and staff were permitted to work in multiple facilities. These failures combined with longstanding nursing home problems like chronic understaffing, entrenched underenforcement of regulatory standards, and disproportional long term care spending on institutional settings over home and community based settings (“perhaps the most fundamental policy failure”), to create a system that was almost totally unequipped to deal with a highly contagious, highly lethal virus.

    The policy prescriptions Professor Kohn advises are comprehensive. She observes that facilities providing awful nursing home care are paid just about the same as facilities providing high quality care. Policymakers must do a better job of aligning nursing home reimbursement with higher quality. Higher direct care staffing should either be mandated or financially rewarded. The U.S. and states should consider adopting spending floors on direct care. Finally, more public dollars should be allocated away from institutional settings and directed to home and community based services.

    Professor Kohn ends her article with a familiar axiom: creating a more humane long term care system is completely doable - the question is whether society and our policymakers are willing to make the commitment.

    click to read more
    (posted May 4, 2021)
  • Court Ruling a Watershed for Victims of Resident Dumping
    In a big victory for nursing home residents, a California court has ruled that residents who are dumped and refused readmission only need to prevail in their administrative fair hearing in order to establish a violation of their rights in a civil action against the facility.

    The case involves former nursing home resident Gloria Single, who was dumped from a Sacramento nursing home called Pioneer House into a hospital and refused readmission in 2017. Ms. Single's husband lived at Pioneer House too so the facility's illegal refusal to readmit her meant the couple was kept apart for the rest of Ms. Single's life (she passed away in 2019). 

    Shortly after her illegal eviction, Ms. Single exercised her right to appeal with the state Department of Health Care Services. Her appeal was successful and Pioneer House was ordered to readmit Ms. Single. But it didn't, choosing instead to thumb its nose at the State. Eventually, Ms. Single filed suit.

    The court's order found that Ms. Single's successful appeal creates "issue preclusion," meaning the determination of Pioneer House's conduct as illegal had already been adjudicated in the administrative appeal and carried over to Ms. Single's civil case. Thus, nursing home residents who prove that their facility violated their rights in a state eviction hearing are entitled to judgment as a matter of law in a subsequent civil action.

    Gloria Single is represented by Matt Borden of Braunhagey & Borden. Braunhagey & Borden have spent the last several years successfully fighting for justice for illegally dumped nursing home residents.

    click to read more
    (posted April 23, 2021)
  • Nonprofit Newsrooms Put Spotlight on Unfit, Unlicensed Nursing Home Operators in California
    On April 6, two nonprofit newsrooms in California published findings of remarkable investigations of California nursing home chains that are expanding their operations despite decisions by state regulators that they are unfit to be licensed. 

    Reporters for KPCC/LAist investigated ReNew Health Group and its CEO, Crystal Solorzano, who it reports owns or is affiliated with at least 26 nursing homes throughout California. Their article – Immediate Jeopardy: Death and Neglect Inside a Troubled California Nursing Home Chain ­– reports that the chain racked up an inordinate number of citations, many for severe infractions known as “Immediate Jeopardies” related to extreme abuse and neglect of residents, such as an alleged rape, an extraordinarily unsafe discharge, and more. State regulators denied Solorzano’s request to take over nine nursing homes and moved to revoke her nursing home administrator license, yet the story reports they have not stopped her from growing the nursing home chain she founded. 

    A CalMatters investigation found that state officials have let the state’s largest nursing home owner, Shlomo Rechnitz, and his companies operate 18 nursing homes for years while failing to decide whether to grant the required licenses. Furthermore, CalMatters reports that Rechnitz and his companies are operating five other skilled nursing facilities despite the Department of Public Health denying their licensure applications in 2016 due to poor track records. According to the story – California oversight of nursing homes called ‘befuddling,’ ‘broken’ – Rechnitz continued to acquire nursing homes during the pandemic.

    Both stories reported that AB 1502 (Muratsuchi) – a CANHR sponsored bill to reform nursing home ownership in California – has been sidelined and will not be heard until next year.

    The stories are part of 'Unprotected,' an ongoing series examining California's failures on nursing home oversight, done in collaboration with other nonprofit newsrooms.

    click to read more
    (posted April 12, 2021)
  • Human Rights Watch Report Examines Lethal Nursing Home Understaffing and Neglect
    new report from Human Rights Watch (HRW) summarizes the horrible neglect and isolation in nursing homes during the pandemic.  In the knee jerk (and ultimately highly unsuccessful) effort to protect residents from COVID-19, policymakers banned visitors that had previously provided significant levels of care to residents, waived minimum staffing requirements, and suspended routine oversight.  As explained to HRW by several dozen nursing home staff members, residents and resident family members, these policies strained pre-existing understaffing problems and led to weight loss, dehydration, bed sores, poor hygiene, and profound isolation among residents.  As of November 2020, it was estimated that nursing homes experienced 40,000 excess deaths (more than would be expected given historical data) not caused by COVID-19.  Policymakers' decisions to isolate nursing homes and withdraw access and oversight in order to save residents tragically "caused serious harm to many people."
    (posted March 26, 2021)
  • AG Becerra and DA Coalition Sue Brookdale Senior Living for Illegal Discharges and Five-Star Fraud
    On March 15, 2021, Attorney General Xavier Becerra and a coalition of district and city attorneys, led by Kern County District Attorney Cynthia Zimmer, sued Brookdale Senior Living, Inc. in Kern County Superior Court, alleging that Brookdale endangered residents of ten California skilled nursing facilities by failing to properly notify or prepare residents before transfers and discharges. The lawsuit also alleges that Brookdale over-reported staffing levels to the federal government, resulting in fraudulent increases to its federal star ratings for purposes of attracting potential residents. Brookdale is the nation’s largest senior living facility operator.
    Read the press release.
    (posted March 17, 2021)
  • New York Times Slams Federal Rating System for Nursing Homes
    A scathing March 13, 2021 article by the New York Times – In U.S. nursing homes, where Covid-19 killed scores, even reports of maggots and rape don’t dock five-star ratings – bluntly declared that the federal government’s five-star rating system for nursing homes “is broken.” The Times described five-star rated nursing homes with residents who had bone-deep bed sores and others who were reportedly raped, drugged, abused and seriously injured due to mistreatment. Moreover, it documented operators routinely gaming the ratings by submitting inflated staffing data and falsified resident care information that makes facilities seem cleaner and safer than they are. Because operators could score high ratings without improving their care, it concluded that nursing homes may have been unprepared for the pandemic. More than 130,000 U.S. nursing home residents have died of Covid-19, and the Times’s analysis found that people at five-star facilities were roughly as likely to die of the disease as those at one-star homes.
    (posted March 17, 2021)
  • Vaccines Are Reducing COVID Outbreaks in Nursing Homes

    study from the American Health Care Association has found that the COVID-19 vaccines are contributing to lower infection rates and COVID spread in nursing homes.  This study, based on preliminary data gathered shortly after the introduction of the vaccine in nursing homes in late 2020, provides evidence in favor of reopening nursing homes after its residents and staff have been vaccinated.

    Nursing homes residents have largely had no in-person visitation with family and friends since COVID first blew up in the United States in March 2020.  While outbreaks have ebbed and flowed in facilities across the country, the visitation prohibition has persisted, leaving residents suffering from extreme isolation and neglect.

    CLICK TO READ MORE
    (posted February 23, 2021)
  • Los Angeles County Inspector General Issues Second Report on Nursing Home Crisis

    On February 16, the Los Angeles County Office of Inspector General (OIG) issued its second report of an ongoing investigation into the crisis in nursing homes. The report and related findings from the Auditor-Controller pick up where the first interim report left off in describing the County Department of Public Health’s dysfunctional nursing home oversight system.

    The new report takes an in-depth look at the evacuation of two Pasadena nursing homes that exposed their residents to life-threatening conditions during the pandemic; describes the concerns of numerous inspectors who complained that the safety of residents who live in nursing homes in L.A. County is compromised by pressures they face to prematurely close investigations and understate serious violations; makes the connection between chronically poor care and profiteering nursing home chains; and identifies systemic management failures that prevent the Department of Public Health’s Health Facility Inspection Division from prioritizing its work and from holding nursing homes accountable.

    The report contains thirteen recommendations, beginning with a recommendation to develop a comprehensive county-wide skilled nursing facility crisis mitigation and response plan. It closes with a statement that “the OIG will further analyze the complex issues involving ownership structures, and make corresponding recommendations, in its final report.”

    click to read more
    (posted February 18, 2021)

  • 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)
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