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EVENTS

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, 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.

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Violation of the Month Archive

New Developments

  • 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
    https://www.cdph.ca.gov/Programs/CHCQ/LCP/CalHealthFind/Pages/Complaint.aspx
    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)
  • Governor Newsom Vetoes CANHR Co-sponsored Bill Requiring Skilled Nursing Facilities to Keep Residents Safe During Power Outages
    On September 25, Governor Newsom vetoed SB 1207, a critically important bill by Senator Hannah-Beth Jackson that would have required skilled nursing facilities to have an alternative source of power to protect resident health and safety and maintain safe temperatures for at least 96 hours during any type of power outage. Senator Jackson’s bill – The Nursing Home Resident Safety Act – had near unanimous, bipartisan support in the Legislature and was a priority measure for the Senate Wildfire Working Group. SB 1207 was co-sponsored by CANHR and Long Term Care Ombudsman Services of San Luis Obispo County and supported by many advocacy, human service and governmental organizations. Read CANHR’s September 28, 2020 press release on the veto
    (posted September 28, 2020)
  • White House Commission Urges Feds for More Resources (But Not Enforcement) in Nursing Homes
    The White House's Coronavirus Commission on Safety and Quality in Nursing Homes released an extensive report reviewing lessons learned from the COVID-19 pandemic and making recommendations to improve safety in nursing homes related to infection control. The report sets forth dozens of potential "action steps" for the Centers for Medicare and Medicaid Services (CMS) and other federal and state agencies to take to foster better infection control involving:
    - COVID-19 testing;
    - providing PPE and training staff to use it;
    - updating resident visitation and cohorting policies to be more sensitive to the balance between safety and quality of life; and
    - supporting staff/caregivers.
    Essentially, the report calls for more funding and guidance from the government to nursing homes. The report is notably missing recommendations regarding better enforcement of nursing home standards of care and are meant to reduce the spread of infection and enhance resident well-being.
    Commission member Eric Carlson of Justice in Aging refused to endorse the report, instead writing a three-page rebuke of the report's failures. Eric writes "[the report] recommends dozens of obligations for the federal government, but does little to set higher standards for nursing homes, or to ensure nursing home accountability." The report sets up CMS to act as financial supporter, consultant, and educator to nursing homes rather than its legal role as an enforcement agency charged with consumer protection. A similar effort to transform regulators from enforcers to job coaches has taken root in California and threatens to further degrade regulatory compliance.
    (posted September 28, 2020)
  • Health Affairs Study: Lower COVID Mortality Rates at Unionized Nursing Homes
    A new study from Health Affairs shows that nursing homes with unionized staff members have had 30% fewer resident deaths from COVID-19 than facilities without unions. In addition, the unionized nursing homes had a 42% smaller COVID infection rate than homes without unions. The study reviewed COVID cases in New York nursing homes from March through May 2020. The authors of the study pointed out that unionized nursing homes benefited from having greater access to PPE, such as N95 masks and face shields, and generally provide better care historically than nursing homes without unions. In addition to the lack of union presence, the study found that facilities fared worse on COVID-19 when they were part of a nursing home chain chain or had poor CNA staffing.
    (posted September 14, 2020)
  • Urge Governor to Protect Nursing Home Residents from Deadly Power Outages
    Please help support SB 1207 (Jackson) by urging Governor Newsom to sign it. This critical bill codifies federal standards that require skilled nursing facilities to have an alternative source of power to protect resident health and safety and maintain safe temperatures for 96 hours during any type of power outage. CANHR and Long Term Care Ombudsman Services of San Luis Obispo County are co-sponsoring SB 1207.
    Click to Read More
    (posted September 9, 2020)
  • California Department of Public Health Issues New Visitation Guidance
    On August 25, the California Department of Public Health (DPH) issued All Facilities Letter 20-22.4 outlining some significant changes to the State’s ever-evolving guidance relating to visiting nursing homes and other health facilities during the COVID pandemic.
    Click to Read More
    (posted September 3, 2020)
  • New Research: Nursing Homes Inflate CMS "Quality Measures"
    It should surprise nobody to hear that new research finds nursing homes inaccurately report the conditions of their residents when submitting "quality measure" data to the Centers for Medicare and Medicaid Services. The self-reported data is used as one of three major components to a facility's federal 5-star rating. For years, nursing home resident advocates have argued that any ratings system should not rely on unaudited, self-reported data from the nursing homes themselves because they have an incentive to report inflated data. In the new research, quality measure data was compared to Medicare claims data for nursing home residents who were hospitalized. The comparisons demonstrated that nursing homes substantially underreport the number of residents who develop pressure sores while in the facility. The data also showed inaccurate reporting regarding urinary tract infections (UTIs) and resident falls.
    (posted August 31, 2020)
  • Looking for something no longer here? View our "New Developments" archives

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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.