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Judge orders state to speed up probes of nursing homes

The Mercury News

By Barbara Feder Ostrov
Wed, Sep. 13, 2006

A San Francisco judge on Tuesday ordered state health officials to dramatically speed up investigations of nursing home complaints, dismissing their protests that the task was too onerous and that they needed more time.

It was a clear victory for advocates of the elderly, who had sued the California Department of Health Services in October for what they called the agency’s pervasive and egregious failure to quickly investigate such complaints.

"I don’t see a reason why it can’t be done," San Francisco Superior Court Judge Peter Busch told the attorneys in the case. "Unless the court puts pressure on . . . it won't be done."

State law requires inspectors to investigate complaints of neglect or maltreatment within 10 working days. But in the first half of 2006, the Department of Health Services investigated fewer than half of complaints within that time, a dramatic decline since 2003, when the agency managed to investigate 71 percent of complaints on time.

The state agency has maintained that it has too few inspectors to investigate allegations by the 10–day deadline, although a recent $20 million budget boost is allowing more staffers to be hired. George Prince, an attorney representing the state agency, told the court the agency could not start investigating most complaints quickly until April 2007 nor clear the agency’s backlog of complaints until October 2007.

But the judge left little room for delay Tuesday, ordering the agency to clear nearly half its backlog and start investigating at least 80 percent of new complaints within four months. Within eight months, the agency must investigate every complaint and completely clear its backlog.

As of mid–August, the agency had at least 460 cases, some dating from January of this year, that have not been investigated, according to its records. While the agency quickly investigates the majority of cases involving imminent harm or death to a patient, the agency failed to investigate at least one of those cases, and an additional 200–plus cases in the backlog are classified at the second highest level of concern. In some cases where the agency did finally investigate, it took as long as 145 days to investigate a highest–priority complaint, records show.

"It’s about time that victims of abuse and neglect get timely attention to their complaints," said Mike Connors of California Advocates for Nursing Home Reform, which filed the lawsuit.

Betsy Hite, a spokeswoman for a nursing home industry group called the California Association of Health Facilities, praised the ruling. "A nursing home also wants to know what went wrong and what remedial steps it should take."

One of the plaintiffs, Los Gatos resident Julie Fudge, had filed a complaint with the state agency after her 93–year–old mother died in a Saratoga nursing home under suspicious circumstances but did not get an official response for 10 months. Her complaint, involving a potential medical error, was never substantiated.

"It’s a good step; we’re inching forward," Fudge said. "But there’s a long road ahead. The system has many, many problems."

Information on filing a complaint against a nursing home and how to evaluate nursing home quality is online (