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"Nursing homes go uninspected"

The Examiner

Edward Carpenter, The Examiner
2007–02–19 11:00:00.0


Staffing shortages are largely to blame for a huge backlog of inspections and failure by the state to investigate nursing home complaints that is only now beginning to be cleared, according to officials and advocates.

The problem became so severe that the California Advocates for Nursing Home Reform, along with the daughters of two elderly neglect victims, successfully sued the state in an effort to force reform. San Francisco Superior Court Judge Peter Busch last September ordered the state Department of Health Services to immediately begin clearing its nearly 1,300–complaint backlog and begin investigating 80 percent of new, noncritical, complaints within the 10–day period required by law.

Since then, progress has been made. To meet the mandate, Gov. Arnold Schwarzenegger committed $20 million in the current budget to hire 141 new nursing home surveyors, a 27 percent increase, said Kathleen Billingsley, deputy director of Licensing and Certification Program, Department of Health Services.

"We just didn’t have the resources to make both the complaints and the surveys a priority," Billingsley said.

She has hired 91 of the 141 positions so far, Billingsley said. To date, 99 percent of the complaint backlog has been cleared and 96 percent of complaints requiring an investigation within 10 days are getting one, Billingsley said.

The department has always promptly investigated all critical cases requiring investigation within 24 hours, Billingsley said.

The lawsuit came about as it became clearer to the Advocates that residents in the state’s 1,360 nursing homes were being put at risk as a result of the severe staffing shortage, said Pat McGinnis, executive director of the California Advocates for Nursing Home Reform.

As nursing home complaints soared 30 percent to 15,008 in 2003–04, the state fell further behind, investigating just 50 percent of them, according to court records.

"They were so far behind, it had become a policy to not investigate [noncritical] complaints until the next inspection, which could be as long as 14 months," McGinnis said.

While staffing has been a primary concern, officials with the ombudsman’s office, local district attorney and the Advocates are also concerned about who is caring for the elderly. As inspections and investigations dropped in recent years, authorities saw a disturbing upward trend in elder abuse cases many attribute to poor training and hiring practices in facilities.

Offering a different perspective, Vince Muzzi, owner of Millbrae Serra Convalescent nursing home, said increased inspections and documentation after an accident or injury can themselves contribute to residents receiving inferior care. "Nurses go to school to work with people, not fill out paperwork," Muzzi said.

While he did not pretend to have all the answers, Muzzi said the current system of surprise inspections and complaint investigations sets up an adversarial relationship between nursing facility staff and state inspectors.

Facilities’ information hard to access

Even professionals run up against walls when attempting to find information on nursing homes, information that under state law should be made public to consumers, said Pat McGinnis, executive director of the California Advocates for Nursing Home Reform.

State data on violations going back more than two years has only recently been made available to California Advocates for Nursing Home Reform, McGinnis said. Now her agency is working to post the information online.

Laws protecting private medical information prevent the Ombudsman Program of San Mateo County – tasked with investigating local nursing home and other senior care facility complaints – from publicizing violations to anyone except the state, Executive Director Tippy Irwin said.

The state is working on a Web site and hopes to have it up and running by this summer, said Kathleen Billingsley, deputy director of Licensing and Certification Program, Department of Health Services.

For the most up–to–date information available, the California Advocates for Nursing Home Reform Web site may be the best bet. The local ombudsman, too, can tell consumers what to look for in a quality facility and where to find archived state inspection records.

> The nonprofit California Advocates for Nursing Home Reform offers information on facility violations, advocate programs and finding a lawyer. They can be reached at (415) 947–5171 or (800) 474–1116, or at

> The Ombudsman Program of San Mateo County investigates long–term care facility complaints and ensures confidentiality. They can be reached at (650) 349–7008.

> The San Mateo County District Attorney’s Office investigates and prosecutes elder abuse. It can be reached at (650) 363–4636.