In this Issue
- Assisted Living Waiver Bill Passes the Legislature
- California’s Top Nursing Home Regulator Owns Interest in Nursing Home Chain
- Federal Watchdog to Probe Enforcement of Nursing Home Staffing Standards
- Curious About Nursing Home Staffing Levels in Your Community?
- Study Finds Breast Cancer Surgery May Do More Harm Than Good for Frail Nursing Home Residents
- Nursing Home Violation of the Month
- CANHR on the Move
Assisted Living Waiver Bill Passes the Legislature
The Assisted Living Waiver (ALW) provides Californians with an alternative to nursing homes, offering Medi-Cal-funded care in community-based settings, like assisted living facilities or public subsidized housing. The program has proven to be popular and cost-effective, but demand for the program has outpaced supply, and there is currently a significant waitlist.
AB 2233 (Kalra) makes much-needed improvements to the ALW by increasing the number of participant slots, expanding the program statewide, and requiring the state to modify provider reimbursement rates to ensure participation from providers.
AB 2233 just passed the legislature with nearly unanimous bipartisan support! Now it’s time to tell the Governor to sign the bill.
Click here to download a sample support letter to the Governor.
California’s Top Nursing Home Regulator Owns Interest in Nursing Home Chain
On August 12, 2018, Politico reported that Karen Smith – the Director of the California Department of Public Health – has ownership interest in Brookdale Senior Living, which operates many long-term care facilities in California, including ten nursing homes that are regulated by Smith’s Department. According to Politico, Smith denied her financial stake in Brookdale has any effect on her decisions.
The public might disagree. Under Smith’s watch, the Department has favored nursing home operators over nursing home residents at almost every opportunity. For example, Smith’s Department:
- is allowing unfit and unlicensed operators to acquire and run nursing homes;
- has developed a waiver system that will allow hundreds of California’s most poorly staffed nursing homes to ignore modest new staffing requirements;
- was blasted by the California State Auditor for endangering nursing home residents by failing to enforce nursing home standards;
- opposed legislation that would have required timely investigations of abuse and neglect reports filed by nursing homes; and
- continues to treat sexual assaults of nursing home residents as minor offenses.
While complaints against nursing homes soared to levels never seen before and nursing home chains siphoned off hundreds of millions of dollars intended for resident care, Smith stood silent. It is more than fair to wonder whose interests she is protecting.
Federal Watchdog to Probe Enforcement of Nursing Home Staffing Standards
Quickly responding to a July 7, 2018 New York Times article written by Kaiser Health News – It’s Almost Like a Ghost Town, Most Nursing Homes Overstated Staffing for Years – the Inspector General at the Department of Health and Human Services in August launched an examination into federal oversight of nursing facility staffing levels.
One of the issues it will investigate is whether the Centers for Medicare and Medicaid Services (CMS) is using the payroll-based staffing data it now collects from nursing homes to enforce federal staffing standards, including the requirement that a nursing home have a registered nurse on duty for at least 8 consecutive hours every day. According to the CMS data, hundreds of nursing homes are violating this requirement.
Curious About Nursing Home Staffing Levels in Your Community?
On August 8, 2018, the Long Term Care Community Coalition (LTCCC) – a New York based advocacy group for long term care facility residents – published updated data on nursing home staffing. The data are presented in easy-to-use charts for each state that show a nursing home’s census; its direct RN, LVN and CNA staffing levels; and the amount of staff care hours per resident, per day. City and county information is included to facilitate local searches. The data is derived from payroll-based data collected by the Centers for Medicare and Medicaid Services (CMS) for the first quarter of 2018. Read the alert from LTCCC.
The LTCCC charts present quarterly average staffing levels for each nursing home. For those who are interested in reported daily staffing levels at a federally certified nursing facility, it is available directly from CMS on its website.
Study Finds Breast Cancer Surgery May Do More Harm Than Good for Frail Nursing Home Residents
Although surgery is often the treatment of choice for women who have breast cancer, a new study found it can harm health and hasten death for frail nursing home residents. The study findings were published in JAMA Surgery and are discussed in an August 29, 2018 California Healthline article. Most residents in the study got sicker and less independent in the year following breast surgery. Residents who were the least able to take care of themselves before surgery were the most likely to die within the following year. Dementia also increased the risk of death. However, the findings may not apply to healthier nursing home residents who are strong enough to undergo outpatient surgery, as they were not part of the study.
Nursing Home Violation of the Month
DPH Waits Over Four Years to Issue Tiny Fine After Two Residents of Windsor Terrace Healthcare Center Are Sexually Assaulted: Two female residents were sexually assaulted on March 28, 2014, when a male certified nursing assistant (CNA) penetrated their vaginas with his finger while providing personal care. While assaulting them, the CNA asked the residents if it felt good.
According to the Department of Public Health (DPH) citation, Windsor Terrace Healthcare Center in Van Nuys reported the sexual assaults to DPH on April 1, 2014. Yet, DPH did not issue its citation until July 6, 2018 – 52 months later – when it issued an outrageously small $2,000 fine. DPH routinely treats sexual crimes against nursing home residents as trivial offenses.