September 2017

In this Issue

Are California Nursing Homes Prepared for Emergencies?
Families and Residents Defeat Sutter’s Attempt to Close St. Luke’s Sub-acute Unit
Shlomo Rechnitz Drops Appeal of Denied License for Chico Nursing Home
Revised Nursing Home Staffing Requirements Under Development
Report by Office of Inspector General Finds Steep Increase in Nursing Home Complaints
Possible Closures of Two Genesis Owned Nursing Homes Put Residents at Risk
Mort Cohen – The Movie: A Trailblazer for Rights of Elders and Disabled
Nursing Home Citations – Hall of Shame

Upcoming Events

CANHR will be hosting an information booth at the following events

Are California Nursing Homes Prepared for Emergencies?

If the recent tragedies that unfolded following hurricanes Irma and Harvey are any indication, the answer is undoubtedly no. In Florida, twelve residents of The Rehabilitation Center at Hollywood Hills died shortly after Hurricane Irma swept through the state, knocking out a transformer that powered the nursing home’s air conditioning system. On September 13, eight residents died after suffering there in sweltering conditions, with body temperatures reaching as high as 109.9 degrees. At least four more residents of the facility died during the following days and many more needed intensive care after emergency responders evacuated over 140 of them to local hospitals. Crime scene tape now drapes the nursing home as investigators ponder why so many critically ill residents were left in extremely dangerous conditions when a fully functioning hospital was just yards away. The nation is justly horrified by this tragedy.
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Families and Residents Defeat Sutter’s Attempt to Close St. Luke’s Sub-acute Unit

California hospitals are finding that some families and residents are prepared to fight back when they try to close sub-acute units. Such was the case at St. Luke’s sub-acute unit in San Francisco after the California Pacific Medical Center (CPMC) announced in June 2017 that it would close the unit. The 24 residents – many whom have lived at St. Luke’s for years and depend on various medical devices and specialized nursing care to keep them alive – were threatened with transfers to facilities as far away as Sacramento and Los Angeles. Instead of accepting the trauma, isolation and likely death that would accompany such evictions, the families chose to fight back.
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Shlomo Rechnitz Drops Appeal of Denied License for Chico Nursing Home

On September 18, 2017, three years after the Department of Public Health (DPH) denied his change of ownership licensure application to operate the Riverside Convalescent Hospital at 375 Cohasset Road in Chico, attorneys for Shlomo Rechnitz filed a notice of withdrawal and request for dismissal with the Department of Health Care Services Office (DHCS) of Administrative Hearings and Appeals that he was dropping the appeal. Three days later, on September 21, 2017, an administrative law judge for the DHCS dismissed the appeal.

The DPH denied Mr. Rechnitz’s application to operate the Riverside Convalescent Hospital on September 16, 2014. Its letter stated he had not provided evidence satisfactory to be licensed and described serious violations in other nursing homes he operates in California.

The DPH has not announced what actions will be taken to transition operation of the facility to a qualified operator.

A large number of other nursing home change of ownership applications submitted by Mr. Rechnitz are in various stages of appeal or review before DPH. Appeals are pending on five change of ownership applications DPH denied in July 2016. The Department has not acted on an additional 18 applications involving former Country Villa nursing homes.
Order of Dismissal Pursuant to Request for Withdrawal

Revised Nursing Home Staffing Requirements Under Development

The Department of Public Health (DPH) is beginning to move forward in developing emergency regulations to implement SB 97, a budget bill passed during the summer that will increase minimum staffing requirements for freestanding skilled nursing facilities from 3.2 nursing hours per resident (HPRPD) to 3.5 direct care HPRPD, effective July 1, 2018. Although an increase in staffing requirements sounds like good news, some of the revised law’s provisions are potentially harmful to nursing home residents, depending on how they are interpreted and implemented. CANHR wrote the DPH on August 14, 2017 to address these concerns and make initial recommendations. DPH has posted minutes of separate meetings it has held with advocates, labor officials and the nursing home industry about the law and letters it has received from these stakeholders.

In a related development, the Governor signed another budget bill (AB 130) on September 16 that will allow nursing homes that seek and obtain waivers of the new minimum staffing requirements to receive incentive payments from Medi-Cal. CANHR opposed this provision.

Report by Office of Inspector General Finds Steep Increase in Nursing Home Complaints

A September report by the U.S. Department of Health & Human Services Office of Inspector General (OIG) found that States received one-third more nursing home complaints in 2015 than in 2011 even though the number of residents decreased by about three percent during this period. Over half of the complaints were in the most serious categories. OIG found that California has one of the highest rates of nursing home complaints in the nation, 60.5 complaints per 1,000 residents. The report identifies California as one of four states that failed to conduct onsite investigations for more than 10 high priority complaints in at least 1 of the 5 years studied. The findings are the latest indication that neglect and abuse are increasing in California nursing homes.

The OIG report tells only part of the story on California nursing home complaints because its review period ended in 2015. According to Department of Public Health data, the number of complaints filed against California nursing homes has increased by more than 40 percent over the last three years.

Possible Closures of Two Genesis Owned Nursing Homes Put Residents at Risk

On September 2, 2017, the Sacramento Bee reported that Eagle Crest, a Carmichael nursing home operated by Genesis Healthcare was closing following a June 22, 2017 notice from the Department of Public Health (DPH) advising it that it was recommending to the Centers for Medicare and Medicaid Services (CMS) to terminate its provider agreement. CMS has classified Eagle Crest as a Special Focus Facility for the last three years, meaning it is considered one of the worst performing nursing homes in California. Before CMS acted on DPH’s termination recommendation, Eagle Crest issued notice it would be closing and filed a relocation plan with the DPH. The relocation plan indicates Eagle Crest could be moving many of the residents to other Genesis nursing homes, some of which also have poor compliance histories or are not near Carmichael.
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Mort Cohen – The Movie: A Trailblazer for Rights of Elders and Disabled

Nursing Home Citations – Hall of Shame

Kindred Transitional Care and Rehabilitation – Walnut Creek -1224 Rossmoor Parkway
8/7/17 Citation Class: AA Category: Patient Care Fine: $100,000

A resident died on 10/28/15 following a scheduled tracheostomy tube change at the facility. Prior to the procedure, the resident did not have any respiratory issues and her vital signs were stable. After the tracheostomy change, the resident’s oxygen saturation level dropped, her skin changed to an ashy color, and she experienced acute respiratory failure. The Director of Respiratory Therapy who helped perform the procedure stated the facility did not have emergency protocols in an event like this, only to call 911. She was transported to the emergency room where she died a short time later. The Coroner issued a report stating that the cause of death was acute respiratory failure, with bilateral collapsed lungs, due to improper placement of tracheostomy tube, with tracheal and esophageal perforation. The facility was cited because it failed to ensure staff hyperextended the resident’s neck prior to changing her tracheostomy tube and failed to use an oral bag mask to ventilate when she experienced respiratory difficulty after the new tracheostomy tube was inserted, resulting in her death. Citation# 020013410.

Twilight Haven – 1717 S. Winery Ave, Fresno, CA
9/13/17 Citation Class: A Category: Patient Rights Fine: $20,000

On 4/19/2017, at about 1:30 am, a certified nurse assistant repeatedly stabbed a 90 year old resident in the head with a ball point pen. A licensed nurse who witnessed the stabbing heard the resident yell, “OW! OW! Why are you doing this to me? What did I do to deserve this?” The nurse pushed the CNA away from the resident, who was sitting in her wheelchair with both hands held over the top of her head. Blood was seeping through the resident’s fingers. The police were called and took the CNA from the building. The resident was taken to the hospital where she underwent a CT scan examination of her brain and treatment of a superficial wound to the head. The facility was cited for failing to ensure the resident was free from abuse.
Citation #040013483.