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The Department of Public Health Fiddles While Rome Burns

In an open letter to the Department of Public Health last summer, CANHR asked the Department why it is putting the interests of Shlomo Rechnitz, a nursing home operator with a disturbing record of poor care, above the rights of residents to receive high quality care. At year’s end, it appears the answer to that question is that DPH’s leaders have completely abandoned their duty to protect residents from unfit operators.

There seems to be no end to scandals involving Mr. Rechnitz’s nursing homes. To name a few recent ones: the U.S Department of Justice settled charges against Brius (a holding company owned by Mr. Rechnitz) nursing homes for illegal kickbacks for patient referrals and false claims to government health care programs; the California Legislature ordered an audit of Brius Healthcare transactions; the California attorney general’s office is prosecuting the administrator of a Rechnitz-affiliated nursing home for elder abuse in wrongfully discharging residents who could not care for themselves; the National Union of Healthcare Workers (NUHW) filed a complaint with the Department of Public Health that Rechnitz falsely described his compliance history in nearly two dozen nursing home licensure applications; multiple wrongful death cases have been filed against his nursing homes; and the NUHW published a report, “Brius Healthcare’s Insider Transactions,” on how Rechnitz may be profiting at nursing home residents’ expense by steering millions of dollars in taxpayer funds to a web of companies he created to service his nursing homes. Evidence that residents are being neglected and exploited goes on and on and on.

CANHR’s open letter took DPH to task for allowing Rechnitz and his companies to continue operating over 20 nursing homes for which they do not have licenses. In several cases, the DPH had denied licenses sought by Rechnitz; while 18 other skilled nursing facility licensing applications he submitted to DPH have been pending for nearly two years. Many hundreds of residents live in these facilities.

California laws do not give operators squatters’ rights to occupy and run nursing homes without a license. Yet DPH is not only allowing chain operators to run nursing homes without a license, it continues to certify them so they will get paid by Medicare and Medi-Cal while doing so, even in instances where license applications have been denied and appeals lost. DPH’s leaders offer no justification for these actions and identify no laws to support them.

One such instance involves the Riverside Convalescent Hospital, a Chico skilled nursing facility Rechnitz acquired in 2014. DPH denied a Rechnitz change-ofownership licensing application on September 16, 2014, citing poor care in other facilities, and Rechnitz appealed. The appeals dragged on for three years until his attorneys withdrew the appeal on September 18, 2017. Throughout this period, DPH allowed Rechnitzaffiliated companies to run Riverside Convalescent Hospital, and is still allowing them to do so today.

Since 2015, Riverside Convalescent Hospital has been cited for more than 100 deficiencies and currently has a 1-star rating from the Centers for Medicare & Medicaid Services. A DPH complaint investigation completed on July 7, 2017 found the facility did not have enough nursing staff to meet residents’ needs. Residents’ call lights were not promptly answered; a family member reported a resident was in tears due to lack of help; nursing assistants stated no one wanted to work at the facility; and the Director of Nursing reported that “when he first started working 5/2017 at the facility, at one point 100 percent of the staff were from the nursing registry.”

Although this finding is just one of many violations that have occurred at Riverside Convalescent, it speaks to the fundamental betrayal of the public trust by DPH. The Department’s findings suggest that Riverside Convalescent has a toxic reputation and cannot hire and retain enough staff to provide even the most basic of care. Why did DPH allow Rechnitz and his companies to continue operating the facility in this condition for years after declaring him unfit for a license to run this facility in 2014?

When operators are denied licenses and lose appeals, why is it that only residents face any consequences?

While years go by with unfit, unlicensed operators running nursing homes, the public is left with only one conclusion as to why: DPH does not care enough to do anything. Time is not on the side of DPH’s leaders, however, who are under increasing scrutiny for their shocking indifference to the suffering of residents who are increasingly being abused, neglected and mistreated.

As the 2018 Governor’s race heats up, candidates are already talking about cleaning house at DPH and banning unfit nursing home operators. The top four leading Democratic candidates engaged in an eyeopening debate on this subject at an October 22, 2017 forum hosted by NUHW. During the eleven minute exchange, State Treasurer John Chiang promised to “identify those bad actors so they can’t create subsequent companies,” Lt. Gov. Gavin Newsom stated he would call out bad actors and make sure “the folks appointed to oversight are doing their jobs,” and former Los Angeles Mayor Antonio Villaraigosa vowed to ensure our laws have teeth and that operators “don’t get away with murder.”

Former State Superintendent of Public Instruction Delaine Eastin said it best, declaring “We need to make sure that those agencies that do the oversight over your hospitals and your nursing homes have people on fire to do the right things for all of you but especially for all those patients who are not getting the kind of care they deserve in California.”

Take note, bad actors, squatters and indifferent DPH leaders: questions are accumulating, concern is growing, and the spotlight is intensifying.