Attorney General Investigation Finds Numerous Violations at Northern California Nursing Homes
A recent investigation of Northern California nursing homes has revealed that all of the facilities "fell short of providing quality care," the San Francisco Chronicle reports. The random inspections were part of Operation Guardians, a "crackdown ... on abuse of the institutionalized elderly" spearheaded by the state attorney general's office. Inspection teams consisted of health, accounting, fire and building code "experts" (Sarkar, San Francisco Chronicle, 4/17). The teams inspected 22 nursing homes in Alameda, Fresno, Monterey, Napa, Sacramento and Santa Clara Counties. The problems cited by the investigators fell into five categories:
- Environmental non-compliance: Twenty-one of the homes had problems related to "substandard maintenance of the grounds or buildings," including foul odors from urine, loose or otherwise unsafe handrails, mildew, "dilapidated" living quarters or broken screens allowing infestations by flies and other bugs.
- Patient care non-compliance: Twenty homes exhibited compliance problems relating to patient care, including failure to keep adequate patient charts, poor maintenance of emergency medical equipment, unsafe storage of prescription drugs or "non-response to patients seeking attention using call lights."
- Administrative non-compliance: Fifteen homes had problems in areas such as maintenance of patient records or poor accounting practices.
- Fire safety violations: Eight homes violated local fire safety ordinances. If "left unabated," the violations could lead to serious harm or death, the report stated.
- Staffing level non-compliance: Two nursing homes violated state and federal laws mandating certain staffing levels for skilled nursing home facilities (Attorney General release, 4/16).
Collin Wong, director of the attorney general's Bureau of Medi-Cal Fraud and Elder Abuse, said, "Not one facility was able to escape our inspection process without several compliance problems found." Twelve nursing homes have been referred to the state Department of Health Services or medical licensing boards. Five nursing homes have been referred to local district attorneys for possible criminal investigation, but officials would not disclose the names of the facilities. Although state health inspectors review licensed nursing homes for compliance every 15 months, Attorney General Bill Lockyer (D) said that the surprise inspections provide "an extra measure of oversight" (San Francisco Chronicle, 4/17).
Lockyer said that the numerous violations revealed by the investigations show that the state "lacks strong controls to ensure patient health and well-being." He added that a lack of funding hampers inspection and regulatory enforcement efforts, although he "stopped short" of criticizing the health department and state legislators. Prescott Cole, an attorney with the California Advocates for Nursing Home Reform, agreed that funding for inspections and regulation must be increased. "DHS is not giving the attorney general the kinds of things to go out and have successful prosecutions," he said (Peele, Contra Costa Times, 4/17). To view the report, go to http://caag.state.ca.us/press/2001/01_036.pdf.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.