CALIFORNIA: GAO LAUNCHES INVESTIGATION OF NURSING HOMES
"Federal auditors are investigating a claim that nearlyThis is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
22,000 nursing home patients in California died from preventable
conditions such as malnutrition, dehydration and urinary tract
infections between 1986 and 1993," Los Angeles Times reports.
The General Accounting Office was asked by U.S. Senate Aging
Committee Chair Sen. Chuck Grassley (R-IA) to verify claims by a
California attorney that his review of the death certificates of
300,000 nursing home residents found that abuse in state nursing
homes was commonplace. GAO investigators began arriving in
California last week.
DENIALS
According to the Times, state nursing home official said
that attorney Von Packard's "method of examining death
certificates was not a sound way to assess the quality of care."
Lori Costa, director of regulatory programs for the California
Association of Health Facilities, said, "The study is just
fraught with big holes. A cause of death has to be proven by an
autopsy." Packard brought the results of his review to Grassley
last summer. After five weeks of negotiations, Grassley sent a
letter to the GAO October 1 requesting an "independent"
verification of Packard's results. Grassley wrote, "Because of
the seriousness of this request and the potential life-
threatening implications of its subject matter, the committee
respectfully requests that the GAO address this request
immediately."
REAX
California health officials said that they "are cooperating
with the GAO and, for now, expect a review of only three Northern
California facilities." Brenda Klutz, deputy director of state
licensing, said that the initial findings of Packard "raise a red
flag," particularly because the findings were "malnutrition or
dehydration without evidence of an underlying condition." She
said, "I would want to investigate further." However, Beate
Ritz, of the UCLA School of Public Health, said that it would be
a mistake to rely only on death certificates for information
about cause of death. Ritz said, "It may be the only way to get
cheap data, but it should be interpreted with caution." A
Grassley spokesperson said that the "GAO's findings in California
will be used to determine whether there is a national crisis of
preventable deaths in nursing homes" (Romney/Marquis, 10/23).
Paul Willging, of the AHCA, said, "We in this industry are often
accused of providing poor quality care. We are, however, proud
of what we do and we are willing to be measured" ("NBC's Nightly
News," 10/22).
HCFA INVESTIGATION
According to a committee spokesperson, Grassley "is also
looking into whether the federal Health Care Financing
Administration is doing an adequate job of disciplining nursing
homes where violations of federal nursing home rules are
reported." Time magazine reported in this week's issue that
"only 2% of nearly 10,000 nursing homes with significant
deficiencies were fined or penalized." However, HCFA said
yesterday that fines are meant to be used only after a facility
fails to "adequately correct its problems." According to HCFA
spokesperson Chris Peabody, the "low penalty rate reflects the
fact that most homes fixed their deficiencies" (Los Angeles
Times10/23).