Contra Costa Times Investigation Finds Care at Nursing Homes Worsening

A five-month investigation by the Contra Costa Times has revealed that the level of care in California's 1,479 nursing homes has "plung[ed]" in recent years and that nursing facilities "often fail miserably [and] sometimes fatally." The Times began its inquiry after Gov. Gray Davis (D) signed nursing home reform legislation last September. The report is based on public records and government and private reports on the industry. As a baseline indicator for measuring improvement, the Times used a "scathing" July 1998 congressional report on nursing home care in California. Here are some of the main conclusions of the Times investigation:

• In the 30 months since the 1998 report, the California Department of Health Services attributed 61 patient deaths to "staff errors" compared to 33 deaths of this nature in the 30 months preceding the report.
  
• In Contra Costa and Alameda counties, 13 patient deaths were blamed on staff errors after the report, compared to four deaths prior.
  
• California's nursing homes "more than doubl[e] the national average for federal health deficiencies" -- the state averaged 11 deficiencies per home during their past three inspections (conducted every 15 months), compared to the national average of six.
  
• Complaints about nursing homes increased 11% in the first ten months of 2000, while the "number of complaints resulting in citations dropped 34%." This apparent discrepancy led one "leading nursing home advocate" to conclude that the state "dismisses too many complaints without a substantive investigation."
  
• In "three keys signs of inadequate care" -- patients with bedsores, patients with urinary and bowel incontinence and patients kept restrained -- California "exceeds the national average."
  
• The general consensus among workers, the industry, advocates and regulators is that the shortage of nursing home staffers has reached a "crisis."

Pat McGinnes, executive director of the California Advocates for Nursing Home Reform, said, "The situation [with nursing homes] is more precarious today than ever before. More than ever, this is an industry that is focused on investor return rather than on quality of care." DHS Director Diana Bonta, while stating that state investigators had become "more diligent" in examining nursing homes, "expressed shock" at the increasing number of staff-related deaths since 1998, of which she said she was not aware. Betsy Hite, public affairs director for the California Association of Health Facilities, said, "We do not excuse [such deaths]. But we think the vast majority of [nursing homes] do a very good job. I am not sure you can necessarily gauge the quality of care provided by looking at the reports" (Peele, Contra Costa Times, 2/25).

In other nursing home news, four lawsuits have been filed against the Kaweah Manor Convalescent Hospital in Visalia and its parent company, Moyle's Central Valley Health Care Inc., alleging that negligent care by employees at the facility led to the death of three patients and the abuse and battery of a fourth, the Fresno Bee reports. Filed in December in Tulare County Superior Court, the suits also contend that hospital staff took medications intended for patients and then "mark[ed] patient charts to show the medication had been given." Three of the suits were sought by the relatives of Leona Reed, Dorothy Chaney and Percy Bosanko, all of whom died after the alleged negligent care, while the fourth was filed by Eppie Rodriguez, who is still alive but "alleges elder abuse, willful misconduct, negligence and battery by a staff member." Robert Schwartz, the lawyer for the nursing home, said the allegations have "no basis in fact," adding, "Obviously, it's unfortunate that three of the patients died, but they were old people. Kaweah Manor is a very good facility." Ombudsman Zelma Howard said the Kings/Tulare Long Term Care Program was "investigating the nursing home on unrelated matters" (Griswold, Fresno Bee, 2/22).