New Nursing Home Oversight Rules Raise Concerns
State officials are hopeful that new regulations set to take effect Jan. 1 will allow them to inspect and monitor nursing homes more extensively, but both nursing home administrators and patient advocates remain skeptical of the new rules, the San Diego Union-Tribune reports. The Governor's Aging With Dignity Initiative will allocate $16 million for the state Division of Licensing and Certification to hire an additional 150 workers to examine complaints at the state's 1,400 skilled nursing facilities. The initiative also calls for a "central desk" to be established by July 1 so staff members can "rapidly evaluate complaints for severity and route them to the correct districts for evaluation." The law also mandates that the agency inspect a nursing home within 24 hours of a complaint that could pose "serious danger or possible death of a resident." In addition, the law provides more stringent and less time-consuming standards for review and will quadruple state fines from $25,000 to $100,000 in instances where poor care leads to the death of a patient. Gloria Johnson Barrows, assistant deputy director of the agency, said the increased personnel will allow the division to conduct more timely, thorough examinations of nursing homes. "We're finally getting the ability to correct some things we've all known needed correcting," she said, adding that addressing nursing home complaints in the past was difficult because her staff spent "so much time" on "conducting annual inspections, documenting abuses and attending legal hearings." Barrows also is "optimistic" that the new law's elimination of the "predictable survey period" and installation of surprise inspections will increase the effective oversight of nursing homes.
Pat McGinnis, director of California Advocates for Nursing Home Reform, a San Francisco agency that keeps an "extensive database on nursing home performance," said that she is encouraged by the state's plan to increase the speed of investigations. McGinnis said, "For years, our main concern has not been that complaints don't get investigated. It's that they're investigated after the fact, maybe six months later, after the patient died, the witnesses are gone or the records may be doctored." Still, McGinnis "harbors doubts about how well things will work." She attributed the problem to a "lackadaisical attitude toward the complaints on the part of the leaders of each of the 13 districts, who don't take complaints seriously, who don't realize they have to get out there -- and that, the longer you wait, the worse it gets, and you lose evidence." Sheree Crum, spokesperson for the California Association of Health Facilities, which represents 1,100 California skilled nursing homes, said the new regulations could "increase confusion over already complex requirements." She said, "It's hard to know with whom, what, when and why you have to comply." She added that the state's response to allegations that may have no merit "is certainly not something we want precious government resources wasted on" (Clark, San Diego Union-Tribune, 12/17).
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