NURSING HOME REFORM: Backers of Bill Voice Support, but Obstacles Remain

      The heads of both the California Advocates for Nursing Home Reform and the California Association of Health Facilities are expressing cautious optimism that AB 1160, which is set for a hearing before the Assembly Health Committee this week, is a reform measure that everyone can support, the Chico Enterprise-Record reports. The measure would require the county coroner to investigate when a resident of a nursing homes dies, mandate staff-to-patient ratios, provide for more pay and training for aides, "speed up investigations and require facilities to post the amount of any fine levied against them before citations are appealed," and require the state Department of Health Services and the state attorney general to report to the state Legislature "on their actions to enforce nursing home rules." Pat McGinnis of the California Advocates for Nursing Home Reform said the bill was strong because "it tackles several key issues at once." Peggy Goldstein of the California Association of Health Facilities said "the system is broken and ... reforms are necessary," but noted that the industry still has concerns about the bill, including the inflexibility of the staffing ratios, provisions for giving aides more training, and the measure's "punitive" approach to discipline. She said "[i]nspections ought to focus on spotting potential problems and commending facilities for what they do well." She also said the "cornerstone" of reform is changing how nursing homes are reimbursed for care, noting that the state is one of the few that pays a flat-rate for care rather than adjusting reimbursements based on the "true costs of caring for the kinds of patients they house" (Mitchell, 4/8). The reform measure would "change Medi-Cal reimbursement from a flat rate to a payment based on the patient's condition."

No Support Here
      The Orange County Register reports that more than 100 people with parents in nursing homes -- or headed to one themselves -- tried to persuade" Assembly Minority Leader Scott Baugh (R-Huntington Beach) to support the nursing home reform measure. But Baugh said such reform measures are not the cure the nursing home industry needs. He said, "When you have 80% turnover of staff in an industry, when they're not even staying long enough to care, it doesn't matter how high the fines are. You still have the core problem." He added that higher fines could put good homes out of business. "Then we have a different kind of problem. We have nowhere to take our parents." He said he will work on a compromise measure (Kowalczyk, 4/11).