Nursing Homes Cut Staff Despite Funding Boosts, California Watch Reports
About 232 California nursing homes cut staff or reduced wages following the passage of a 2004 state law designed to help them boost wages and increase staffing levels, according to a new investigation by California Watch, a project of the Center for Investigative Reporting, the San Jose Mercury News reports.
The investigation found that California's 1,100 nursing homes have collected about $880 million under the Nursing Home Quality Care Act of 2004. The 232 facilities that made cuts received about $236 million from the law through 2008, according to California Watch.
The legislation aimed to address the nursing homes' low Medi-Cal reimbursement rates by replacing the flat fee-per-patient system with one that provided reimbursements based on the cost of care. Medi-Cal is California's Medicaid program.
According to California Watch, state regulators have not taken action to ensure that nursing homes are using the increased funding as intended.
Investigation Details
For the investigation, California Watch examined financial and staffing data for the 645 nursing homes that serve the largest number of Medi-Cal beneficiaries.
The Department of Health Care Services has provided those facilities with total funding increases of nearly 25% since the enactment of the 2004 law.
After adjusting for inflation, more than 400 of the examined facilities cut wages for the lowest-paid workers, according to California Watch.
The investigation also found that the two dozen nursing homes that made the deepest wage and personnel cuts had about a third more deficiencies than other state facilities.
In addition, California Watch found that many California nursing homes operated below state-mandated minimum staffing levels in 2008. The investigation also notes that the state has not issued any staffing-related fines.
A provision in the 2004 law allows nursing homes to bill the state for legal costs associated with combating fines, citations and lawsuits. Since the law's passage, nursing homes have doubled the number of citations they challenge, according to California Watch.
Future Funding
The nursing home funding increases were suspended last year due to opposition from patient groups.
Senate Health Committee Chair Elaine Alquist (D-Santa Clara) said lawmakers will reconsider the funding policies during a legislative review this year (Jewett/Armendariz, San Jose Mercury News, 4/18).
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