NURSING HOMES: Feinstein Urges Wilson To Take Action
Sen. Dianne Feinstein (D) yesterday urged Gov. Pete Wilson to "take strong and immediate steps" to improve state and federal oversight of nursing homes. In a letter to Wilson, Feinstein stated: "In the interest of California's 141,000 nursing home residents and their families, I urge you to move swiftly and forcefully to provide good care for these very frail Californians and I pledge my continued help." The senator urged that the following steps be taken:
- Stagger scheduling of "surprise" inspections, making inspections less predictable.
- Take better samples and review sufficient numbers of cases.
- Eliminate the grace period for homes cited for repeated violations; impose sanctions promptly.
- For problem homes, substantiate a home's resumed compliance.
- Target and more intensely review homes with a poor compliance record.
- Put inspection reports on the Internet and require disclosure of inspection records to prospective residents and their families.
- Strengthen staff training and pay.
Robert Scrivano, a Sacramento-based senior care consultant, says there is "a lot more abuse happening in California's nursing homes than the kind being detailed this week in Washington, DC" ( see yesterday's CHL). He said the emotional abuse can be just as bad as the physical abuse. "In an estimated 20% of the cases, nursing home officials tell the patient's family that if they go on Medi-Cal, Dad's going to eat gruel every night and the treatment is going to get worse." Scrivano said nursing homes make less money if their patients go on Medi-Cal because the state pays thousands of dollars less than a family would, so they often keep families uninformed of Medi-Cal options. He called the practice "fiduciary abuse." Under state law, it is illegal for a nursing home to change the level of a patient's care once he or she goes on Medi-Cal (release, 7/29).
An editorial in the Chico Enterprise-Record says it is "certainly wise to monitor [nursing home] operations closely ... to make sure they meet the required standards." However, the editorial contends, "[p]art of the answer to the problem ... also may be solved by the competitive growth of increasingly capable home health care services." While nursing homes will always be necessary, "there are now more choices for many" elderly Americans, the piece concludes (7/29).