NURSING HOMES: Senate Committee Hears Of Abuses In California
In testimony yesterday before the Senate Special Committee on Aging, a California nursing home inspector charged "that state nursing homes operators do not hire enough staff members to provide decent care and use their influence to keep aggressive inspectors away from their facilities." The Los Angeles Times reports that the anonymous witness -- identified only as "Florence N." -- summed up the condition of nursing homes in California, saying: "The focus is no longer on patient care -- the focus appears to be on warehousing the elderly, running the facility as cheaply as possible" (Rosenblatt, 7/28).
Trouble At The Capitol
The Sacramento Bee reports that the witness told the Senate panel that "her recommended punishments of substandard facilities for the elderly often are reversed by Gov. Pete Wilson's political appointees." Sean Walsh, Wilson's spokesperson, called the account "nonsense," saying the woman has "been watching one too many 'X-Files' this summer." He added, "If indeed there are problems in nursing homes, that's a very serious matter and they should be reviewed and corrected. But to make a sweeping statement that the governor's political officials are doing the bidding of nursing home operators is a bit of a stretch" (O'Rourke, 7/28).
Bigger Is Better
In response to the testimony heard yesterday, Sen. Chuck Grassley (R-IA), chair of the committee who called for the hearings, said he "has ordered the General Accounting Office ... to expand the scope of its probe" beyond California to the rest of the nation. "Is there a nationwide problem? I do not know, but I am going to find out," Grassley said. "Probably other states have similar problems, and we will explore that," said Sen. John Breaux (D-LA), the committee's ranking Democrat (Times, 7/28). The committee hearings, scheduled for yesterday and today, coincide with the release of a GAO report finding that one-third of all California nursing homes have "serious or potentially life-threatening care problems" ( see yesterday's CHL).
The Riverside Press-Enterprise reports that the GAO report and the tone of the Senate hearings have state regulators "concerned" and the nursing home industry "bracing itself." Ken August, spokesperson for the California Department of Health Services, said, "The title of the hearing -- 'Betrayal: the Quality of Care in California Nursing Homes' -- indicates up front that this is not to be a discussion of some of the issues involved in nursing homes, but rather an attempt to get some headlines about some specific nursing homes." Peggy Goldstein of the California Association of Health Facilities said, "There's a sort of hysteria" regarding the industry. "You really can't make these kind of sweeping judgements. You need to look at each case," she added (Soto, 7/27). Dr. Paul Willging, executive vice president of the American Health Care Association, testifying yesterday said, "I do not feel that the GAO report represents the best scientific methodology." He noted that allegations of malnutrition and dehydration need to be viewed in light of the fact that many disorders and illnesses common to the elderly prevent them from eating or drinking (AHCA release, 7/27). According to Gary Macomber, executive director of the California Association of Health Facilities, "[a]t least half the people who reportedly died recently of malnutrition and dehydration were terminally ill and had signed papers asking not to be fed or hydrated so as not to delay death" ( Orange County Register, 7/27).
In response to the allegations brought against California nursing homes yesterday, Brenda Klutz, deputy director of licensing and certifications for the California Department of Health Services, "said the state is working diligently to maintain the quality of nursing homes despite budgetary constraints." She "acknowledged in an interview that too many nursing homes do not have enough employees to care for residents," but she denied that regulators shifted "inspectors to accommodate the complaints of nursing home operators." She said, "I don't take people off nursing home teams unless there is inappropriate behavior." Because of lack of funding, inspectors are only able to visit a facility once a year, said Klutz, but under a new policy, the visitations will be upped to twice a year (Times, 7/28). Kim Belshe, director of the California Department of Health Services, declined to testify but sent a 14-page response to Grassley's committee, the Bee reports. She wrote: "The title of the hearing indicates that the committee has already drawn conclusions about the quality of care being provided to California nursing home residents, a conclusion to which we take considerable exception." She said that California is one of the "most aggressive states" in terms of overseeing nursing homes (7/28).