NURSING HOMES: Senate Passes Bill to Increase Standards
The state Senate Friday unanimously approved a bill that would increase "staffing standards" at California's 1,400 nursing homes, the AP/Sacramento Bee reports. The bill would substantially increase current fines for the death or harm of a resident and boost the number of required hours of care, as well as allow the state Department of Health Services to appoint a nursing home manager to prevent imminent danger and assure residents' safe transport to other facilities. The legislation stemmed from a recent federal General Accounting Office report on nursing home deaths in California, which found that in 1993, 34 of the 62 deaths involved "care that was unacceptable and that sometimes endangered [residents'] health and safety," and noted that one-third of California nursing homes were cited for "serious or potentially life-threatening care problems" between 1995-1998. The bill's author, Assembly Majority Leader Kevin Shelley (D-San Francisco), said the provisions are necessary to repair nursing homes' "state of disgrace," because "the time has come for ... that to change." State Sen. John Vasconcellos (D- San Jose), said the bill is "the biggest step in nursing home reform in probably two decades" (9/6).
Nuts and Bolts
Under the legislation, nursing home workers whose actions resulted in a patient's death would be subjected to maximum fines of $50,000, an increase of $25,000. For causing serious harm, workers would be fined $25,000 -- a $15,000 increase -- and those inflicting less serious harm would incur fees up to $2,500, a $1,500 increase. The bill also alters the number of direct care hours per patient, previously set at 3.2 hours. It eliminates a quirk in the current law that allows every hour a registered nurse or licensed vocational nurse provides to count twice. While some larger facilities are exempt from that condition until Jan. 1, 2001, all facilities will have to increase their direct care hours over the next four years. By 2003, if the state provides enough Medi-Cal funding to provide additional staffing, facilities must provide 3.5 direct care hours per patient. The bill now returns to the General Assembly for a vote on the Senate's amendments, making it only "one step from the governor's desk" (9/6).