Aiding Nursing Home Oversight

Two days of Washington hearings and a federal report on conditions in California nursing homes, with Orange County prominent, have resulted in a promise of improvement. But such pledges have been made before. Washington and Sacramento need to follow through this time.

Federal inspectors who visited a Huntington Beach nursing home found that state inspectors who had looked at the same facility “missed numerous major quality-of-care problems.” Those deficiencies included meals lacking in nutrition and some residents suffering sores that required attention. The state inspectors reported finding relatively minor flaws, such as not storing food properly and a failure to issue a discharge notice for a patient.

Unfortunately, the gap uncovered in nursing home oversight was met not with reform but with buck passing. A state official said the federal government should have told Sacramento of its concerns earlier. When state inspectors revisited the home, they indeed found problems. The corporate owners of the facility said they would do better.

The consumer needs to be able to count on reliable oversight from government inspectors. Friends or relatives of those who may soon need nursing home care can inspect nearby facilities, checking for cleanliness, staff size and attitude of caregivers. But many residents of nursing homes have no family members or friends to conduct on-site visits and monitor care. In those cases, state and federal regulators should help ensure that the elderly are treated with dignity, given proper medication and well cared for.

Also, the government too often is not getting its money’s worth. The average cost in California for nursing home care is $3,460 a month, with much of that paid for by Medicare and Medi-Cal.

State officials are right in complaining that federal laws are too lax in giving most homes a month or more to correct problems and then taking a home’s written declaration of compliance as fact. But California should have enacted tougher regulations, despite opposition from the politically powerful nursing home industry. Also, the state has not done a good job of enforcing the regulations already on the books.

A Times review of inspection reports, lawsuits, medical records and death certificates from 1996 and 1997 found that Orange County nursing homes that repeatedly broke the rules usually drew light punishments. Eighteen were cited for poor care last year; half were threatened with a loss of Medicare funds. Only three actually had funding cut off.

After last month’s hearings, a federal regulator said inspectors would single out the worst homes in various regions and ride herd on them. That’s a pledge that must be kept. Agencies using taxpayer money to pay most nursing home bills need to do their job and help the elderly receive the treatment they deserve.