Regulators way behind in policing California's nursing homes

California has a tremendous backlog of complaints on nursing homes due to mismanagement by state regulators, Kaiser Health News has reported.

Altogether, the California Department of Public Health (CDPH) has yet to fully investigate some 11,000 filed complaints. The agency does not mandate that investigations be completed within a certain timeframe after they are opened. State law does require that an investigation begin within 10 days of a report being filed. Of the open complaints, about 370 involved incidents that put patients in "immediate jeopardy" of losing their lives.

A lot of patients are discharged from hospitals to nursing homes and vice versa, and uneven quality at the nursing homes likely drives up hospital readmissions. About 300,000 Californians receive care in nursing homes every year. A recent study by the Journal of the American Geriatrics Society concluded that nearly a quarter of Medicare beneficiaries treated at skilled nursing facilities needed emergency medical care within 30 days of discharge, and nearly 40 percent required hospital care within 90 days. There was some correlation to whether the facility operated as a for-profit and the likelihood of readmission.

The California State Auditor's office reviewed how the CDPH handled investigations, concluding that district offices conducted them unevenly at best. In San Francisco, for example, cases were closed without supervisors signing off on them, which is against the law. A serious patient fall at a Sacramento facility was not investigated until nine months after the incident occurred. In Los Angeles and Orange Counties--the most populous area in California--on-site investigations occurred less than 20 percent of the time in 2012 and last year.

"There has been almost a culture of indifference," Assemblywoman Mariko Yamada told Kaiser Health News. She had requested the audit of the nursing homes.

CDPH Director Ron Chapman, M.D., said his agency would tighten oversight of district offices.

To learn more:
- read the Kaiser Health News article