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Crisis In State's Nursing Homes
Santa Maria Times
August 9, 2005
California has a problem in its nursing homes, and it's not just that the 100,000 or so people who stay there are too old or too infirm to care for themselves.
A recent analysis of nursing home data shows that the state Department of Health Services is performing fewer inspections, resulting in a reduced number of citations for such infractions as aides giving the wrong medication to a patient, physical abuse or not treating infections in a timely manner.
The outcome of the reduction in inspections is that the state has issued 36 percent fewer citations than the average number issued each year since 2000. The dollar amount of fines has also fallen by 36 percent in roughly the same time period.
And this comes at a time when state agencies have received 23 percent more complaints about nursing home problems in the past four years.
Government agencies responsible for such matters complain that budget cuts have forced them to reduce the level of services. But the real problem may be that state officials are virtually required to enforce federal nursing home standards, which are not nearly as tough as California's laws.
It turns out that this is a case in which federal law supersedes state law because state agencies have contracts with the federal government to enforce federal laws - even though in doing that, nursing homes are allowed to get away with more rules infractions, and the fines they pay under federal guidelines are lower than would have to be paid if California's laws were applied.
State agencies are caught between enforcing laws their officials know should be enforced, and receiving federal funds. The agency that oversees nursing home licensing, for example, receives half of its $111-million annual budget from the federal government. If it doesn't enforce federal law, it could lose that funding.
This is no small problem. California already has about 3.5 million people 65 and older - about 10 percent of the total population - and more than 40 percent of them are or will be residents of a nursing home. And with the coming tidal wave of baby boomers, that number is expected to double in the next 20 years.
The federal rules governing nursing homes clearly are not strong enough for California, where too many elderly people are now made more vulnerable to possible abuse because state laws are not being applied. This is one case in which state laws should trump federal rules - for the people's sake.
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