Despite Law, State Agency Slow to Post Nursing Home Data on Internet

Mary Jobe fell down the stairs of her San Francisco home a month ago, fracturing her pelvis. Only time and therapy would heal the bone, and social workers recommended a nursing home where the 84-year-old could recuperate.

With Jobe’s release from the hospital imminent, her relatives had little more than a day to check out the facility or come up with an alternative.

As Jobe’s daughter drove out to see it, her niece logged on to the Internet.

She found the website for the Department of Health Services, the state agency that inspects nursing homes for compliance with health and safety standards -- but it offered no information on the recommended home or on any other.

“If you’re going to oversee something, shouldn’t you have links of recent reports or violations?” asked the niece, Kathy Garcia, 52.

The state does not provide inspection reports and other information on the Internet, despite a 1999 law that requires it to do so.

Some information can be found on websites run by the federal government and nonprofit agencies, but it is limited or out-of-date.

“In this age of technology, I’m just outraged. This information ought to be available online and easily accessible,” said State Sen. Liz Figueroa (D-Fremont), who was among legislators who sponsored the 1999 law.

Health services spokeswoman Lea Brooks attributed the delay to a host of complications. Among them: The state received $100,000 from the Legislature to do a feasibility study on developing a publicly accessible system. It was unable to get more money to follow through with the plans, she said.

Another federally mandated project intervened, sapping staff time and attention, and in the meantime, the state’s internal database became obsolete, and the department had to start from scratch.

Now, she said, the state is arranging for a new feasibility study and hopes to provide online access by April 2007.

For years, consumers were able to get fairly current information online through websites operated by two non-profit advocacy groups, the California HealthCare Foundation and California Advocates for Nursing Home Reform.

The organizations would receive electronic copies of the data and then post it on their searchable websites.

But because of database problems, the health department has stopped providing most of the information. As a result, California Advocates for Nursing Home Reform said the most recent comprehensive data on its website is from January 2004.

The group offered to foot the bill if the department would hire a consultant to write the necessary programming to continue posting the data.

“They haven’t said no. They haven’t said yes. It’s kind of: ‘We’ll think about it,’ ” said Louis Nuyens, the organization’s manager of information systems. “In the meantime, consumers are left in the dark.”

Nursing home regulation is complex under the best of circumstances, and consumers easily can become confused. Facilities have to abide by two sets of laws -- state and federal--which require the homes to give patients quality care in a safe and healthy environment. When state inspectors visit facilities, they can find state or federal violations, a combination of both or neither.

The Internet posting delay affects only violations of state law. The federal government provides fairly current information on federal violations on www.medicare.gov.

State regulations cover a broad range of issues, which include specifying how many hours of nursing care patients should receive, prohibiting verbal and physical abuse and requiring staff to answer call buttons and maintain health records.

Without the online posting, examining a nursing home’s state record is not impossible, but it is often inconvenient. Members of the public must find the regional office that has a copy of the home’s paper file and then make an appointment to review the file with the inspector who oversees that particular home.

“It’s a morass,” said Jody Spiegel, director of a nursing home advocacy project for Bet Tzedek legal services. “The information is not in one place and it’s not current and it’s not in a format that is meaningful for consumers who are trying to make healthcare decisions about their loved ones.”

Actually, all of the data is in one place: the computer systems used by the state Department of Health Services.

“Gosh, we do have transparent government or not?” Nuyens asked. “If it’s in a computer, why can’t they set up a little script and push a button and post it on their website?”

Researchers are hampered by the inaccessibility of the data as well. Charlene Harrington is a professor of sociology at the UC San Francisco and an author of numerous studies on long-term care. She said she had planned to work on an analysis of differences in the quality of nursing homes, but the lack of current data has stopped the project.

“We can use the federal data, but ... for California, that’s a real problem,” she said. “California is one of the states that give out large numbers of deficiencies. Without those state deficiencies, we’re missing an important part of what’s going on.”

Garcia, Jobe’s niece, said she ended up taking a leap of faith by going with the recommendation of hospital social workers. She hopes it was the right decision.

“She’s like my mother,” Garcia said of Jobe. “I don’t want to stick her in a facility where bedsores and other horrible things happen.”