Landmark Nursing Home Bills Signed : Penalties for Abuses Strengthened, Medi-Cal Payments Boosted

Landmark legislation to improve care in California nursing homes became law Wednesday with the signature of Gov. George Deukmejian, five months after he vetoed a similar package of bills.

At a formal Capitol ceremony, Deukmejian signed two identical measures by Sen. Henry Mello (D-Watsonville) and Assemblyman Phillip Isenberg (D-Sacramento) that strengthen penalties for the abuse of patients and increase Medi-Cal payments to nursing homes.

“Embodied in these bills are significant reforms that I believe will improve the quality of care for our seniors who are residents of nursing homes,” the governor said.

Last September, Deukmejian caught legislators by surprise when he vetoed a package of 15 similar bills that had the backing of senior citizen groups, as well as the nursing home industry.

Minor Provisions

Deukmejian objected to minor provisions in the earlier legislation, such as the creation of two advisory committees. Since the bills were linked so that all of them had to be signed for any of them to become law, he scuttled the entire package.

The bills he signed Wednesday resurrect the main elements of that legislation and take effect immediately--nine weeks after the initial package would have become law.

The Legislature sent the governor two identical bills so that members of both houses can claim credit for nursing home reforms.

Among its provisions, the new law increases Medi-Cal payments to nursing homes this fiscal year by $8 million and provides for an annual increase of $87 million, starting with the 1985-86 state budget, Deukmejian said. The money must be used to raise wages and staffing levels.

Better Inspection

In addition, the law prohibits discrimination against Medi-Cal patients and provides for better state inspection of nursing homes.

“This culminates 10 years of work,” said Richard C. Mahan, executive director of the state Little Hoover Commission, which prompted the legislation with a 1983 study that found conditions were deplorable in many of the state’s 1,200 nursing homes.

“This is not only landmark legislation in California but anywhere in the country,” Mahan said. “Now we’re going to look very closely to make sure these laws are implemented.”

Deukmejian was flanked at the bill-signing ceremony by Mahan, legislators from both parties and representatives of senior citizen groups and the nursing home industry.

‘Evidence of Commitment’

“The strong bipartisan support for these bills, I think, is evidence of the Legislature’s commitment and the commitment of this Administration to ensure that our state’s senior citizens have the opportunity to live their lives with dignity and with respect,” Deukmejian said.

Asked by reporters about his previous veto, Deukmejian was vague about what his specific objections had been. He made it clear, however, that he disliked the fact that the 15 bills had been tied together, making it impossible for him to veto some of the measures.

“I think there were three or four bills we objected to,” he said. “And of course the main problem last year was that all of the bills were double joined (tied together). It took away the authority of the governor to decide which bills to sign and which bills to veto. When it arrived at my desk it was all or nothing.”

In a related development, state Auditor General Thomas J. Hayes released a report Wednesday charging that some nursing home operators have billed Medi-Cal for millions of dollars in illegitimate expenses, such as automobiles, travel and entertainment.

Labor Costs Hit

In addition, Hayes found that some operators have not been spending a proportionate share of their Medi-Cal funds to cover increased labor costs.

Hayes recommended that the Legislature impose sanctions on nursing home operators who repeatedly overstate their Medi-Cal costs and enact laws to ensure that employees are appropriately compensated.

THE NURSING HOME LAW

Legislation signed Wednesday by Gov. George Deukmejian increases penalties for neglect or abuse of patients in the state’s 1,200 nursing homes for 105,000 elderly patients, including 75,000 who are on Medi-Cal. It also increases funds for nursing homes that care for the Medi-Cal patients. The legislation would:

Increase Medi-Cal payments to nursing homes this fiscal year by $8 million and provide for an annual increase of $87 million in future years. The money must be used to raise wages and staffing levels.

Stiffen penalties for negligence in patient care and levy fines for falsifying patients’ medical records.

Increase civil penalties for violations of licensing standards and provide stiffer penalties for repeat violators of licensing provisions.

Outlaw discrimination against Medi-Cal patients and prohibit retribution against patients or employees who file complaints.

Improve the training of nursing home inspectors employed by the state.

Require the state to publish a quarterly list of nursing homes that are in good standing.

Provide for establishing patient-oriented councils in nursing homes.

Give municipal and justice courts jurisdiction over alleged nursing home violations.