Nursing Home Patient Care

The articles and editorial (“The Nursing Home Scandal,” April 9) concerning the plight of nursing homes and the impact of the Medi-Cal program are hardly to be considered as news.

Yet there are two causes of the shameful condition. There are unscrupulous operators of nursing homes who do lower standards for the sake of remaining solvent. But the primary cause of the shameful report is the Medi-Cal reimbursement program. California is one of the few states that follows the flat reimbursement program for all facilities in a given geographic area. Most states follow a direct-cost reimbursement program which fosters a higher standard of care.

The Retirement Housing Foundation, which I served as a founder and as the CEO for over 20 years, has skilled nursing programs in Florida, Indiana and California. The reimbursement rates in California fall well below the rates received in the other states.

There has been a deliberate and intentional effort for many years in California to force nursing homes to charge the private-pay patients as much as $10 to $20 a day more than the reimbursement rate for Medi-Cal patients. The stark fact resulting has been and remains that the private beds are indirectly taxed to support the Medi-Cal beds.

California is poorly serving its neediest and most helpless citizens.

REV. CLARK HARSHFIELD

Los Angeles