Panel Calls for Probe Into Nursing Home Regulators’ Job Performance

Following five hours of often heart-wrenching testimony, a fact-finding panel Friday called for an investigation into whether state nursing home regulators in Orange County are doing an adequate job.

Advocates for nursing home patients contended during a hearing here that the Orange County district office of the state Department of Health Services, which licenses and regulates the county’s 76 skilled nursing homes, has fallen behind the rest of the state in enforcement.

Patricia McGinnis, president of California Advocates for Nursing Home Reform, quoted a statewide study conducted by her organization that showed state regulators in Orange County issued only two citations and $7,500 in fines in 1992, while in Santa Clara County, which has fewer nursing homes, regulators issued 162 citations and more than $350,000 in fines.

However, Jacqueline A. Lincer, chief of the Department of Health Services office in Anaheim, explained that in 1992 she decided to cope with an overwhelming workload by instructing her staff to write fewer citations.

Lincer said that instead of issuing citations, her office punished errant nursing homes by removing the certification that enables them to bill Medi-Cal and Medicare. Decertification, she said, is a quicker and more effective remedy than citations and fines, which are often delayed for years in the appeals process. In 1992, she said, the decertifications in Orange County far outpaced other parts of the state.

“Decertification is 10 times worse than a citation,” agreed Kathy Byrne, spokeswoman for the California Assn. of Health Facilities, which contends that regulators in Orange County are just as tough on nursing homes as they are in the rest of the state.

Lincer said the state Department of Health Services in Sacramento sent a team to investigate complaints about her office. “At the end of the review, I was told we were doing it the way it was supposed to be done,” she said.

However, she added, the office also has stepped up the writing of citations since October, 1993.

At the end of Friday’s five-hour hearing, the fact-finding panel called for the state auditor general to investigate whether state regulators in Orange County are doing an adequate job in protecting patients. The panel was chaired by Assemblyman Gil Ferguson (R-Newport Beach), whose district includes the Leisure World retirement community.

Ferguson said the panel, which also included Assemblymen Mickey Conroy (R-Orange) and Tom Umberg (D-Garden Grove), former Assemblywoman Marian LaFollette and Richard R. Terzian, chairman of the state’s Little Hoover Commission, also would push for reform legislation.

Ferguson said he learned that laws are needed to protect nursing home employees who file complaints against their employers and to enable nursing homes to share information about the prior abuse record of job applicants.

One of the nearly two dozen people who testified was Diane S. Sandell, founder of a volunteer organization that advocates better nursing home care. Sandell said her mother was severely beaten twice in the night in 1988 when she was living at a nursing home in Orange, but there was no citation or fine levied against the facility.

Nursing home officials acknowledged that there are abuses in their industry. However, they argued that the solution is not to add regulations but to improve the screening and training of nursing home personnel.