Keeping Watch Over Nursing Homes : State Inspectors Are Doing a Better Job of Checking Up on Facilities in the County

By one measurement, the state is finally facing its responsibility in ensuring that residents of Orange County nursing homes are getting the care they deserve and the law requires. The attention is overdue.

Two years ago, inspectors issued county nursing homes only three citations for fines totaling $8,250. Last year’s totals were 56 citations calling for $96,800 in fines; for the first seven months of this year, the total citations were more than 80, with the amount of fines not yet determined. It is true that inspectors can take other punitive actions against nursing homes besides fines, but hitting the pocketbook remains one valid measurement of how well inspectors are keeping tabs on the facilities.

The 1992 citation record prompted complaints from a private group that monitors nursing homes, and a hearing by a legislative fact-finding panel chaired by Assemblyman Gil Ferguson (R-Newport Beach).

State statistics painted a disturbing picture of deficiencies in the more than 70 nursing homes in the county. Those homes made up a relatively small district on state organization charts, yet they registered many more serious deficiencies than larger districts.

Private individuals investigating a nursing home before placing a parent or other relative there can read the state inspection reports, which are kept at each facility. The reports explain the circumstances and context in which deficiencies were found, as well as detailing how serious each was. But many nursing home residents have no relatives and no visitors. They are dependent on volunteer ombudsmen, conscientious employees and, ultimately, state and federal inspectors to see they receive adequate care.

The tale of Harbor Health Care in Fullerton is instructive. The facility since has been sold and has not had problems lately, state officials said, but under the old owners, inspectors found numerous deficiencies. The state recommended at one point that the home be ruled ineligible for Medicare or Medi-Cal payments, without which most nursing homes cannot exist. But the federal government wrongly overruled the state, and the facility under previous ownership continued to pile up deficiencies. The lack of proper treatment of patients and maintenance of facilities detailed in state records represents a shocking failure of the system. State officials said the situation that once existed at Harbor Health Care was by no means typical, but they must use their powers to see it does not recur at any nursing home.