Need for Oversight at Nursing Homes

I read with great interest the Jan. 18 article on Orange County nursing homes.

Our congratulations for placing this poignant issue on the front page.

During the past 14 years I have been the chief executive officer and president of an Orange County-based independent bank. As such, I have been subject to rigid government regulators from state and federal agencies.

This type of regulation is a necessity in an industry that is responsible for handling our precious money. This strict regulation doesn’t seem to exist in the care of our frail elderly in nursing homes, board and care homes or long-term care facilities.

The necessity for this kind of rigid regulation is far greater for the long-term care industry than it is for our monetary system, as this industry is responsible for the lives of our elderly loved ones. Life is certainly much more valuable than our money.

The state Department of Licensing can levy fines on facilities that violate state or federal standards. Unfortunately these fines are most often drastically reduced or waived if appealed by the facility. Fines of $500 to $1,000 are not uncommon for a violation that results in an untimely resident death. Fines for a violation of banking laws can run up to $10,000 per day for “risky” operations in a bank.

Something is dreadfully wrong here. The California nursing home lobby has far too great an influence on those who license and regulate nursing homes, when fines concerning a death due to dehydration are levied at $1,000.

Currently pending in the California Legislature is AB 1133, which would cause some positive and significant changes in the nursing home regulations. I understand our governor has threatened to veto the bill. How can he? People are dying and being treated poorly in some of our nursing homes today.

The oversight of nursing home operations belongs with a strong and effective state or federal regulator, not an industry-dominated lobby. The nursing home industry is in the business of healing and protecting the lives of our citizens, most of them the frail elderly.

DONALD L. SOLSBY

Newport Beach

* I lost my wonderful grandmother in January of 1996 to, in part, neglect by Port Bay Care Center in Costa Mesa. If I knew what I know now, I would have fought my family and the system to get her out of there.

In the year or so that my grandmother was confined there, she not only deteriorated rapidly mentally and physically but she broke her elbow and hip, often had bruises, and was incoherent. What little creature comforts she had were stolen.

I visited her once a week [and] spoke to staff to make sure that she was treated well. All to seemingly no avail. They did not even notify me when she was dying due to pneumonia and she died alone. A thought that greatly disturbs me even to this day.

Housing a loved one in a convalescent center is extremely expensive. Medicare and Medicaid benefits are inadequate. There are not enough good care facilities that accept Medicaid patients.

The system forces people to give up what little financial security they have to be basically a ward of the system. It’s a degrading process with no bright light at the end of the tunnel. The patient is left to fend for himself or herself at a time when they are most vulnerable.

Your article was bittersweet and one that I hope gets periodically reprinted or updated so that the public stays aware of the conditions of these homes.

As elder care issues become more prevalent as we baby boomers are challenged with caring for our parents and our own families, changes need to be made to the system. We need all of the information and resources available to make the best informed decisions about the care of our loved ones.

These sorts of horror stories exist far too often. It’s better to have all of your cards on the table, choices available, and informed information in order to make good decisions before a family has to put a loved one in this type of facility.

CATHY KOWALSKI

Dana Point

* Every one of us who is entrusted with the care of an elderly loved one should kneel down and give thanks for the well-written and hard-hitting story on nursing home abuses Jan. 18.

It is disgraceful that the segments of this industry who repeatedly break the rules, causing widespread suffering and other elder abuses, are not dealt with more severely by our state and local regulatory agencies.

KENT S. MOORE

Corona del Mar

* Your Jan. 25 editorial, “Ailing Nursing Homes,” serves only to perpetuate long-standing misconceptions about California’s nursing facilities.

The vast majority of nursing facility residents receive excellent care provided by dedicated, hard-working caregivers. Today’s facilities are a far cry from those of 15 or 20 years ago. Increased nursing hours, better tools to screen potential employees, technological improvements, and ongoing quality improvement efforts by facilities have resulted in a significantly higher level of care and understanding.

However, these improvements don’t come easily. Nursing facilities must demonstrate daily compliance with over 900 complex regulations, many of which are written in language that can be interpreted differently by facility staff and individual surveyors.

We’ll never get away from the need to have rules and regulations, but it’s essential that we move toward a system that focuses on quality paperwork.

Rather than increasing fines and penalties, let’s work toward a system that not only identifies potential problems, but also provides the tools to strengthen facility efforts to fix problems--or better yet, prevent them altogether.

GARY D. MACOMBER

Executive Vice President

California Assn. of Health Facilities

Sacramento