Federal Report Cites Violations at 83 County Nursing Homes

Residents of nearly one in five nursing homes in Los Angeles County are beset by such problems as unsanitary conditions, untreated bedsores and improper use of restraints, according to a congressional staff investigation to be made public today.

Eighty-three homes serving more than 8,000 people violated federal standards, placing patients at risk of serious injury or death, said the report by the Democratic staff of the House Government Operations Committee. The study will be released by Rep. Henry A. Waxman (D-Los Angeles), the committee’s ranking Democrat.

“People have a right to know how their parents, relatives and friends are being treated in Los Angeles nursing homes,” Waxman said in an interview. He called the study’s results “shocking and disturbing.”

The staff reviewed reports by state inspectors, who check nursing homes that receive federal Medicare or Medi-Cal money to see if they comply with federal standards for the health, safety and treatment of patients. Los Angeles County has 439 participating nursing homes, and 83 of them, or 19%, were found to have major violations of federal rules.

“These deficiencies involved serious problems, such as pressure sores, accidents, improper use of medications or restraints, malnutrition, dehydration and unsanitary conditions,” the 21-page report stated. “Many residents are not receiving the care that their families expect and that federal law requires.”

Nursing home industry officials say inspection reports can be misleading. A report “may be a year or two old, and the management of the nursing home may have been changed,” said Peggy Goldstein, vice president for the California Assn. of Health Facilities, which represents 1,600 nursing homes with 250,000 residents.

The inspection reports lag behind nursing homes’ adoption of remedies, she said, concluding that the reports often “do not provide a true picture of what is going on.”

The report called itself a “snapshot” of current conditions, which it said could change quickly. “New management or enforcement activities can bring rapid improvement,” it said; “other changes can lead to rapid deterioration.”

The report analyzed the results of state inspections conducted between November 1997 and August 1999, the most recent reports available for each of the 439 nursing homes in the county with residents covered by Medicare or Medi-Cal.

State inspection reports cover an extensive series of topics, ranging from bookkeeping failures to violations that threaten patients’ safety and life. The staff investigators looked at inspection reports from homes “cited for violations that caused actual harm to patients,” the report said.

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The federal government makes available information on all of the nation’s 17,000 nursing homes. The Health Care Financing Administration has a Web site with information on each home, including the violations noted in the most recent inspection report. The site is www.medicare.gov/nursing.html, The same information is available over the phone at (800) 633-4227.

Inspection reports for Los Angeles County are available through the district office of the California Department of Health Services at (800) 228-1019. The California nursing home ombudsman, at (800) 231-4024, can answer questions about nursing homes or resolve disputes between nursing homes and residents or family members. California Advocates for Nursing Home Reform, at (415) 474-5171 and www.canhr.org, has reports on violations and complaints for all nursing homes in the state, and information about the Medi-Cal program, which pays for nursing home care for the indigent.