California Department of Public Health’s (CDPH) Licensing & Certification Program’s Failure to Protect Elder Abuse Victims in Nursing Homes
In the February 2012 report entitled Federal Survey Requirements Not Always Met for Three California Nursing Homes Participating in the Medicare and Medicaid Programs, the U.S. Department of Health and Human Services (HHS), Office of Inspector General (OIG), found that nursing home inspectors working for the California Department of Public Health’s (CDPH) Licensing and Certification Program “understated deficiencies, did not ensure that corrective action plans contained specific information addressing the five corrective action elements[,] . . . did not verify correction of identified deficiencies,” but instead “used their judgment in contradiction to guidance in the [Centers for Medicare & Medicaid Services (CMS) State Operations] Manual.”
California licensing and regulatory agencies’ complicity in the “corrupted” and “broken” nursing home inspection and enforcement system
Elder Abuse Exposed.com exposes to the light of day the following disturbing secrets about California licensing and regulatory agencies charged with protecting vulnerable patients in health care facilities, including hospitals and nursing homes:
- The broken nursing home inspection and complaint investigation process that U.S. Senator Charles Grassley (R-Iowa), a staunch and longtime advocate of abused nursing home residents and government whistleblowers, revealed “has been seriously corrupted” by an intertwined, “unspoken political presence” and “high-level state bureaucrats” and “state lawmakers acting on behalf of facility administrators” who pressure state nursing home inspectors to overlook or systematically downgrade even high-level citations and quality-of-care deficiencies.
- A “seriously corrupted” and “broken” nursing home oversight and enforcement system that becomes more entrenched year after year throughout the U.S. despite:
- More than 20 U.S. Government Accountability Office (GAO) reports on nursing home quality, from 1998 to 2012.
- Numerous reports by the U.S. Department of Health and Human Services’ (HHS) Office of Inspector General (OIG) detailing persistently deficient oversight of nursing homes and inadequate enforcement of federal and state nursing home regulations by state inspectors, including those working for the California Department of Public Health’s (CDPH) Licensing and Certification Program.
- Numerous hearings in the U.S. Senate Special Committee on Aging on the quality of care in U.S. nursing homes, including Betrayal: The Quality of Care in California Nursing Homes (PDF, 20.2 MB, opens new window), which was led by Senator Grassley, a former chairman of the committee.
- Countless investigative reports by media outlets and patients’ rights advocacy organizations.
- State and federal nursing home regulators who overlook understaffing, fraud, patient records falsification, neglect, and elder abuse in noncompliant nursing homes.
- State and federal nursing home regulators who “go easy” on noncompliant nursing homes to protect wealthy, politically connected nursing home owners who get taxpayer-funded Medicare and Medicaid payments, which require nursing homes’ “substantial compliance” with minimum quality-of-care laws.
- High-ranking program managers at CDPH’s Licensing and Certification Program and Los Angeles County Department of Public Health (LADPH) who protect the nursing home operators from responsibility for the harm they inflict on their vulnerable residents by:
- Supporting the CDPH and LADPH district offices’ flagrant bias in favor of nursing homes.
- Deliberately overlooking and thereby condoning fraud, patient records falsification, and elder abuse in nursing homes.
- Issuing official complaint investigation reports on nursing homes containing willful and material falsifications and omissions designed to help conceal elder abuse.
- Officials at CDPH’s Licensing and Certification Program and LADPH district offices who have a “cozy” relationship with nursing home administrators and unlawfully disclose to them the identity of anonymous complainants and whistleblowers and the content of confidential communications, in violation of California Health and Safety Code § 1419(e).
- CDPH and LADPH district office officials who deliberately refuse to enforce California’s whistleblower protection statute designed to protect anonymous reporters of elder abuse and other violations in nursing homes, i.e., California Health and Safety Code § 1432, when nursing homes illegally retaliate against complainants “outed” by state officials and try to evict and “resident-dump” frail and abused residents.
- Government investigators working for CDPH’s Licensing and Certification Program, LADPH, California Board of Registered Nursing, and California Board of Vocational Nursing and Psychiatric Technicians who brazenly display bias in favor of wealthy, politically connected nursing home owners and against vulnerable, frail nursing home residents, e.g., by telling complainants that the inspectors will ignore photo, video, and other evidence of elder abuse and will presume that nursing homes’ statements in patient records are totally true.
- CDPH and LADPH district office officials who flat out refuse to enforce California’s Health and Safety Code § 1424, which prohibits nursing homes and other health care providers from willful falsifications and omissions in patient records.
- CDPH and LADPH district office officials who overlook nursing homes’ practice of falsifying patients’ medical records, which according to the September 18, 2011 “Falsified Patient Records Are Untold Story of California Nursing Home Care,” by the Sacramento Bee‘s Pulitzer Prize-winning investigative journalist Marjie Lundstrom, “masks serious conditions and covers up care not given[,] . . . puts patients at risk and sometimes leads to death[,]” and sometimes has “disastrous human consequences.”
- CDPH high officials who cannot explain CDPH inspectors’ “dramatic decline in citations for fraudulent records.” The Sacramento Bee’s “Falsified Patient Records Are Untold Story of California Nursing Home Care” said that while “the state issued 180 citations against long-term care facilities for ‘willful material falsification,’ or doctoring records[,]” in the 1990s, “the state issued only 29 citations for willful material falsification” in the entire following decade, between 2000 and 2010. But The Bee reported that Scott Vivona, chief of field operations for CDPH’s Licensing and Certification Program, “said he isn’t sure why nursing home citations for willful material falsification declined so steeply, while the total number of complaints and on-site inspections rose in the last decade.”
