Kaiser Health News recently revealed that several hundred nursing home cases in Los Angeles County were closed without any investigation as part of the so-called “Complaint Workload Clean Up Project.” Anna Gorman, the author of the exposÃ©, notes that this is not the first time that California has been singled out for criticism when it comes to health issues–the state public health department had to deal with a lawsuit in 2005, an audit in 2007, an Inspector General’s report in 2011, and sanctions by the Centers for Medicare and Medicaid Services in 2012. California’s dismal record on health issues is apparently well deserved.
This time, according to classified internal documents, public health supervisors in LA County, home to about one-third of California’s nursing homes, ordered inspectors to close anonymously submitted complaints with the designation “No Action Necessary” and to close “other cases by examining previous reports about the facility instead of thoroughly investigating the complaint at hand. If two other inspections done around the same time did not reveal problems similar to the new allegation, the complaint was to be determined ‘unsubstantiated.’” Many such complaints concerned insufficient staffing, misconduct on the part of staff members, unsafe working conditions, and more specific ones like patients being given “unnecessary medication” or getting bed sores.
“Cleaning up” complaints that should be fully investigated is, in the words of nursing home reform activist Michael Connors, “unconscionable.” He goes on to state, “They are supposed to take action to protect people from harm. They are supposed to set out right away, investigate and take action to stop [abuse] from occurring […] They don’t have the option of picking and choosing [cases].”
California law states that these investigations are required to begin at the latest ten days after a report is filed, but the author of this article reports that statewide there are more than 9000 cases dating back to 2001. To make matters worse, the state employs only 600 investigators to handle active complaints. This backlog is especially egregious; elder care advocates point out that cases must be pursued as quickly as possible: “staff turnover is high, memories fade and residents may move or even pass away.”
State legislators are making strides toward a more efficient and thorough regulatory process, with an assemblywoman recently proposing a measure that would require investigations to be completed within 40 days. Her questions for the rest of the assembly were powerful: “How many current investigations have been open for more than two months? Four months? Six months? One year? 18 months? Two years? Three years or more?”
When the state engages in substandard regulation of nursing homes, the most vulnerable of citizens are placed at even greater risk. Remediation and redress for victims of nursing negligence, abuse and neglect only ensures that these practices will continue. California’s clean up of complaints is a government-directed and government-sanctioned cover up of serious wrongdoing. As we have noted before on this blog, it is often only through the civil justice system, and particularly through plaintiffs’ investigation that nursing home negligence and neglect are exposed. In the pursuit of civil remedies, attorneys’ discovery will open up the closed and cleaned up investigations.