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California and the West

Seniors Back Nursing Home Reform

Legislation: Bill seeks to help remedy conditions reported last year in federal audit, which found numerous violations.


SACRAMENTO — Several hundred senior citizens from around the state descended on the Capitol on Tuesday to lobby for the most extensive nursing home reform in more than a decade.

Embodied in a bill by Assemblyman Kevin Shelley (D-San Francisco) that easily passed its first committee hearing Tuesday, the reforms would do several things, including:

* Reduce the patient load of nurse's aides, who now provide 70% of patient care.

* Require immediate state response to complaints of practices that put patients in danger.

* Increase fines for the most serious violations from a maximum of $20,000 to $100,000.

Testimony presented to the Assembly Health Committee was at times dramatic. Charles Arnold, for example, pleaded with legislators to help his grandmother, housed in a Vallejo convalescent home.

Recently, Arnold said, he "found her soaked in urine up to her bra."

The bill, AB 1160, was approved on a bipartisan 9-1 vote and sent to the lower house's Committee on Aging for a second hearing next week.

Shelley's legislation is a partial response to last year's scathing federal assessment of California's 1,440 nursing homes, which reported that a third had committed serious violations. That assessment repeated many of the criticisms of a 1983 report by an independent California commission.

"How many bad reports do we need. . . ? How many people have to die?" said Shelley, whose interest in reform was piqued when he toured dozens of nursing homes trying to find a place for his ailing mother.

"I gotta tell you, what I found as a result of those visits was staggeringly appalling," he said.

Nursing home representatives say Shelley's measure will cost the state at least $190 million a year. Reform advocates claim that number is inflated to doom the bill; they estimate it would cost closer to $42 million annually.

But nursing home lobbyists do not deny that the problems are grave. In a proposal released Tuesday to coincide with the hearing, the California Assn. of Health Facilities suggested more money, not more punishment, is the answer.

"Current efforts in the Legislature to enact 'reform' by simply imposing new penalties on nursing homes only provides superficial treatment for a seriously ailing system," said Gary Macomber, the organization's executive vice president.

At the hearing, nursing home lobbyist Dave Helmsin testified that year after year, regulations are heaped on the industry without noticeable improvement. Staff should be better paid, he said, but nursing homes cannot pay more without higher state Medi-Cal reimbursement rates.

In taking the industry's side, Assemblyman Tony Strickland (R-Thousand Oaks) spoke of his years as a volunteer in a nursing home. State inspectors were so stringent, he said, that the home could be cited for a Ding Dong brought in by a patient's relatives because it attracted ants.

"We're making it a lot more difficult to provide good care by adding these regulations," he said.

Senior citizens who came to the hearing Tuesday said they are realistic that, even if the bill eventually becomes law, it will not solve all nursing home woes.

"If it was any stronger, it wouldn't even get to where it is now," said Jeanette Ambroge, vice president of the Petaluma chapter of the American Assn. of Retired Persons. "To gain a mile, we first have to crawl an inch."

Ambroge led one of a dozen groups that donned yellow T-shirts urging reform "Now!" and spent the morning visiting their legislators' offices. Most came away disappointed, told that many lawmakers were in hearings or absent, their staff members unavailable or sick.

Ambroge and others muttered their dissatisfaction: "Typical government employee," said one. "They don't even know why we're here," said another.

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