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Wednesday, May 18, 2022

After pandemic hits nursing homes, lawmakers push for tightening licensing rules

SACRAMENTO – When Johanna Traineri found a nursing home for her husband, she expected their stay to be temporary.

He never came home.

Arthur Traineri passed away in October 2020 at Windsor Redding Care Center in Northern California. The 82-year-old great-grandfather is among more than 9,900 California nursing home residents who have died of COVID-19.

The nursing home where Traineri died is licensed by the state, but not under its current owner, Schlomo Rechnitz. The state refused to license Rechnitz, citing at least one death and several cases of “serious harm” at other nursing homes. To get around this, Rechnitz formed a business partnership with one of the home’s former owners, who continues to license the facility.

Some California lawmakers want to end these types of business arrangements and ban people or entities from buying or operating nursing homes unless they have a license—which is the situation in most states. They are also proposing changes to the licensing process to reject applicants who are underperforming and without sufficient experience or financial resources.

The ambitious effort, which the industry considers an overreach, could make California’s oversight the gold standard and a model for other states trying to improve nursing home care. Nationwide, more than 152,000 nursing home residents have died of Covid during the pandemic, according to federal figures.

“The public health emergency we’ve experienced could be something that becomes a catalyst for real change,” said Dr. Debra Saliba, a professor of medicine at UCLA. A comprehensive report on nursing homes in April. “One of the things we have right now is the determination, the resources to do things.”

In his State of the Union address in March, President Joe Biden said the quality of care at nursing homes acquired by investors had declined — and vowed to set higher federal standards. In anticipation of the speech, the White House issued a resolution to Congress to boost funding for nursing home inspections and empower federal regulators to deny Medicare funds to underperforming facilities. The administration also directed the Centers for Medicare and Medicaid Services to propose minimum staffing standards within one year.

States are also taking steps to improve the quality. For example, New Jersey this year adopted a law that toughens penalties for health violations and requires nursing homes to disclose financial records.

In California, lawmakers are considering a number of proposals, including changes to nursing home licensing rules.

Companies and individuals can buy or run nursing homes in California before obtaining a license, a process that even an industry lobbyist described as “backward” and unique to the state at a legislative hearing this year.

“In California, nursing home owners and operators can operate without a license even after being denied a license,” said state assembly member Al Murasuchi (D-Torrance), author of AB 1502. , unfortunately, an extensive history of neglect and abuse.”

Muratsuchi’s bill would require an owner or company to apply for a license 120 days before purchasing or operating a nursing home and would include financial records that would name all owners and investors. The state will reject applicants who fail to meet the standards for character, performance in other households, and financial ability to run a household. Homes that operate without a license will lose Medicaid funding and will not be able to accept new residents.

The powerful California Association of Health Facilities, which represents more than 800 nursing homes, has blocked previous licensing legislation and has set its sights on Muratsuchi’s bill. The group is led by Craig Cornett, a veteran of the state capitol who has worked for four Assembly Speakers and two Senate leaders.

According to records recorded in the Office of the California Secretary of State, the organization has made just over $2 million in political contributions and spent $5.9 million lobbying lawmakers from January 1, 2011 to March 31, 2022.

The bill fails to consider the state’s “complex regulatory environment” and would create “extensive” disclosure requirements on proprietary applications that “in many cases would fill an entire room with boxes and boxes of paper,” said Jennifer Snyder, A lobbyist for the association, told lawmakers in January.

The measure “will eliminate the ability for most current owners in California to actually apply for or even apply for a change of ownership,” she said.

But this year, the industry is facing a changed political landscape.

Covid has prompted lawmakers to act – and Muratsuchi has secured a valuable co-sponsor for his bill, Democratic state legislature member Jim Wood, head of the Assembly’s health committee. Wood has denounced nursing homes for not doing enough during the pandemic and directed state regulators to conduct stricter oversight.

Muratsuchi’s measure has been approved by the state assembly and awaits a hearing in the Senate.

An investigation by news organizations CalMatters and LAist last year found that at least two California nursing home operators were operating dozens of facilities without a license, even though state Department of Public Health officials disqualified them for doing so. Had given.

Homes remain open, in large part because it is incredibly difficult for residents to find another nursing home.

In July 2016, state regulators refused to license Rechnitz – who had purchased the Windsor Redding Care Center where Arthur Trenery died – citing 265 health and safety code violations at his other facilities over the past three years. Happened. Nevertheless, Rechnitz continues to operate the home in partnership with a former owner, Lee Samson, who is listed in state records as the holder of the license.

Mark Johnson, an attorney representing Rechnitz and his company, Bryce Healthcare, said Windsor Redding Care Center’s “license is in good standing” and that Rechnitz is managing the facility under an agreement “that is customary in the skilled nursing facility industry.” is.” Johnson said Rechnitz has filed a new and updated license application with the state.

Johanna Traineri said she did not know that Rechnitz had been denied a license. Had she known, she said, she would never have kept her husband of 60 years at Windsor Redding.

She said that before her husband caught Covid, Traineri and their children were trying to move him to another home because he seemed highly medicated, could no longer hold his head, and had to get out of bed. Fell several times in the attempt, he said. One time, she remembered, the nursing home took the wrong person out when the family came.

One of Traineri’s eight children, Nancy Harden, said they kept her “so intoxicated”. “And I think it was just because it was easy for him. He wasn’t going to his rehab. I thought, ‘We have to get him out of this place.'”

Then he became covid.

Sixty of the 84 residents came down with the disease in September 2020 – and at least two dozen of them died. According to a lawsuit filed by family members of 15 residents who died, including Traineri, the house staff were forced to work despite having symptoms of Covid. The lawsuit refers to state citations that found that the home did not supply enough personal protective equipment to employees, did not test employees, and placed COVID patients and unused patients in the same room with residents who were not infected. were.

Johnson denied the allegations.

KHN (Kaiser Health News) is a national newsroom that conducts in-depth journalism about health issues. Along with policy analysis and polling, KHN is one of the three major operational programs of the KFF (Kaiser Family Foundation). KFF is a thriving non-profit organization that provides information on health issues to the nation.

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