Medi-Cal Benefit Increase for Nursing Homes Fails to Improve Care

In 2004, California legislatures passed a law that provided California nursing homes with $590 million by raising Medi-Cal (California’s Medicaid program) payments. The purpose of this law was to give nursing homes more financial resources to help poor residents. From 2004 through 2006, a UC-San Francisco study found that nursing homes not only received the $590 million, but their total revenues rose by $1.1 billion.

The increase in funding and profits does not appear to have translated into better care. The same UCSF study reports the following statistics in 2006:

1. A 3.6% decrease in nursing home spending on direct patient care

2. A 6% increase in state and federal citations of nursing homes

3. A 38% increase in complaints of patient mistreatment

4. 16% of nursing homes still did not meet California’s minimum staffing levels

5. 88% of nursing homes did not comply with federal regulations

6. 22% of nursing homes had violations that harmed patients or jeopardized patient care

The study also found that nursing assistant wages increased an average of 71 cents per hour (or 6%), licensed nurses increased by 9% and administrators pay rose by 13%. Nursing homes also enjoyed a rise in net profits of 233% to $248,047.

Nursing Home Residents Bill of Rights
The California Health and Safety Code, Section 1771.7(b) provides that all residents in residential living units (such as nursing homes) shall have all of the following rights:

1. To live in an attractive, safe, and well maintained physical environment.

2. To live in an environment that enhances personal dignity, maintains independence, and encourages self-determination.

3. To participate in activities that meet individual physical, intellectual, social, and spiritual needs.

4. To expect effective channels of communication between residents and staff, and between residents and the administration or provider's governing body.

5. To receive a clear and complete written contract that establishes the mutual rights and obligations of the resident and the continuing care retirement community.

6. To maintain and establish ties to the local community.

7. To organize and participate freely in the operation of resident associations.

The increase in funding was meant to help California nursing homes comply with California statutes such as Section 1771.7(b). It appears from the UCSF study that nursing homes have not really improved; while administrator salaries benefitted from the influx of funds, patient care actually became worse. It is important to keep a watchful eye on your loved ones who reside in nursing homes. Be especially on the look-out if the nursing home has difficulty keeping staff. With nursing assistant wage increases not even keeping up with inflation, a high turn-over is likely, leading to poorly trained employees and a high likelihood of neglected patients. If any of the rights listed above has been violated, it is important that you consult an elder law attorney as soon as possible.

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