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Widespread Abuse, Broken Oversight In California Nursing Homes

A new CANHR report - Nursing Home Abuse and California’s Broken Enforcement System (available at - exposes the physical, sexual and verbal abuse that are shocking realities for hundreds of nursing home victims throughout California. More nursing home residents are now at risk for abuse than ever before because the California Department of Health Services (DHS) has abandoned its role as a consumer protection agency.

Rapes, beatings, neglect, and mockery are certainly not what nursing home residents should experience when they depend on others for care. In too many California nursing homes, however, abuse is an all-too-common and frightening concern for residents.

The CANHR report reviewed "citations" (fines) issued by DHS against nursing homes from January 2004 through April 2006 and found at least of 266 cases of abuse in the following categories: physical abuse (39%); sexual abuse (12%); mental abuse (13%); verbal abuse (19%); abuse committed by non-staff (17%).

Unfortunately, the incidents that are cited are the tip of the iceberg. Analysis of the citations issued shows that incidents of abuse are under-reported, and incident descriptions portray widespread acceptance of abusive behavior. Nursing homes are required to report suspected abuse, but some do not.

The report finds that some abused residents are victimized again when their abuse is reported to DHS. Its abuse investigation system is severely compromised by slow investigations, tardy citations, and minimal fines that have little deterrent value and no relation to the physical and emotional trauma suffered by abuse victims.

DHS’ most serious failures are seen in its failure to properly investigate complaints, its decision to ignore California nursing home reforms during inspections, its practice of withholding performance data on California nursing homes and its failure to apply enforcement remedies when needed.

CANHR is fighting these failures through litigation, legislative advocacy and use of the media.

For example:

  • In October 2005, CANHR and the daughters of deceased neglect victims sued DHS due to its pervasive failure to investigate nursing home complaints within the mandatory 10-day response time required by California law. The case is pending in San Francisco Superior Court.
  • In March, CANHR submitted testimony supporting an audit of the DHS Licensing and Certification Division. The Legislature ordered the audit.
  • On April 26, the Los Angeles Times published an article citing CANHR’s concern that DHS is withholding key regulatory data on nursing homes, leading DHS to release some information.

The administration has responded by proposing substantial new funding for Licensing and Certification. CANHR is conditionally supporting the budget proposal, but is urging the Legislature to tie funding to specific actions that will improve oversight and enforcement. As it stands, much of the new money is likely to be spent on business -friendly initiatives rather than protecting consumers through improved oversight. The Legislature is scheduled to take final action on the budget in mid-to-late June.

In another important development, the California Senate approved Senate Bill 1312 (Alquist), which now goes to the Assembly for consideration. SB 1312 would require DHS to evaluate nursing home compliance with numerous California nursing home reform laws, including its minimum staffing requirements. Currently, DHS ignores these laws during inspections and investigations, rendering them meaningless. CANHR welcomes the Legislature’s attention to this problem but has not taken an official position on SB 1312 because we believe that DHS already has a duty to enforce California laws governing nursing homes.

Please join our fight against nursing home abuse by contacting your California Senator and Assembly Member. Tell them your concerns about abuse and our broken enforcement system. Urge them to closely monitor the audit, tie Licensing’s budget to improved oversight, support Senate Bills 1312 and 1248 (see Legislative Update), and defend California’s elder abuse laws. Please read CANHR’s abuse report and urge support for its more detailed recommendations. The report has been mailed to every California legislator. (The abuse report can be downloaded from CANHR’s web site at If you do not have access to a computer, contact the CANHR office for a copy of the report.)