|
Reports/Studies
Table of Contents:
CANHR Reports
 |
- Who’s Fault Is It - Are Nursing Homes to Blame for Their COVID Outbreaks? (09/2020) (pdf)
As nursing homes across the country continue to be overrun with coronavirus outbreaks and the number of residents killed by COVID-19 continues to rise, a dispute has emerged over assigning blame. The nursing home industry, unsurprisingly, has been pushing a narrative that nursing homes are “victims” of coronavirus and blameless for the outbreaks in their buildings. The problem with the industry narrative is that it conflates COVID “incidence” (having one case of COVID-19 in a facility) with COVID “extent” (the size of the outbreak within a facility, once it had a case). While incidence is very likely associated with community outbreaks, it is after the virus has entered a nursing home when the differences in quality of care among facilities will matter. Good and bad facilities both have COVID outbreaks; but extensive COVID spread is much more likely to occur in bad facilities.
CLICK HERE to download the report.
|
 |
- CANHR’s Ten-Point Plan to Reform California Nursing Homes (06/2020) (pdf)
This is CANHR's Ten-Point Reform Plan that responds to the nightmarish conditions California nursing home residents have faced throughout the pandemic and for years before the coronavirus arrived. The sweeping plan addresses longstanding failings that the pandemic has exposed for all to see, starting with the need to give top priority to helping people stay out of nursing homes. It also addresses living conditions, safe staffing, emergency preparedness, nursing home slumlords, bad actors, self-dealing schemes, justice for elder abuse victims and independence from the nursing home industry.
CLICK HERE to download the report.
|
 |
- Bad Deal, Bad Care - Reforming the AB 1629 Nursing Home
Reimbursement System (10/2019) (pdf)
In 2020, California’s controversial and extraordinarily expensive reimbursement system for skilled nursing facilities – known as AB 1629 – is about to sunset. Reauthorizing AB 1629 offers a rare chance to redesign the failed reimbursement system to serve residents’ interests.Instead of improved resident care, AB 1629 has produced billionaire owners, scandalous abuse and neglect, rampant discrimination against Medi-Cal beneficiaries and over a billion dollars per year in new General Fund costs while home and community-based services faced relentless cuts.It is time to start over and create a reimbursement system that does not rely on blind trust with California’s disreputable nursing home chains. CANHR has issued a report, “Bad Deal, Bad Care,” to explain the problems with AB 1629 and to list the reforms available to the state to ensure that nursing home reimbursement is finally tied to quality care and fits properly into a long term care system that maximizes consumer well-being.
CLICK HERE to download the report.
|
 |
|
 |
- California's Broken Long-Term Care System: What's Wrong and What Needs to Be Done (11/2018) (pdf)
CANHR has released a white paper summarizing major problems in long term care in California and offering suggestions as to what needs to be done to improve nursing home and residential care; create more affordable and accessible home and community based services; and hold predators and abusers accountable for elder abuse.
CLICK HERE to download the report.
|
 |
- Don't Believe the Hype: Inappropriate Psychotropic Drug Use in Nursing Homes Still an Epidemic (12/2017) (pdf)
In 2012, the Centers for Medicare and Medicaid Services (CMS) announced the Partnership to Improve Dementia Care in Nursing Homes following a withering Office of Inspector General (OIG) report finding rampant misuse of antipsychotic drugs in nursing homes throughout the country. A centerpiece of the Partnership was a series of antipsychotic reduction goals, which ultimately called for a 30% reduction in antipsychotic use in nursing homes by the end of 2016...
|
 |
-
No Standards: How Nursing Homes Attempted to Undermine California’s Standard Admission Agreement and
Diminish Residents’ Rights (2014) (pdf)
California nursing homes are required to use a standard admission agreement (SAA) to set forth all the contractual terms of service with their residents. The adoption of the SAA took twelve contentious years, due to concerns over the content highlighted by a facility-led lawsuit against the state’s Department of Public Health (DPH). When the dust settled, California had a nursing home SAA that had been through two rounds of regulatory adoption procedures with extensive public comment and a lawsuit where all of the nursing home industry’s objections were heard by a state Superior Court judge.
|
 |
- Residential Care in California - Unsafe, Unregulated & Unaccountable (2013) (pdf)
California Advocates for Nursing Home Reform (CANHR) released the attached report on the crisis in care at California's 7,500 Residential Care Facilities for the Elderly (RCFEs). The recent abandonment of 14 bedridden residents at Valley Springs Manor in Castro Valley highlights the serious problems in oversight and enforcement.
|
 |
-
Citation Report 2013 (8/2014) (pdf)
A listing of Nursing Home Citations in California, arranged by county, with summaries & fines issued. In an effort to provide concise yet meaningful information about fines (“citations”) received by California’s ~1,235 nursing homes, CANHR has summarized the citations issued by the Licensing and Certification Division of the Department of Public Health to nursing homes in 2013.
|
 |
|
 |
- New! Your Right to Leave: a Guide for Battling Forced Placement in Long-Term Care Facilities (2015) (pdf)
A free guide to the rights of long-term care consumers to be free from false imprisonment. Residents are often illegally held in nursing homes or assisted living facilities against their will despite no judicial decision or legal process. "Your Right to Leave" explains how and why this happens but more importantly, details residents' rights to be free from forced placement and gives guidance on remedies.
|
 |
-
Your Right To Visit: A Guide To Visiting Residents of Long-Term Care Facilities and Hospitals (2011) (pdf) updated: 8/2015
Visitation is extremely important to hospital patients and residents of long-term care facilities. Studies show visitation is highly correlated with improved quality of life for patients and residents. Visitors to hospitals and long-term care facilities often defer to the institution’s rules about visitation, legal or not. However, such deference lacks the perspective that these institutions are also often the homes of the residents. Visitation rules are only enforceable if they honor the basic rights of the residents.
|
 |
|
 |
|
|
|
|
|
|
|
Assisted Living/Residential Care Studies
-
Quality of Care in Residential Care for the Elderly, A Study of the Limitations & Potential of Community Care Licensing’s Current Data Systems
University of California, San Francisco with California Advocates for Nursing Home Reform (CANHR), Final Report, March 2008.
-
Residential Care and Assisted Living: State Oversight Practices and State Information Available to Consumers Agency for Healthcare Research and Quality, No. 06-M051-EF, 09/2006
-
Environmental Scan of Instruments to Inform Consumer Choice in Assisted Living Facilities
Agency for Healthcare Research and Quality, No. 07-0032-EF, (12/2006)
-
National Academy of State Health Policy: NASHP publishes reports on assisted living including:
-
Critical Issues in Assisted Living National Senior Citizens Law Center. Analyzes how consumers are protected, or harmed, by states' assisted living policies. Available through NSCLC website, $14.95 + s/h (5/2005)
-
Assisted Living: Examples of State Efforts to Improve Consumer Protections
— GAO Report GAO 04-684 (pdf) (4/2004)
-
CANHR Report Reveals Problems with Residential Care Admission Agreements (3/2003)
-
Using Medicaid to Cover Services for Elderly Persons in Residential Care Settings, State Policy Maker and Stakeholder Views in Six States
DHHS (12/2003)
-
Department of Social Services: Continuing Weaknesses in the Department's Community Care Licensing Programs May Put the Health and Safety of Vulnerable Clients at Risk California State Auditor 2002-114 (8/2003)
-
Residential Care for the Elderly: Supply, Demand and Quality Assurance Prepared for the California Healthcare Foundation by Robert Newcomer & Robert Maynard, UCSF (1/2002)
-
Assisted Living Industry Organizes to Stop Consumer Protections (6/2002)
Conservatorship & Guardianship
Elder Financial Abuse
Litigation
Long Term Care Demographics
Long Term Care Insurance
Home and Community Based Services
Medicaid/Medi-Cal
Asset Transfers
Deficit Reduction Act of 2005
Estate Recovery
Fraud & Abuse
Payments for Long Term Care
Nursing Homes
Abuse
- Nursing Home Residents at Risk. The Administration is prioritizing nursing home lobbyists over resident (6/2018) (pdf)
Nursing home lobbyists have urged the Centers for Medicare & Medicaid Services (CMS) to eliminate or delay regulations and dramatically reduce enforcement of violations.
- Don't Believe the Hype: Inappropriate Psychotropic Drug Use in Nursing Homes Still an Epidemic (12/18/2017)
- Toxic Medicine: What You Should Know to Fight the Misuse of Psychoactive Drugs in Nursing Homes
This guidebook covers all of the basics regarding psychoactive drugs in nursing homes, from a description of their uses and side effects to an examination of the applicable laws. Most importantly, the guide gives practical tips for nursing home residents or their family members to prevent misuse of psychoactive drugs. (2/2010)
- The Faces of Neglect: Behind the Closed Doors of Nursing Homes
National Citizens Coalition for Nursing Home Reform (5/2006)
- Elder Abuse in Residential Long-Term Care Facilities: What is Known About Prevalence, Causes and Prevention Catherine Hawes, Testimony Before the U.S. Senate Committee on Finance (6/2002)
- Nursing Homes: More Can Be Done to Protect Residents from Abuse — GAO Report GAO-02-312 (pdf) (3/2002)
- Abuse of Residents Is a Major Problem in U.S. Nursing Homes Report for Rep. Henry Waxman, Minority Staff, Special Investigations Division, Committee on Government Reform, U.S. House of Representatives (7/2001)
- Abuse and Neglect of the Elderly
in Nursing Homes and Long-Term Care Facilities
This National Center on Elder Abuse bibliography
highlights many articles, books, reports, and online resources regarding many aspects of abuse, neglect,
and exploitation in nursing homes and assisted living facilities.
Disaster Preparedness
Oversight & Enforcement
- California’s Elder Abuse Investigators: Ombudsman Shackled by Conflicting Laws and Duties, Senate Office of Oversight & Outcomes (11/2009)
- CMS Needs to Reexamine Its Approach for Funding State Oversight of Health Care Facilities, GAO-09-64 (2/2009)
- Nursing Homes: Federal Monitoring Surveys Demonstrate Continued Understatement of Serious Care Problems and CMS Oversight Weaknesses, GAO-08-517 (5/2008)
- Department of Health Services: Its Licensing and Certification Division Is Struggling to Meet State and Federal Oversight Requirements for Skilled Nursing Facilities California State Auditor, Bureau of State Audits, 2006-106 (4/2007)
- Nursing Homes: Efforts to Strengthen Federal Enforcement Have Not Deterred Some Homes from Repeatedly Harming Residents, GAO-07-241 (3/2007)
- Improving Nursing Home Enforcement: Findings From Enforcement Case Studies Health Care Policy and Research Center, University of Colorado (3/2007)
- Snapshot: Changing Face of Nursing Homes, California Health Care Foundation (2/2007)
- Nursing Home Enforcement: Application of Mandatory Remedies, DHHS Office of Inspector General, OEI-06-03-00410 (5/2006)
- Despite Increased Oversight, Challenges Remain in Ensuring High-Quality Care and Resident Safety — Highlights of GAO-06-117 — (pdf) (12/2005)
- Nursing Home Enforcement: Collection of Civil Money Penalties DHHS Office of Inspector General, OEI-06-03-00420 (pdf) (7/2005)
- Nursing Home Enforcement: The Use of Civil Money Penalties — OEI-06-02-00720, Office of the Inspector General, Department of Health and Human Services — (pdf) (4/2005)
- Nursing Home Deaths: Arkansas Coroner Referrals Confirm Weaknesses in State and Federal Oversight of Quality of Care GAO-05-78 (pdf) (11/2004)
- U.S. Senator Charles Grassley's (R - Iowa) letter to the U.S. Dept. of Health and Human Services regarding the corruption of the nursing home inspection system. (7/2004)
- Prevalence of Serious Problems,While Declining, Reinforces Importance of Enhanced Oversight — GAO Report GAO-03-561 — (pdf) (7/2003)
- Nursing Home Deficiency Trends and Survey and Certification Process Consistency DHHS Office of Inspector General, OEI-02-01-00600 (3/2003)
- Nursing Homes: Complaint Investigation Processes Often Inadequate to Protect Residents GAO-99-80 (3/1999)
- Nursing Homes: Additional Steps Needed to Strengthen Enforcement of Federal Quality Standards GAO 99-46 (3/1999)
- California Nursing Homes: Care Problems Persist Despite Federal and State Oversight GAO 98-202 (7/1998)
Racial Discrimination
Public Information
Public Opinion
Quality
- Nursing Facilities, Staffing and Facility Deficiencies, 2001 Through 2007, Charlene Harrington, Helen Carrillo and Brandee Woleslagle Blank, UCSF (9/2008)
- Trends in Nursing Home Deficiencies and Complaints, OEI-02-08-00140, Office of Inspector General, U.S. Department of Health and Human Services (9/2008)
- The Faces of Neglect: Behind the Closed Doors of Nursing Homes National Citizens Coalition for Nursing Home Reform (pdf) (5/2006)
- Nursing Homes: Business as Usual Consumer Reports Magazine (5/2006)
- Long-Term Care Facilities: Information on Residents Who Are Registered Sex Offenders or Are Paroled for Other Crimes GAO-06-326 (3/2006)
- State of Neglect The New Orleans Times-Picayune, April 17-21, 2005
- Report on California's Nursing Homes, Home Health Agencies and Hospice Programs, prepared by Charlene Harrington and Janis O'Meara, UCSF, for the California HealthCare Foundation (12/2004)
- Operation Guardians 2001-02 and 2002-03 Results, California Department of Justice, Bureau of Medi-Cal Fraud and Elder Abuse (1/2004)
- Nursing Home Conditions in Los Angeles County: Many Homes Fail to Meet Federal Standards for Adequate Care Prepared for Rep. Henry Waxman, Minority Staff, Special Investigations Division, Committee on Government Reform, U.S. House of Representatives (2/2003)
- Nursing Home Care: When Will We Get it Right? Alliance for Retired Americans (6/2002)
Resident Characteristics
Staffing
- Nurse Aide Registries: Long Term Care Facility Compliance and Practices DHHS Office of Inspector General, OEI-07-04-00140 (7/2005)
- We Shall Travel On: Quality of Care, Economic Development, and the International
Migration of Long-Term Care Workers AARP Public Policy Institute (2005)
- Relationship of Nursing Home Staffing to Quality of Care — John F Schnelle, Sandra F Simmons, Charlene Harrington, Mary Cadogan, Emily Garcia, and Barbara M Bates-Jensen; Health Services Research, 39 (2):225-250 — (pdf) (4/2004)
- Nursing Home Medical Directors Survey U.S. Office of Inspector General, Department of Health and Human Services (2/2003)
- Nurse Aide Training, DHHS Office of Inspector General, OEI-05-01-00030 (11/2002)
- Available Data Show Average Nursing Staff Time Changed Little after Medicare Payment Increase — GAO Report GAO-03-176 (pdf) (11/2002)
- Quality of Care More Related to Staffing than Spending GAO-02-431R (pdf) (6/2002)
- Government Study Provides 'Compelling Evidence' for Nurse Staffing Standards in Nursing Home" — National Citizens’ Coalition for Nursing Home Reform Press Release (2/2002)
- Appropriateness of Minimum Nurse Staffing Ratios in Nursing Homes, Report to Congress: Phase II Final U.S. Centers for Medicare and Medicaid Services, prepared by Abt Associates Inc. (2005)
To access additional General Accounting Office (GAO) reports, visit the GAO web site at http://www.gao.gov
|