Last year, we heaped praise on the U.S. Department of Justice for filing a False Claims Act against two Watsonville, California nursing homes that had dangerously drugged multiple residents over several years.
This week, the Department announced the case had been settled. The defendants agreed to pay $3.8 million dollars to settle the false claims allegations, an impressive sum that will send a needed message that poor resident care relying on sedating drugs to “solve” residents’ problems will not be tolerated by the government that often foots the bill.
In addition to the financial settlement, the nursing homes entered into a “corporate integrity agreement” to provide five years of federal oversight to ensure better care. The agreement is quite disappointing. It makes no mention of improved dementia care or reduced use of chemical restraints, even though both issues were at the heart of the false claims case (e.g., “defendants persistently overmedicated elderly and vulnerable residents”). In fact, psychotropic drugs are mentioned only one time in the 55 page agreement: as part of the facilities’ duty to report deaths or injuries to the “independent monitor.”
Unfortunately, the corporate integrity agreement looks like a boilerplate contract whereby the nursing homes agree to set up bureaucratic layers (“compliance officer,” “compliance committee,” “quality of care program”) to make sure they are following the basic laws and regulations already applicable to nursing homes. That seems like a lot of work to achieve standards that have been required for nearly thirty years. We hoped for more.
A look at the drugging rates at the defendant nursing homes indicate the federal lawsuit has had little impact on the quality of care the residents are receiving. Antipsychotic use at one defendant facility rose 22% from the second quarter 2014 (before the lawsuit) to the fourth quarter 2014 (after the lawsuit) to a whopping 27.71% overall while use at the other defendant facility rose 45% in the same period. Clearly, the lawsuit did not trigger any soul-searching in the defendant nursing homes and we do not expect the corporate integrity agreement to either.
We’re pleased the federal government took a stand for quality nursing home care and targeted illegal and immoral drugging practices in the process. We’re also pleased the government received a partial refund for care that was truly grossly inadequate. Nonetheless, we’re disappointed the chemical restraint band likely plays on in Watsonville.