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Oversight of nursing home chains lacking
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SACRAMENTO (AP) — The California Department of Public Health does not try to determine how nursing home chains compare on key quality measures even though the information would be valuable and potentially life-saving for consumers, a newspaper in the state capital reported Sunday.

The Sacramento Bee said it reviewed compliance, staffing and complaint reports for California’s 1,260 nursing homes along with often-tangled ownership records to identify chainwide patterns. Among the findings from its review were that a Pennsylvania company that operates 15 nursing and rehabilitation centers in California tallied a record of abuse complaints seven times higher than the statewide average, while a Los Angeles company that runs more than 35 facilities has a higher-than-average record of using restraints on its patients.

Although individual homes are supposed to be inspected routinely and investigated when complaints arise, the Bee said there is no easy way for families to get a read on the standards of the 25 for-profit companies that control about half of the state’s 120,000 licensed nursing home beds. Yet its investigation showed that 10 of those companies had below-average performance on quality-of-care measures such as the frequency of pressure sores, infections and falls among patients.

“It’s a huge maze to try and figure out who owns what,” Charlene Harrington, professor emerita of sociology and nursing at the University of California, San Francisco, told the newspaper. “And that’s deliberately done.”

California Association of Health Facilities legal adviser Mark Reagan disputed The Bee’s conclusions. Reagan said nursing homes are heavily regulated by local, state and federal agencies and that “government regulators do look broadly” for patterns.

“You have a very robust range of investigative entities that look at every element,” he said.

The Bee identified Brius Healthcare owner Shlomo Rechnitz of Los Angeles as California’s largest nursing home operator, finding he has an ownership stake in 54 homes each licensed to a separate company. Facilities associated with Rechnitz were below average in 35 of the 46 categories the newspaper used in its comparisons, including staffing rates and turnover.

His legal and public relations teams told The Bee in written responses that Brius Healthcare’s inventory includes facilities that were troubled before the company acquired them and that Brius Healthcare has taken over numerous troubled facilities suffering significant patient-care issues.

“Every single facility has met or exceeded state staffing requirements on a monthly or even weekly basis since acquisition,” they said.