County Battles Backlog of Nursing Home Complaints

Los Angeles County health officials, responding Tuesday to allegations that complaints about conditions at area nursing homes were not fully investigated, said thousands of reports were backlogged, but investigations were thorough and up-to-date.

The Board of Supervisors was caught off guard by a story in the Daily News, which reported that complaint cases were closed without investigation unless deemed to be high-profile, related to a lawsuit or involving abuse or neglect.

Supervisor Don Knabe said no one interviewed for the article had contacted the board, to "the shock of all of us reading the paper this morning."

Department of Public Health Director Dr. Jonathan Fielding, who was summoned from a meeting at City Hall to address the board on the subject, said he, too, was in the dark.

"I did not know about this until yesterday," Fielding said. But he assured the board that "every single complaint has been investigated and followed up."

The problem is that there are not enough resources to file all the paperwork backing up those investigations, due to a lack of state funding.

State officials, dealing with a backlog of their own, are now investigating. And federal officials told the newspaper that they were also "looking into those allegations."

Citing confidential internal documents and a department inspector who spoke anonymously, the Daily News said inspectors were told to rely on earlier inspections in verifying new complaints. If a facility was in compliance with health and safety regulations based on other recent inspections, new complaints were administratively closed.

Ernest Poolean, the department's division chief responsible for inspections, said nursing home residents were not being left vulnerable.

"If it's immediate jeopardy or immediate abuse or neglect, we go out within 24 hours" to inspect, Poolean said.

Supervisor Zev Yaroslavsky asked for more details.

"What if I told you that I went there to see my grandmother and ... that it's filthy, that it smells of urine, that it doesn't look like the place has been cleaned in two weeks?" Yaroslavsky asked.

"That would be a high priority," Poolean responded. "That would be 24 hours."

Other lower priority complaints, of a dirty facility, for example, are investigated within 10 days, as required by state law, Poolean told the board. He could not say what percentage of complaints received fell into each category.

Los Angeles County is the only California county that contracts to inspect facilities for the state, a decision Fielding said was in the best interests of nursing home patients.

"(They're) better off with local control," Fielding told the board.

Supervisor Michael Antonovich suggested that the county cancel the contract if the state couldn't provide more funding.

"Why don't we cancel the contract for insufficient funding?" he said.

There is a statewide backlog of more than 9,000 open cases, according to the Daily News. Poolean estimated that the county's backlog amounts to 2,000- 3,000 reports and dates back to 2010 or 2011, but stressed that it was a matter of filing paperwork, not of investigating concerns.

Investigative findings have been entered into a federal-state database, according to Poolean and Fielding, but separate reports required by the state to close out the cases had not been filed for the backlogged cases.

The newspaper cited the case of an 89-year-old woman who died after a series of falls at a Canoga Park nursing home as an example of cases that go unresolved.

The woman's daughter, Jeanne Callan, told the Daily News that the home should have taken precautions given her mother's history of falls, and that she didn't get a response from county officials for a year and a half.

"I always expected that somehow, somebody would be there ... to help protect people," Callan told the Daily News. "that isn't happening."

Poolean said the case was investigated and no actionable violations were found, but is now being re-investigated due to an appeal.

The board directed the department to provide a point-by-point response to the article no later than tomorrow and to report back within 30 days with an analysis of the backlog and potential solutions.

Early this evening, the department released a statement calling reports that investigations were backlogged "erroneous," but acknowledging that staffers have been "falling behind in developing the extensive written reports for some completed investigations where one or more violations was identified.

"The county is committed to work with the state to secure sufficient resources and streamline current processes to fulfill all state and federal requirements," the statement read.