SACRAMENTO, California – When Johanna found a nursing home for her husband after a trainee stroke, she hoped her stay would be temporary.
He never came home.
Arthur Trainee died in October 2020 at Windsor Redding Care Center in Northern California. The 82-year-old grandparents are among more than 9,900 California nursing home residents who have died in Covid-19.
The nursing home where the trainee died is state-licensed, but not under its current owner, Shlomo Reknitz. The state has denied Reknits a license, citing at least one death and multiple cases of “serious harm” in other nursing homes owned or operated by him. To get closer to this, Rechnitz has formed a business partnership with one of the former homeowners who holds the license of the facility.
Some California lawmakers want to end this type of business and ban people or companies from buying or operating nursing homes unless they have a license – which is the situation in most states. They are proposing an overhaul of the licensing process to reject applicants with poor performance and insufficient experience or financial resources.
The ambitious effort, which the industry sees as an excessive expansion, could set a precedent for other states trying to improve the quality of nursing care and nursing home care in California. Nationwide, more than 152,000 residents of nursing homes died of covid during the epidemic, according to federal data.
“The public health emergency we are facing may be something that could be a catalyst for real change,” said Dr. Debra Saliba, a UCLA professor of medicine who worked on the National Academy of Sciences, Engineering and Medicine Committee that was published. A comprehensive report on nursing homes in April. “One of the things we have now is determination, the resources to make things happen.”
In his State of the Union address in March, President Joe Biden said the quality of care in nursing homes taken by investors has declined – and promised higher federal standards. In anticipation of the speech, the White House issued a resolution calling on Congress to increase funding for nursing home visits and to give federal regulators the power to deny Medicare funds low-performing benefits. The administration has instructed centers for Medicare and Medicaid services to offer minimum stuffing standards within a year.
States are also taking steps to improve quality New Jersey, for example, passed a law this year that tightened fines for health violations and required nursing homes to disclose financial records.
In California, lawmakers are considering a number of proposals, including changes to nursing home licensing rules.
Companies and individuals can buy or operate a nursing home in California before obtaining a license, a process that even an industry lobbyist described as “backward” and unique to the state at a legal hearing this year.
“In California, nursing home owners and operators can operate without a license even after a license has been revoked,” said Al Muratsuchi (D-Terence), a member of the State Council, author of AB 1502. “Many of these owners and operators, unfortunately, have a long history of neglect and abuse.”
For Muratsuchi’s bill, an owner or company must apply for a license 120 days prior to purchasing or operating a nursing home and must include financial records containing the names of all owners and investors. The state will reject applicants who fail to meet the standards of character, performance in other homes, and financial ability to run a home. Homes operated without a license will lose Medicaid funding and will not be able to admit new residents.
The powerful California Association of Health Facilities, which represents more than 800 nursing homes, has blocked previous licensing laws and focused on Muratsuchi’s bill. The group is led by a veteran of the State Capitol who has worked for four Assembly Speakers and two Senate leaders.
The organization made just over $ 2 million in political contributions and spent $ 5.9 million lobbying lawmakers from January 1, 2011 to March 31, 2022, according to records filed with the California Secretary of State’s office.
The bill fails to consider the state’s “complex regulatory environment” and would create the need for “broad” disclosure in proprietary applications that would “in many cases fill the entire house in boxes and paper boxes,” Jennifer Snyder, a lobbyist for the association, told lawmakers in January.
The measure would “exclude current California owners the ability to actually apply or even apply for a change of ownership,” he added.
But this year, the industry faces a changing political landscape.
Kovid has pushed lawmakers to work – and Muratsuchi has found a valuable co-sponsor for his bill, Democratic State Assembly member Jim Wood, head of the Assembly Health Committee. Wood condemned nursing homes for not doing enough during the epidemic and called on state regulators to keep a close eye.
Muratsuchi’s measure has cleared the state legislature and is awaiting a hearing in the Senate.
An investigation by news agencies CalMatters and LAist last year found that at least two California nursing home operators were operating dozens of facilities without a license even though state public health officials had declared them ineligible to do so.
Homes are open, in large part because residents find it incredibly difficult to find another nursing home.
In July 2016, state regulators revoked Reknits’ license – which bought the Windsor Redding Care Center, where Arthur Trenery died – citing 265 health and safety code violations at his other facilities in the previous three years. Nonetheless, Reckinitz continues to operate the home in partnership with Lee Samson, a former owner who is listed as a licensee on state records.
Mark Johnson, a lawyer who represents Rechnitz and his company, Brius Healthcare, said the Windsor Redding Care Center was “well licensed” and that Rechnitz was operating the facility under a contract “which is prevalent in the skilled nursing facilities industry.” Rechnitz has filed a new and updated license application with the state, Johnson said.
Johanna Trenery said Recknitz had no idea the license had been denied. If she had known, she would have said, she would never have kept her 60-year-old husband in Windsor Redding.
Even before her husband, Cavid, was caught, the trainee and her children were trying to move her to another home because she seemed to have taken too much medicine, could no longer hold her head, and fell numerous times trying to get out of bed, she said. Once, she recalled, the nursing home brought out the wrong person while visiting the family.
They “kept him so addicted,” said Nancy Harden, one of Trainee’s eight children. “And I think it was easier for them because it was. He couldn’t go to his rehabilitation. I felt, ‘We have to get him out of this place.’
Then he gets Kovid.
As of September 2020, 60 of the facility’s 84 residents had contracted the disease – and at least two dozen of them had died. According to a lawsuit filed by family members of 15 residents who died, including trainees, homeowners were forced to work despite having symptoms of covid. The lawsuit alleges state citations that the home did not provide adequate personal protective equipment to staff, did not examine staff, and kept covid patients and untested patients in the same room who were not infected.
Johnson has denied the allegations.
The story was produced by KHN, which publishes the California Healthline, an editorially independent service of the California Health Care Foundation.
KHN (Kaiser Health News) is a national newsroom that creates in-depth journalism about health issues. KHN is one of the three major operating programs of KFF (Kaiser Family Foundation), including policy analysis and polling. KFF is a non-profit organization that provides health information to the nation.
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