Most CA nursing homes are substandard — Report

Only 23% in substantial compliance

More than 75% of nursing homes in California do not meet federal quality standards, and 44% violate the state’s minimum nurse staffing level requirements, according to a study released Oct. 15 by the California HealthCare Foundation (CHCF).

The study was based on 32 months of data from nine public databases that included nursing home inspection information and financial reports, according to the Los Angeles Times. Researchers from UCLA and the University of Wisconsin conducted the $2 million study. The study found:

  • 44% of nursing homes did not meet a state requirement to provide 3.2 nursing hours per resident per day, and 92% of homes did not meet the federal standard of 4.2 hours.
  • Nursing homes statewide had an average annual staff turnover rate of 78%, and some facilities had a rate as high as 296%.
  • Only 23% of nursing homes statewide were in "substantial compliance" with federal standards, and 15% had "very serious" deficiencies.
  • Inspectors at 30 nursing homes selected at random found that residents at the facilities "did not receive as much care as their charts indicated" because employees over-reported the number of times residents received assistance with certain tasks.

In addition to the report, the foundation has launched a new web site,, to provide the public with access to detailed information on the state’s 1,406 nursing homes. The site provides information on specialized services, staffing, employee turnover, complaints, state citations and fines, facility ownership, and bankruptcy information for individual nursing homes.

"This is the richest source of nursing home information ever generated for one state," CHCF president and CEO Mark Smith told the San Francisco Chronicle.

Betsy Hite, director of public affairs for the California Association of Health Facilities, criticized some parts of the nursing home study. She told the Sacramento Bee newspaper that the study "holds nursing homes to standards that were not enforced at the time some of the data were collected.

"For example, the state did not enforce the minimum nurse staffing level requirement of 3.2 nursing hours per patient per day until April 2000, although the data were collected for all of 2000."

In addition, Hite said that she considered some of the "serious deficiencies" cited in the report — such as a tissue left on the floor or a two-degree difference in water temperature — as unfair. She added, "I’m not sure we’re really giving the consumer an actual idea of the quality of care in a home."

"We have a long history of experimenting with various kinds of report cards in the health business, and the history is very dismal," says Robert Kane, MD, a professor of long-term care and aging at the University of Minnesota School of Public Health. "I don’t think that simply raising people’s anxieties about the quality of care is the same thing as improving it."