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Partners in Slime 

The California service employees' union and the nursing home industry join forces to increase corporate profit, grow union membership, and sell out abused nursing home patients

Wednesday, Jun 30 2004

Page 2 of 3

Though little-publicized, the "alliance" (as the SEIU and the nursing home industry call it) has been long in coming. In fact, lobbying pacts between the SEIU and the nursing home industry had previously been struck in Florida and Texas, AARP's de la Cruz says.

"We were approached by the industry a year and a half ago. They told us what they were doing in Florida, and they had every intention of doing it here," de la Cruz says.

Over the past two years, various corporate nursing home chains and the SEIU, which has thousands of members who work in nursing homes, decided to lay down their arms and pursue their mutual goals of more money for the nursing home industry and for union employees. Nursing home operators had previously spent thousands of dollars on union busting, hoping to keep worker pay low. Meanwhile, union members worked hand in hand with the industry's bitterest enemies, including advocates for the elderly, who were seeking to reduce the unwarranted death, injury, and psychological trauma that have been grist for dozens of media investigations of substandard nursing home practices.

But that was before the birth of the "alliance," which has created a Web site, established a front group called California United for Nursing Home Care, and put forth a list of "principles" -- including adequate staffing of and more accountability for nursing homes and increased wages and benefits for nursing home workers. "They were principles my cat would sign," California Advocates for Nursing Home Reform's McGinnis said. "These are things nobody would argue with."

But the principles didn't directly address the deal's seamy underbelly: labor's support for tort reform in exchange for relaxed union-busting by nursing home chains.

With the innocuous "principles" as bait, the "alliance" obtained signatures from members of the clergy and from consumer and community organizations, thereby creating the appearance that the deal's key players -- workers and employers -- were just two of many participants in a broad coalition.

Earlier this year, nursing home industry representatives put forward a proposal, drafted in cooperation with the SEIU, that would increase staffing at nursing homes while creating a Medi-Cal reimbursement system that would give nursing homes a guaranteed profit along the lines of a regulated public utility -- without the high levels of regulation that public utilities receive. Under this scheme, taxpayers would guarantee nursing home owners an 8 percent return on investment.

These warm/fuzzy aspects of the proposal certainly appealed to the nursing industry, which would love to have a larger government-sanctioned revenue stream. Perhaps even more important to the industry, however, are sections of the bill that would limit a patient's right to sue a nursing home.

The nursing home industry has long sought to limit its legal liability, because lawsuits have become the only significant regulatory weapon against an industry notorious for choosing profits over patient care. Despite stacks of state and federal reports showing widespread elder abuse in nursing homes, state regulation is anemic. Even in the best of times, California regulators are required to go into homes only once every 15 months to perform spot checks. In residential care facilities, government bureaucrats poke their heads in just once every five years.

Counties typically employ a single "ombudsman" who checks up on nursing homes. But these officials have thousands of patients to monitor and no enforcement authority -- all they can do is pass along complaints to the state, which has a complaint backlog going back months, at a minimum. So while the number of actual complaints in categories such as physical abuse, sexual abuse, and gross neglect increased in California by 38 percent between 2000 and 2002, and as owners sought to eke out more profit from nursing home chains, the state actually inspected and verified fewer complaints.

Depending on how life-threatening a complaint may be, state inspectors are required to arrive from one to 70 days after a formal allegation is made, to see what is going on. According to a report just completed by UCSF nursing home expert Charlene Harrington, state inspectors arrived an average of three months after the time limit, giving homes ample time to cover up problems. Partly as a result of this lack of oversight, the federal General Accounting Office estimated in 1998 that residents at one-third of California's 1,400 nursing homes are at risk of being unnecessarily killed or injured.

The state's abdication of duty in regulating nursing homes leaves private lawsuits as the primary method of checking nursing home abuse. Actually, nursing homes are sued fairly rarely -- around one suit per 1,000 patients, according to a November 2003 California Advocates for Nursing Home Reform study -- given the large number of horror stories emanating from the lower, Dickensian level of the industry. The few cases that get to court tend to be particularly grisly: Nursing home orderlies asphyxiated one Sacramento County woman when they illegally used a physical restraint. Another Sacramento County woman died after being sexually assaulted twice. A Santa Clara man died following neglect that led to infected bedsores, dehydration, malnutrition, and other medical problems. A San Mateo County woman died because the temperature inside her nursing home reached 108 degrees. A San Francisco man was trapped and died when his bed collapsed.

Significantly, the SEIU's anti-lawsuit lobbying effort would benefit the worst abusers. Most of these lawsuits target nursing homes that have already been cited numerous times for neglect and abuse. About half of the lawsuits hit the worst 10 percent of abusers, the CANHR report said. In short, lawsuits are the only thing keeping the worst for-profit abusers in check.

And the health-care-for-all SEIU is carrying water for these malfeasants as they seek to get away with what too often amounts to something very close to murder.

There's little to disagree with on most of the California United for Nursing Home Care Web site; like the rest of the "alliance's" propaganda, the messages on the site are designed to create the appearance that this employee-employer compact is all about helping elderly patients. Just the same, the site contains a few lines that hint at the true nature of the unholy SEIU-industry deal, particularly in a section that announces that alliance members "support availability of adequate, affordable professional liability insurance and appropriate compensation for residents who suffer harm."

About The Author

Matt Smith


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