Long Term Care: Providing Compassion Without Confusion (Report #140, December 1996)

While the State has taken some preliminary steps towards restructuring the long-term care services it provides to consumers, Californians needing long-term care still face a bewildering maze of choices. This report, which is the culmination of an in-depth 11-month study, contains four findings: the State's current oversight structure is too fragmented to allow effective coordination and integration of long-term care services; many of the State's policies favor expensive institutionalization at the expense of home and community-based services preferred by consumers; despite new federal regulations, consumers continue to take issue with the quality of care in skilled nursing facilities; and regulatory change has not kept pace with the changing demands placed on residential care facilities. The report offers 24 recommendations to address these problems, including consolidating long-term care into a single state agency, increasing resources for programs that delay institutionalization, and strengthening the consumer complaint systems now in place for skilled nursing facilities and residential care facilities.

Unsafe in Their Own Homes: State Programs Fail to Protect Elderly from Indignity, Abuse and Neglect. (Report #113, November 1991)
WP 6.1

Elderly citizens sometimes are able to remain in their homes despite disabilities with the assistance of a state program, but the flawed system fails to meet the needs of too many senior citizens. In addition, the Commission found that a vast array of services that are supposed to provide a continuum of care for the elderly are not well-integrated and are difficult to access. This report makes five recommendations in regard to the integration of services offered to the elderly and improvements to the In-Home Supportive Services program.

Skilled Nursing Homes: Care Without Dignity (Report #109, April 1991)
WP 6.0

This report focuses on the State's refusal to implement federally mandated reforms, the rights of the elderly to informed consent processes before physical and chemical restraints are used, and the State's flawed enforcement system that has failed to protect the elderly. The Commission makes three findings and seven recommendations urging the Governor and the Legislature to take immediate steps to implement federal nursing home reforms, to guarantee people their rights, and to improve the citation and fine system.

The Snail's Pace of Reforming Residential Care and Facilities for the Elderly (Report #108, February 1991)
WP 6.1

While some improvements have been made in regulating residential care facilities, problems persist. In particular, the implementation of regulations has lagged far behind the statutory changes. In addition, the State has failed to crack down on unlicensed facilities in an expeditious manner. The Commission believes it is time for the State to shift emphasis from reform to enforcement of existing laws through stronger enforcement efforts and speedier adoption of regulations. This report includes two findings and two recommendations.

The Medical Care of California's Nursing Home Residents: Inadequate Care, Inadequate Oversight (Report #93, February 1989)

Unlike the Commission's 1983 and 1987 reports, this report focuses solely on medical care provided to nursing home residents. In essence, the report determined high quality medical care was not the top priority of any state agency or any industry group involved with nursing homes. The Commission proposes that nursing homes be required to set up physician peer review panels, make better efforts to track cases and coordinate records, and make every effort to increase the number of physicians with skills in gerontology and geriatrics. This report includes 18 findings and 18 corresponding recommendations.

A Report on Community Residential Care for the Elderly (Report #92, January 1989)

One in every six residential care facilities is unlicensed and the backlogged, time-consuming licensing process encourages operators to begin their businesses with no licenses. The report also notes that an increased fine structure recommended in earlier Commission reports is either not used at all by the State or is enforced so haphazardly that it's deterrent effect is little. This report makes 11 findings and 10 recommendations regarding the elimination of unlicensed facilities, enforcement of existing laws, and the education and training of facility staff.

New and Continuing Impediments to Improve the Quality of Life and the Quality of Care in California's Nursing Homes (Report #80, May 1987)

Despite reforms, the State is not doing enough to ensure quality care for California's many frail and vulnerable nursing home residents. As a result, residents of these facilities continue to be subjected to indignities and their safety is not assured. This Commission report makes a series of recommendations to improve the quality of life in skilled nursing facilities, including increasing enforcement and penalty collection efforts by the State, allowing state receivership for certain skilled nursing facilities as an intermediate sanction, ensuring that voluntary Medi-Cal decertification does not penalize current residents and increasing consumer information services.