Care in State Nursing Homes

Your editorial “Rights for the Elderly” (March 19) created some mistaken impressions regarding my position on nursing home care and reform. Let me set the record straight.

I have always supported federal efforts to improve care in nursing homes through implementation of the regulations in 1987 federal nursing home legislation, which I supported as senator. The regulations were promulgated through a proper process and I believe California is bound by them.

However, the interpretive guidelines that accompanied the regulations were not rules in any legal sense. The federal government simply imposed the guidelines and the resultant millions of dollars in cost to implement them on the states. The guidelines would have compelled California facilities to meet requirements that went beyond law and regulation--often to redundantly check the judgment of a medical professional or blindly require items for patients that are unnecessary for the patient’s condition. Most fundamental, implementation of the guidelines would not have resulted in improved patient care.

State nursing home residents already receive care that is among the best in the nation. State inspectors carefully monitor facilities and assess fines or close them when serious problems are found. Just within the last two months, the federal government has acknowledged that California’s enforcement system, which has been in place for 16 years, is equivalent to the new federal requirements.

The charge that California did nothing for two years while the regulations were being developed is absolutely unfounded. California officials have been in frequent communication with federal officials since the very inception of the 1987 regulations. We will work with federal officials to modify the interpretive guidelines so that they are just that--guidelines to assist our surveyors as they conduct nursing home reviews. I will render final judgment on the success of the revisions when the review and modification process is complete.

In the meantime, I remain committed to seeing that California leads the nation in assuring highest quality care for residents of all institutions in the state. They deserve nothing less.

GOV. PETE WILSON

Sacramento