An Open Letter to the Department of Public Health

A year ago the California Department of Public Health (DPH) took one of the boldest actions in its history to protect nursing homes residents from neglect and abuse. On July 8, 2016, the Department wrote Shlomo Rechnitz that it had denied his licensure applications for five nursing homes due to an appalling history of neglect and mistreatment in California nursing homes that Rechnitz owned or operated. The Department’s 21-page letters catalog a litany of serious violations in his nursing homes including 39 “immediate jeopardy” level deficiencies, 108 California citations and 13 penalties for understaffing from June 2013 to June 2016. Rechnitz is California’s largest nursing home operator with interests in about 80 facilities.

What happened next speaks volumes about the Department’s apparent lack of concern for the fate of the residents of these (and other) facilities. Instead of requiring a qualified operator to take over control of the five former-Windsor nursing homes in question, the Department has allowed Rechnitz and companies he is associated with to continue running them while he appeals the denials of the licensing applications.  

How can the Department trust Rechnitz with the residents’ care throughout what may be years of appeals if he is not qualified for a license in the first place? Why is the Department putting the interests of an operator with such a disturbing record of poor care above the rights of the residents to receive high quality care?

Residents of other nursing homes are also in jeopardy. Since late 2014, Rechnitz’s companies have operated 18 nursing homes that he acquired from the Country Villa nursing home chain via bankruptcy. According to the Department, none of these nursing homes are licensed to Rechnitz. The Department has not acted on licensure applications he submitted in March 2016 despite the fact the same abysmal track record it cited for denying the Windsor-related applications in July 2016 applies equally to them.

Where is the Department’s sense of urgency and responsibility for the many hundreds of residents who live in these facilities? 

In allowing Rechnitz and his companies to continue running these nursing homes, the Department is turning California laws designed to protect nursing home residents on their head. California licensure laws rightly require the Department to carefully screen nursing home operators in order to keep out those who would exploit or neglect residents. No California law permits anyone or any entity to operate a nursing home without a license or to manage one without the Department’s approval. If the Department believes there is some flaw in these laws, why has it not taken action to fix it?

That the July 2016 license denials are one of the finest moments in the Department’s nursing home regulatory history speaks very poorly of its past. Denying applications from unfit nursing home operators should be a routine part of its job, not considered an act of courage. Yet, for decades, the Department’s oversight of nursing homes has been so weak and ineffective that it has often appeared to be a captive of the nursing home industry. 

Life-threatening conditions have been thoroughly documented in Mr. Rechnitz’s nursing homes, so it leaves us to seriously question the Department’s fitness to oversee the quality of care in California nursing homes and why they find him and his companies suitable to own or operate nursing homes in California.  

The Department must act swiftly and strongly when the lives and well-being of California’s nursing home residents are threatened by unfit operators.  If its current leaders are unable to carry out this core mission, the Department should bring in new leaders, regulators and attorneys who have the knowledge, experience and will to make California’s nursing home licensure laws work as they were intended and to hold nursing home chains accountable. 

It is a privilege, not a right, to own or manage a nursing home in California. The Department’s mission and managers must recognize that this honor is only available to those who demonstrate that they can and will provide first-class care. Those who can’t should be immediately shown the exit, or better yet, never let in at all.