Report of substandard nursing homes misleading.

A recent state congressional report has stirred up a storm in San Francisco. According to the report, at least 40 percent of the area's nursing homes have been cited for serious violations that exposed their residents to serious injury or death. But, according to the California Association of Health Facilities (CAHF), the report does an injustice to the nursing homes.

CAHF claims the report was a review of all paperwork that documents deficiencies in a facility and not just survey results. While no one disagrees with the need to find and correct violations in a facility, Betsy Hite, CAHF director of public affairs, says, "We don't believe that the survey system is a reliable indicator of the quality of care in a facility." Survey results do not give an accurate picture of the situation because end-of-life issues and labor regulations involved are not reflected in them, and the potential harmfulness of the violations facilities were cited for varied greatly.

The report was commissioned and released to coincide with a bill that would make reporting staff-to-patient ratios a requirement for most nursing homes. The lack of a federal minimum staff-to-patient ratio mandates legislation that enforces the state's minimum staff-to-patient ratio. It also puts the federal Health Care Financing Administration up to the task of coming up with ways to improve staff training.

Despite the negative connotations of the report, the proposed bill would be a, step in the right direction for California nursing homes. Human dignity violations are often the result of a facility being understaffed.

Instead of cutting staff, facilities should look for ways to reduce administrative costs, suggests Charlene Harrington, a professor at UC San Francisco, who tracks nursing home issues.