California nursing home stakeholders disagree about benefit of nurse-to-patient ratio law

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The California Association of Health Facilities (CAHF) is squaring off against the Service Employees International Union (SEIU) and a nursing home watchdog group in a debate over the effectiveness of California's nurse-to-patient ratio law, according to recent news items.

The law, Assembly Bill 1629, changed nursing home reimbursement guidelines to more closely reflect how much a nursing home spends. The purpose is to improve the amount of nursing hours per patient per day, according to the Chico Enterprise Record. CAHF points out that, since the law was enacted in 2004, nurse compensation has improved, and average nursing hours per patient per day rose to 3.57 hours in 2007—well above the state's required 3.2 hours.

But the SEIU argues that the law has made little actual improvement in the quality of nursing home care. California Advocates for Nursing Home Reform (CANHR), meanwhile, has said that, although many of the state's nursing homes have used the new reimbursement system to improve quality, as many as 144 nursing homes provided less than the required 3.2 hours of care, the Enterprise Record reported.

Although they disagree over whether the law has improved care, CAHF, SEIU and CANHR all agree that the new reimbursement system is better than the previous flat-rate system. Unless it's made permanent by the state's legislature, the law is set to expire in the middle of next year, according to the Enterprise Record.