Nursing home can't escape billing charges for "worthless care," federal judge rules.

A California judge has ordered nursing home physicians to stop making end-of-life decisions and administering psychiatric drugs to residents deemed mentally incompetent.

Alameda County Superior Court Judge Evelio Grillo issued an order to state health officials to stop allowing nursing home physicians to make decisions for resident, but he suspended enforcement of the January 27 order for two months to give the state Department of public health time to appeal the order or implement it.

Grillo’s order follows his June decision that a 1992 California state law allowing physicians to make decisions for residents declared incompetent is in violation of residents’ constitutional rights. Those rights include deciding their own course of treatment either personally or through a surrogate, if possible, and seeking court review of the nursing home’s decisions, Grillo said.

An estimated 10,000 nursing home residents in California have been declared incompetent and have no family or representative to make decisions for them, the San Francisco Chronicle reported.

A lawyer for the California Association of Health Facilities told the Chronicle that the group plans to appeal Grillo’s order, saying the judgment puts residents with no family or representative at risk of not receiving the care they need.

Mort Cohen, an attorney who argued against the 1992 rule on behalf of California Advocates of Nursing Home reform, said the ruling is the first of its kind in the country and could be a model for other states.

Cohen noted his group may appeal another part of Grillo’s decision that left a section of the law intact that allows physicians to make the initial decision of whether a resident is competent or not.

The lawsuit surrounding the 1992 law stems from the case of a nursing home resident who was deemed incompetent by his doctor and required feeding through a tube. Nursing home staff asked him whether he wanted to live or die, and upon receiving no answer, disconnected his feeding tube and revoked an order for life-sustaining care, according to the Chronicle. He was sent to a hospice where he died two months later.

Grillo acknowledged his ruling “will likely create problems” for some skilled nursing facilities, but said the rights of the residents are “more compelling.”