2010 Annual Report. Dedicated to improving resident care In assisted living facilities by educating Consumers and increasing industry accountability

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1 2010 Annual Report Dedicated to improving resident care In assisted living facilities by educating Consumers and increasing industry accountability Copyright 2010 Consumer Advocates for RCFE Reform All Rights Reserved

2 WELCOME It was indeed a long time coming, but Consumer Advocates for RCFE Reform (CARR) achieved its goal of launching the Consumer Advocates for RCFE Reform ( website. The end was worth the arduousness of the journey: many long and dedicated hours individuals who worked to make it happen. Most of Fiscal Year 2010 was spent building the website, scanning documents, organizing them in a way useful to the consumer, and preparing website content. With that mountain behind us, we now begin the search for research and sustaining grants and funding support, and continue our research projects to assure our advocacy is convincingly grounded and evidence-based. We have also returned to the files at Community Care Licensing (CCL), Department of Social Services to scan more public documents and update the individual facility profiles on our site. CARR s work is just beginning, and we have much work to do. Key to CARR s success is becoming a reputable and valued member of the community, bringing the consumer s voice to community conversations on assisted living. To this end, CARR has been accepted into the Network of Care, and San Diego; also, the long-time influential advocate for nursing home reform, California Advocates for Nursing Home Reform (CANHR) has graciously agreed to link CARR s site to theirs. CARR has also joined San Diego County Council on Aging (SDCCOA) In addition to your visits to our site to read our blogs (The Soapbox) or articles, we encourage referrals to our site for those who have an interest in assisted living, or to those looking to place a family member or loved one. Thank you for your support, for spreading the word about CARR, and for participating in our efforts to improve resident care by exposure of CCLD s documents to the light of day so all can see what happens inside of the assisted living model known as a residential care facility for the elderly. Sincerely, Consumer Advocates for RCFE Reform C. M. Murphy Executive Director Copyright 2010 Consumer Advocates for RCFE Reform All Rights Reserved

3 VISION & MISSION VISION Consumer Advocates for RCFE Reform (CARR) will give consumers the information necessary to hold RCFE owners and administrators accountable for providing high-quality, safe, competent and compassionate resident care; and hold the State of California, through its Department of Social Services, Community Care Licensing's management, supervisors, and inspectors, accountable for consistent and rigorous enforcement of the regulations for RCFEs. MISSION Consumer Advocates for RCFE Reform (CARR) provides free access to regulatory compliance, and other information about RCFEs located in San Diego and Imperial counties by publishing public documents, lawfully obtained through the California Public Records Act from Community Care Licensing and other agencies, about each RCFE in these regions. CARR also advocates for meaningful reform to RCFE regulations in California to ensure consistency in the delivery of quality care to residents, and consistency in the state's rigorous enforcement of the regulations. 3

4 CARR s website launched a compete complement of content and resources: The Home Page contains current articles, late breaking CARR news, and the monthly blog. Straight Talk addresses single topics of interest to the consumer of long-term care. Frequently Asked Questions (FAQ) offers answers and explanations to many questions about long term care. Using our website analytics, we see that this site component is being used as a reference source by hundreds of users. The Facility Search is the gem of the site, offering public documents (inspection and complaint reports, plus many other operational documents) from CCLD, Secretary of State s office searches as well a Superior Court documents on each of the approximately 690 RCFEs located in San Diego and Imperial counties. Consumers of long-term care can search by a facility name, or more generally by city or zip code. About Us satisfies curious users about CARR s Vision, Mission, and bona fides. The Soapbox is CARR s monthly blog, rotating between C. Selder s and C. Murphy s authorship. Rounding out the site are informative articles about using the site, the role of public documents and government transparency as tools for consumers placement decisions. We also include an extensive Links Library which provides the consumer of long term care with easy access to useful resources not provided by CARR. The site is a work-in-progress, with updates, content changes, and website designs to occur throughout the year, as resources become available. 4

5 RESEARCH & ADVOCACY CARR s advocacy is based on evidence, and to obtain evidence, we must collect, analyze and present data. CARR has two research projects underway: the Facility Scorecard and the Responses. The Scorecard Project s objective is to succinctly and visually present information to the consumer about the historical performance of the facility. Due to liability issues CARR cannot assign a subjective rating (i.e. 5-star rating scale) to a facility as an aid for the consumer to select one facility over another. CARR can provide objective information about the number and types of citations and civil penalties a facility has received, and how many times CCL has been in the facility. The concept is that the scorecard would become a tab on the website s individual facility profile. Once the consumer views the facility s public documents, she can then click the Scorecard tab to see annual and cumulative scores for violations, complaints, inspections, CCL visits, and total assessed civil penalties. The facility specific data would be displayed along side category averages for similar facilities. The information can be used by the consumer to vote with her dollars she can choose a facility that has received 5 citations over a similarly sized facility, that in the same time period, has received 15 citations. CARR s advocacy and policy positions will be informed by the analysis of this scorecard data revealing Licensing Program Analysts (LPAs) citation patterns, inconsistencies in application of Title 22, Civil Penalty assessments, mandatory versus discretionary citations, and related associations. The Response Project is collecting five years of response data from each Fire Protection jurisdiction in San Diego and Imperial counties. The data is being collected and entered into a database for analysis. Because no demographic, health, or outcome data is collected by the state from RCFEs, there is no definitive way to show that the population of RCFE residents is becoming sicker and frailer. Further, there are no staff-to-resident ratios in RCFEs, and because the regulations only require Licensees to maintain adequate staff it is difficult to know whether a Licensee s staff is, in fact, adequate to care for the facilities residents. The purpose of the Response Project is to ascertain through data analysis if the types (reason for 911 response i.e. falls, resuscitations, lifts, etc.), frequencies and times of responses to RCFE calls can be proxies for staffing issues, and/or frailty of residents. Data will be analyzed to inform CARR s policy positions and legislative advocacy. 5

6 INTERNSHIPS Community participation is key to CARR becoming a recognized, valued, and credible member of the long-term advocacy network. A significant step in this direction was taken by CARR as it applied for and was accepted as a San Diego State University s School of Social Work s Field Work Intern site. With the Internship contract in place, CARR has been able to host two School of Social Work Gerontology upper division students to assist in CARR s work. CARR views its association with SDSU as a platform for educating upper division and graduate students about the role of advocacy, policy, and governmental transparency as means of effecting change for residents in long-term care facilities. We look forward to our continued association with SDSU as a Field Work Intern site. 6

7 FINANCIAL ACCOUNTABILITY Since inception, CARR has been privately funded (long-term liability) by Dr. & Mrs. C. Murphy. CARR has received no outside funding. CARR s ability to transition into a self-sustaining organization will be largely defined by its ability to move from its private funding source into a donation and grant funding organization. 7

8 PERSONNEL BOARD OF DIRECTORS CARR s is extremely grateful to the Board of Director members for their time attending meetings, and providing advice and direction. Dr. Joaquin Anguera, Professor at SDSU, Gerontology Ms. C. L. Selder, M. S. Gerontology Ms. C. M. Murphy, M. S. Gerontology OFFICERS Ms. C. M. Murphy, Executive Director Dr. C. G. Murphy, Chief Financial Officer Ms. C. L. Selder, Secretary STAFF CARR s website could not have been launched without the most excellent assistance of the following individuals: Ms. Jessica Edrada The Crellen Company, Mr. David Crellen Webmaster Ms. Becky Lawton Ms. Monica Macera Mr. Fernando Mercado Ms. C. L. Selder 8