In a two-part series (one | two) in The Sacramento Bee, Marjie Lundstrom reveals the results into the widespread falsification of patient records in California nursing homes.
While regulators have dogged facilities for years over fraud
ulent Medicare documentation, the issue of bogus records is more than a money matter. In California and elsewhere, nursing homes have been caught altering entries and outright lying on residents’ medical charts – sometimes with disastrous human consequences, according to a Bee investigation.
Medications and treatments are documented as being given when they are not. Inaccurate entries have masked serious conditions in some patients, who ultimately died after not receiving proper care, The Bee found.
Lundstrom writes that while chart falsification is a misdemeanor, nursing home workers are rarely prosecuted, because it’s difficult to prove and time consuming to track down. Instead, she found, sources say its become a pervasive part of the culture in such workplaces. Based on a review of 150 incidents that occurred over the course of two decades, Lundstrom spells out the most common reasons for such mistakes – reasons that will be immediately familiar to anyone with experience in a checklist-driven workplace.
- Covering up bad outcomes. A patient dies or is injured, and the nursing home staff or administrators rewrite the records to minimize blame or liability.
- Fill-in-the-blank charting. Overworked or lazy staff members take massive shortcuts, filling out charts en masse, not knowing whether treatments took place or if the information is accurate.
- Missing medicines. Medications are checked off as being given, but investigators later find unopened boxes or discrepancies with pharmacy records.
She explores each of these bullet points and ideas in subsequent headings and, in the process, lays out a blueprint for other reporters interested in looking for similar issues in their neck of the woods. The first story includes a number of heavy-hitting anecdotes, but Lundstrom doesn’t fully dig into one of the most affecting cases until the second installment of the series.
In two key paragraphs, Lundstrom lays out all you need to know about the significance of the story, one that began with the falsification of medical records. The whole story is well worth a read, and you’ll emerge with a deeper understanding of what makes records falsifications such a unique and tricky subset of nursing home infractions.
Johnnie Esco’s death on March 7, 2008, led to a contentious civil lawsuit, investigations by California’s Department of Justice and Department of Public Health – and the exhumation of her body from Arlington National Cemetery.
Last week, amid inquiries from The Bee, the state Department of Justice reopened its criminal investigation into Johnnie Esco’s treatment at the facility.
In a response published in The Bee, an industry representative took issue with significance of Lundstrom’s findings, accusing her of sounding the alarm “on behalf of trial lawyers” and not putting the problem in perspective.
…in a single day in California there are 30 million entries made on medical charts. The Bee examined 20 years of charting history from 1990 to 2010 – or 219 trillion entries – and found that during that period, regulators issued 209 citations for willful material falsification.
