How could this person at LACDPH – Los Angeles County Department of Public Health tell me that the complaint that I had so carefully documented, tell me “it didn’t happen.” Yes, she literally used those very words! I had included a photo, and a video, of Helen being left not once, but twice, to fall asleep in her wheelchair. She had been waiting an hour-and-a-half for assistance with her bedtime routine. Helen was wheelchair bound. She was dependent on the staff for ADL – Assistance for Daily Living, which included personal hygiene, dressing, toileting, transferring or ambulating. It was cruel that a dependent elderly person would be treated this way. It was incomprehensible that someone who had a photo and a video, would deny it had even happened. Yet, she had made a point of telling me that unsubstantiated meant “it didn’t happen.” I could not reconcile the disparity. I decided to see exactly what she had actually reviewed.
I researched PRA requests – Public Information Act requests:
The CPRA – California Public Records Act, declares that access to government information is a fundamental right of residents. Los Angeles County is committed to transparency and works diligently to ensure that records that are not exempt from disclosure are available for inspection and copying in accordance with the California Public Records Act.
“When the legislature enacted CPRA, it expressly declared that ‘access to information concerning the conduct of the people’s business is a fundamental and necessary right of every person in this state.’ Indeed, in California ‘access to government records has been deemed a fundamental interest of citizenship’ and has emphasized that “maximum disclosure of the conduct of governmental operations [is] to be promoted by the act.’ By promoting prompt public access to government records, the CPRA is “intended to safeguard the accountability of government to the public.” Transparency and accountability was exactly what I was seeking! I filed a Los Angeles County Public information request. My research assistant submitted a request to LACDPH:
“Copies of Consumer/ public complaints and all attachments submitted for the stated years below 2018 to present about *** *** GARDENS.
LACDPH did not respond in writing. Instead, my research assistant received a phone call from someone at LACDPH who told her that she would need to request the documents from the CDPH – California Department Of Public Health.
This statement didn’t ring true. Yes, the CDPH pays LACDPH from its annual Medicare allotment, to investigate nursing homes for both Medicare and the State of California. But the Los Angeles County Board of Supervisors also oversees LACDPH. In fact, in 2014 and again in 2020, the Los Angeles County Board of Supervisors commissioned two reports regarding nursing homes in LA County: (1) LA County Office of Inspector General and (2) LA County Auditor-Controller. If the County Board of Supervisors can order investigations of LACDPH, it’s likely that LACDPH must follow public record act requirements. If the records were used in the course of their business, they are considered public records and must be retained and available to the public.
Nevertheless, I submitted a public records act request, as directed, to the California Department of Public Health.
My question for the Los Angeles Board of Supervisors will be about their County Department of Public Health not retaining consumer complaints and consumer documentation as public records despite being a critical part of the complaint process. The lack of transparency and accountability is egregious. It seems investigations have been limited to uninvestigated complaints, but no investigations of “unsubstantiated complaints.” Nevertheless, a California Public Record Act request was submitted to the California Department of Public Health. I received what I thought was a treasure trove of 500 documents, but not a single consumer complaint and attached documents were included! I followed up with an email stating I had not received the records I had requested. I next received :
No responsive records? What happened to the records? What did they use to investigate complaints that were determined to be “unsubstantiated?” Medicare’s requirement is that they retain these records for seven years. But CDPH had no responsive records! I followed up with a request asking for the regulations that exempted record retention of nursing home complaints as required by the Public Records Act. I received the following response (without signature.)
“There are no policies or regulations that exempts (sic) the California Department of Public Health (CDPH) from retaining consumer complaints at skilled nursing facilities.”
I also received the following response:
“On February 29, 2024, the California Department of Public Health (CDPH) received your request for records under the Public Records Act (PRA) wherein you requested the following:
Copies of Consumer/ public complaints and all attachments submitted for the stated years below.
Complaints are housed in a CMS database. To receive a copy, you will need to file a Freedom of Information Act request with the Centers for Medicare and Medicaid Services (CMS). Please contact the San Francisco regional office of CMS by phone at (415) 744-3502, or by email at SFCMSFOIA@cms.hhs.gov
Sincerely,
***
Information Officer II
OPA (CDPH Public Records Portal • cdph@govqa.us)
I submitted a FOIA – federal Freedom Of Information Act request and within several weeks I received documents, but like the CDPH, they were not the consumer complaints I had requested. Instead, I received the generic complaint summaries of categories with “unsubstantiated” written next to the category. It was now five months since I had made my first request for the same records to LACDPH!
Disgusted, I felt like I had as a kid when we played a game called “Cry Uncle.” The phrase originated around 1900 as a command among school children who, after being taunted or repeatedly hit, would cry “uncle” when they’d had enough. But I wasn’t ready to cry “uncle.”
I patiently contacted CMS explaining these were not the records requested. I received a message to call them, did so and left a message on voicemail. I then received a phone call voice mail:
“Hi, good afternoon ***.
This is *** calling from CMS regarding your FOIA request. Sorry, I wasn’t able to return your call yesterday. When you get a chance, please give me a call back. I’ll be looking for your area code this time, and so I hope to hear from you soon. Thank you, and you have a wonderful day, bye-by.”
I spoke with a gentleman who was a Special Assistant – San Francisco-Seattle Survey & Enforcement Division. San Francisco CMS Regional Office. He was kind, understanding and informative:
- He explained to me that the technical name for the documents I wanted was “Intake packets.” This packet was created for every complaint- both verbally filed or the intake form was attached to a complaint submitted in writing.
- He told me that the CMS database the CDPH referred to as the reason CDPH could not produce the records in reality was a shared data base that they had access to and use to produce public records.
- Upon hearing about Helen sleeping in her wheelchair for an hour-and-a-half waiting for assistance to go to bed, he asked my permission if he could pass this information on to another CMS staff person. I immediately consented and he copied me on his email:
“Hi ***,
I hope all is well and you are enjoying a wonderful day.
I am emailing you regarding a phone call I just had with Ms. *** *** (Cc’d above ) who would like to discuss an egregious complaint submitted by in (sic) resident against *** *** *** Gardens located in LA county that ended in the State Agency finding the complaint unsubstantiated. When you have a moment, could you please reach out to Ms. *** for further details.
Thank you!
***
The next day I received the following email, from the gentleman who had helped with my FOIA, about the documents I was requesting:
Hi ***,
I was finally able to access your request. You will received (sic) 3217 documents from the Freedom of Information Group (FIG) once they have conducted their final review and processing.
Kind regards, ***
I was encouraged. Finally,
something might be done about not only the absence of protections for the most vulnerable of elders in California, but the false appearance that they are being well taken care when the nursing home complaints are falsely labeled unsubstantiated. But I was wrong – again. Instead I received the following from the manager the gentleman had sent the email to about the “…egregious complaint submitted by in (sic) resident against *** *** *** Gardens located in LA county“
that ended in the State Agency finding the complaint unsubstantiated.”
Hello ***,
“I understand, per your below email, that you have made a FOIA request, and this is being processed.”
“I would like to also point you to the resources below for members of the press.
Press contacts & resources
For members of the press:
If you have a request or inquiry, fill out our Media Inquiries Form….”
“V/r,
*** ***, MSN, RN
LCDR, U.S. Public Health Service
Branch Manager, Division of San Francisco/Seattle Survey Branch (AK, AZ, CA, HI, ID, NV, OR, WA, and Outer Pacific Territories)
Yes, as a freelance blogger working on an investigative story, I am considered a member of the press. As a member of the press I was also entitled to expedited processing of the records I was requesting. While I appreciated the press contacts and resources that were listed in the email, I was disappointed when, once again, I was passed on to another department. As directed, I submitted a press inquiry, but there was no response – just stone cold silence. UNCLE.
Now it’s three months later and I am still waiting for the public records I had began requesting eight months ago!
Next week: Skilled Nursing Facilities: What to avoid and what to do instead!