James H. Gomez, president and CEO of the California Association of Health Facilities, is responding to the Sept. 18-19 Bee investigation "Bogus nursing home records get little notice," which reported on the falsification of patient records.

The Bee's two-part series on the falsification of nursing facility health records lacks honesty and perspective at a time when 10,000 baby boomers in the United States are turning 65 every day and beginning to access long-term care for their parents and short-term stays for themselves following serious injury or surgery.

We need to start having frank conversations about this aspect of the long-term care continuum in a thoughtful manner, without anger, guilt or exaggeration.

We also need to arm consumers with facts and tools that enable them to receive the best possible medical treatment. And we need to punish egregious offenders swiftly.

Most consumers are unaware that 89 percent of people who enter a skilled-nursing facility leave within 90 days. Or that 85 percent of residents would recommend their facility to others. Or that quality care is improving despite the increasing acuity of patients who are quickly released from hospitals into skilled-nursing settings.

According to federal regulators at the Centers for Medicare & Medicaid Services, long-stay quality measures have improved significantly in 11 out of 14 categories over the last five years. Residents are receiving flu and pneumonia vaccines, pain is being managed better, and the use of physical restraints like bed rails and seat belts have declined significantly.

As stated in The Bee series, the California Department of Public Health reported that health record falsification is the least common citation issued to nursing facilities. The front-page headlines overlooked that fact.

The Bee failed to point out that there are as many as 100 entries per day on the medical chart of a skilled-nursing resident. There are entries made each time medication is administered as well as notations on therapy treatments, daily nursing notes, behavior assessments, dietary, physician orders, change of condition entries, social services and activities reports.

That means 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.

There is absolutely no excuse for altering medical records, but to sound the alarm on behalf of trial lawyers and characterize the entire profession as inept or, worse yet, malicious is a disservice to your readers.

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James H. Gomez is president and CEO of the California Association of Health Facilities

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