BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 773
                                                                  Page  1

          Date of Hearing:   May 13, 2009 

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Kevin De Leon, Chair

                    AB 773 (Lieu) - As Amended:  April 30, 2009  

          Policy Committee:                              Health Vote:16-1

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              

           SUMMARY  

          This bill requires skilled nursing facilities (SNF or nursing  
          homes), within 30 days of receiving an AA or A citation, to send  
          written notification to the primary contact for all current  
          residents and patients. This bill specifies the contents of the  
          written notice and authorizes the California Department of  
          Public Health (DPH) to assess an administrative penalty of  
          $1,000 for each day a nursing home fails to comply with  
          notification requirements established by this bill. 

          AA citations are issued when a resident death has occurred and  
          deemed to be the responsibility of the facility. AA citations  
          carry a fine of $25,000 to $100,000. Class A citations are  
          issued when violations present imminent danger to patients or  
          the substantial probability of death or serious harm, and carry  
          fines of $2,000 to $20,000. 

           FISCAL EFFECT  

          One-time fee-supported special fund costs of $185,000 for DPH to  
          promulgate regulations to specify when SNF would be subject to  
          penalties. 

           COMMENTS  

           1)Rationale  . This bill, according to the author, is intended to  
            provide additional consumer protections to residents of  
            long-term care facilities and their families. The DPH is  
            responsible for ensuring health and safety standards are met  
            in approximately 7,000 public and private health care  
            facilities throughout the state. These facilities include  
            surgical centers, hospitals, skilled nursing facilities, and  
            home health agencies. SNF and acute care hospitals account for  
            almost 70% of L & C workload. Citations may be issued by DPH  
            during an annual certification visit, complaint investigation,  





                                                                  AB 773
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            or a special incident investigation for violations of state or  
            federal law. 

           2)Concerns  . The California Hospital Association (CHA) is opposed  
            to this bill. CHA indicates the hospital-based SNFs they  
            represent are different than nursing homes due to the short  
            length-of-stay for most patients. The patients in their  
            facilities stay days or weeks, in contrast to nursing home  
            patients who may stay for months or years. According to CHA,  
            the notification requirements established by this bill are  
            onerous. They will not help many patients who will have left  
            the facility by the time the notice goes out. In addition, CHA  
            indicates their SNFs already post federal and state survey  
            information and share information with patients and families. 
           
          Analysis Prepared by  :    Mary Ader / APPR. / (916) 319-2081