BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 773
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          ASSEMBLY THIRD READING
          AB 773 (Lieu)
          As Amended June 1, 2009
          Majority vote 

           HEALTH              16-1        APPROPRIATIONS      12-5        
           
           ------------------------------------------------------------------- 
          |Ayes:|Jones, Fletcher, Ammiano, |Ayes:|De Leon, Ammiano, Charles   |
          |     |Block, Carter, De La      |     |Calderon, Davis, Fuentes,   |
          |     |Torre, De Leon, Emmerson, |     |Hall, John A. Perez, Price, |
          |     |Gaines, Hall, Hayashi,    |     |Skinner, Solorio,           |
          |     |Hernandez, Bonnie         |     |Torlakson, Krekorian        |
          |     |Lowenthal, Nava, V.       |     |                            |
          |     |Manuel Perez, Salas       |     |                            |
          |     |                          |     |                            |
          |-----+--------------------------+-----+----------------------------|
          |Nays:|Conway                    |Nays:|Nielsen, Duvall, Harkey,    |
          |     |                          |     |Miller,                     |
          |     |                          |     |Audra Strickland            |
          |     |                          |     |                            |
           ------------------------------------------------------------------- 
           SUMMARY  :   Requires a cited long-term care facility, within 30  
          days of the issuance of a citation for a class "AA" or "A"  
          violation, to send the families of all current residents or  
          patients written disclosure of the violation for which the  
          citation was issued.  Specifies content of the disclosure and  
          authorizes the Department of Public Health (DPH) to assess an  
          administrative penalty of $1,000 per day for noncompliance.

           EXISTING LAW  :

          1)The Long-Term, Health, Safety, and Security Act of 1973, is  
            administered by DPH to regulate long-term care facilities.   
            Violations of this act are punishable by specified citations  
            and penalties, and in determining the a civil penalty, DPH is  
            required to consider all relevant facts, including the  
            severity of the risk to the patient, the patient's medical  
            condition or disability, the good faith efforts of the  
            facility to prevent violations, and the facility's history of  
            compliance.  

          2)Defines class "AA" citations as violations which DPH  
            determines have been a direct proximate cause of death to a  








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            patient or resident of a long-term care facility.  Class "AA"  
            civil penalties range from $25,000 - $100,000 for each  
            citation.

          3)Defines class "A" citations as violations which DPH determines  
            present either imminent danger of death or serious harm to  
            residents or which may result in a substantial probability of  
            death or serious physical harm.  Class "A" civil penalties  
            range from $2,000 - $20,000 for each citation.

           FISCAL EFFECT  :  The Assembly Appropriations Committee, unknown,  
          likely absorbable impacts to skilled nursing facilities (SNF or  
          nursing homes) to comply with notification requirements  
          established by this bill.  The serious events requiring notice  
          are uncommon, with fewer than two dozen each year issued to an  
          AA citation (patient death) and fewer than 150 issued for A  
          citations (serious harm).

           COMMENTS  : This bill, according to the author, is intended to  
          inform residents and their families whenever serious  
          deficiencies have occurred at their facility.  The disclosure  
          required by this bill will identify the violation causing the  
          citation, include additional information on the events  
          surrounding the citation, and may provide the status of any  
          appeal.  Supporters of this bill such as the Alzheimer's  
          Association, state that families need to be fully informed  
          regarding the quality of care provided to their family members,  
          and that this bill assures that serious lapses in care are  
          quickly brought to each family's attention.

          The federal Department of Health and Human Services, Office of  
          the Inspector General (OIG), annually surveys national  
          information on nursing home deficiencies.  In the most recent  
          (2008) report, "Trends in Nursing Home Deficiency and  
          Complaints," OIG found that in each of the past three years,  
          over 91% of nursing homes surveyed were cited for deficiencies  
          and a greater percentage of for-profit nursing homes were cited  
          than were not-for-profit and government nursing homes.  The most  
          common deficiency categories were quality of care, resident  
          assessment, and quality of life.  Additionally, 17% of nursing  
          homes surveyed in 2007 were cited for actual harm or immediate  
          jeopardy deficiencies, and 3.6% were cited for substandard  
          quality of care deficiencies, representing a slight increase  
          since 2005.  Since 2005, the number of substantiated complaints  








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          has decreased nearly 3%. Almost all California long-term care  
          facilities (99.1%) were cited for some deficiency during 2007.
           
           
           Analysis Prepared by  :    John D. Miller/ HEALTH / (916) 319-2097  



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