BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 1457
                                                                  Page  1


          ASSEMBLY THIRD READING
          AB 1457 (Davis)
          As Amended May 13, 2009
          Majority vote 

           HEALTH              19-0                                        
           
           ----------------------------------- 
          |Ayes:|Jones, Fletcher, Adams,      |
          |     |Ammiano, Block, Carter,      |
          |     |Conway, De La Torre, De      |
          |     |Leon, Emmerson, Gaines,      |
          |     |Hall, Hayashi, Hernandez,    |
          |     |Bonnie Lowenthal, Nava,      |
          |     |V. Manuel Perez, Salas,      |
          |     |Audra Strickland             |
          |     |                             |
           ----------------------------------- 
           SUMMARY  :  Requires all contracts for residents of long-term care  
          facilities (LTCFs) to disclose the name of the facility's owner,  
          licensee and a single entity responsible for patient care and  
          operation of the facility as the first attachment to each  
          contract for admission.  

           EXISTING LAW  :

          1)Requires an applicant for licensure to operate a health  
            facility to file an application with the Department of Public  
            Health with verified evidence of financial resources  
            sufficient to operate the facility, names and addresses of the  
            owner of the building and grounds, and the name of the person  
            in charge of the facility.

          2)Requires skilled nursing and intermediate care facilities to  
            disclose the name and business address of each general partner  
            if the applicant is a partnership; or, each director and  
            officer if the applicant is a corporation; and, each person  
            having a beneficial ownership interest of 5% or more if the  
            applicant is a corporation or partnership.

          3)Requires the facility to communicate the content of the  
            admission contract to and obtain the signature of the person  
            to be admitted.









                                                                  AB 1457
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           FISCAL EFFECT  :  None

           COMMENTS  :  According to the author, this bill will improve the  
          quality of care in nursing homes by informing residents of the  
          ownership and management structure of the LTCF which provides  
          their care.  The bill will require identification of the  
          responsible owners of each facility, as well as parties  
          providing management and administrative services, as an  
          attachment to each contract agreement. 

          In November of 2007, the U.S. House of Representatives Ways and  
          Means Subcommittee on Health held hearings on the effect of  
          private equity investment on the quality of care in nursing  
          homes, which, according to the New York Times (Times), were  
          prompted by the purchase of the nation's largest nursing home  
          chain, HCR Manor Care, for $6.3 billion by the Carlyle Group, a  
          private equity firm.  Testimony before the committee, again  
          according to the Times, indicated that a number of the privately  
          purchased nursing home chains have instituted complex corporate  
          restructuring to avoid liability when residents suffer neglect. 

          California statute requires submission of extensive information  
          regarding the ownership and control of skilled nursing  
          facilities and intermediate care facilities through the  
          licensure process.  State law requires nursing home licensees  
          and applicants to disclose the ownership structure (for-profit  
          corporation, partnership, etc.) and contact information for all  
          principals.  The state requires any subsidiary organization to  
          identify the parent company, and requires any management  
          agreement to identify its owners and individuals with more than  
          a 5% interest.  The licensee is further required to identify the  
          owner of record of the real property and the individual in  
          charge of the facility.  Failure to comply with these  
          requirements is grounds for revocation of the license and all  
          ownership information is required to be updated upon any change.  
           

          The California Advocates for Nursing Home Reform (CANHR), in  
          support of this bill, notes that publicly available ownership  
          information, such as that posted in nursing homes or online,  
          often fails to identify the person or entity that is fully  
          responsible for the nursing home's operation.  This bill  
          requires disclosure of the ownership on a nursing home's  
          admission agreement, a document that all residents sign at  








                                                                  AB 1457
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          admission.  CANHR argues that nursing home residents deserve to  
          know who owns the facility they live in, and given the recent  
          trends in nursing home ownership, this disclosure is  
          increasingly important.

           
          Analysis Prepared by  :    John Miller / HEALTH / (916) 319-2097 


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