BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 1899|
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CONSENT
Bill No: AB 1899
Author: Brown (D)
Amended: 6/26/14 in Senate
Vote: 21
SENATE HUMAN SERVICES COMMITTEE : 4-0, 6/24/14
AYES: Beall, DeSaulnier, Liu, Wyland
NO VOTE RECORDED: Berryhill
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
ASSEMBLY FLOOR : 77-0, 5/28/14 - See last page for vote
SUBJECT : Residential care facilities for the elderly
SOURCE : California Advocates for Nursing Home Reform
DIGEST : This bill provides that a licensee who abandons a
residential care facility and the residents in care resulting in
an immediate and substantial threat to the health and safety of
the abandoned residents, in addition to forfeiture of their
license, shall be excluded from licensure in facilities licensed
by Department Social Services without the right to petition for
reinstatement.
ANALYSIS :
Existing law:
1.Establishes the Residential Care Facilities for the Elderly
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(RCFE) Act which requires the Department of Social Services
(DSS) to license and regulate RCFEs as a separate category
within the existing residential care licensing structure of
DSS.
2.Requires applicants for an RCFE license to file an application
including a criminal record clearance, employment history,
character references, evidence of certification, and
disclosure of previous service in other RCFEs, outpatient
health clinics, health facilities (including hospitals,
skilled nursing facilities or intermediate face facilities),
or a community care facility, among other requirements.
3.Requires that procedures for the suspension, revocation or
denial of license be conducted in accordance with the
administrative adjudication provisions of the Administrative
Procedure Act that grants a licensee the right to appeal a
license denial, revocation or suspension to the Office of
Administrative Hearings.
4.Permits the Director of DSS to temporarily suspend any
license, prior to any hearing when, in the opinion of the
Director, the action is necessary to protect residents or
clients of the facility from physical or mental abuse,
abandonment, or any other substantial threat to health or
safety. Requires DSS to verify within 30 days that the
facility is nonoperational.
5.Provides that a license shall be forfeited when a licensee
sells the facility, surrenders the license to DSS, is
convicted of a prohibited offense, dies, or abandons the
facility.
6.Defines "licensee abandons the facility," through regulation,
to mean either of the following:
A. The licensee informs the licensing agency that the
licensee no longer accepts responsibility for the facility,
or
B. The licensing agency is unable to determine the
licensee's whereabouts after the following:
(1) The licensing agency requests information of the
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licensee's whereabouts from the facility's staff if any
staff can be contacted;
(2) The licensing agency has made at least one phone
call per day, to the licensee's last telephone number of
record, for five consecutive workdays with no response;
and
(3) The licensing agency has sent a certified letter,
requesting the licensee to contact the licensing agency,
to the licensee's last mailing address of record with no
response within seven calendar days.
This bill:
1.Adds to the list of occurrences that a license shall be
forfeited by operation of law prior to its expiration date the
following:
A licensee who abandons the facility and the residents in
care resulting in an immediate and substantial threat to
the health and safety of the abandoned residents, in
addition to forfeiture of the license, shall be excluded
from licensure in facilities licensed by DSS without the
right to petition for reinstatement.
2.Specifies that DSS is permitted to deny an application for a
license or suspend or revoke a license upon the same
occurrence listed in #1.
3.Specifies that a licensee, on and after January 1, 2015, who
fails to comply with these provisions and abandons the
facility and the residents in care resulting in an immediate
and substantial threat to the health and safety of the
abandoned residents, in addition to forfeiture of the license,
as defined, shall be excluded from licensure in facilities
licensed by DSS without the right to petition for
reinstatement.
Comments
DSS oversight . In late October 2013, 19 frail seniors were
abandoned at Valley Springs Manor in Castro Valley by the
licensee and all but two staff after the state began license
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revocation proceedings. DSS inspectors, noting the facility had
been abandoned, left the two unpaid service staff to care for
the abandoned residents with insufficient food and medication,
handing them a $3,800 citation before leaving for the weekend.
The next day sheriff's deputies and paramedics sent the patients
to local hospitals. DSS indicated that the owner of this
facility had previously owned a nursing home facility licensed
by the Department of Public Health, and another facility in
Modesto owned by the same licensee was subsequently taken over
by DSS, which appointed a temporary manager.
The author's office states that nothing in existing law would
prevent this licensee from seeking licensure again in the
future. DSS stated that the maximum civil penalty that it could
assess on the licensee for abandoning the facility was the $150
per day per violation. This bill seeks to block licensees who
are the subject of revocation or who abandon a facility from
being granted licensure again.
Financial structure . More than 90% of RCFE licenses in
California are held by for-profit providers, the majority of
which have six or fewer beds. Most residents pay privately or
with long-term care insurance since there is very little public
funding available through Medi-Cal, Supplemental Security Income
(SSI/SSP) or Medicare, and fees can range from $2,500 to more
than $8,000 per month. A very few beds are available to seniors
who pay their entire SSI/SSP checks in rent. In 2013, the
maximum SSI/SSP grant was $866.40. Residents who rely solely on
Social Security Income may have a maximum payment of $2,642 per
month in 2014, although that amount varies widely based on the
recipient's prior income while working.
Increasingly, complex corporate mergers and acquisitions have
meant that many RCFEs are owned by national corporate chains
that control more than one facility. Administrators employed by
these chains may also oversee multiple facilities. This
development has led to regulatory challenges since community
care licensing citations and other licensing reports are
facility specific, and management problems common to multiple
RCFEs with the same owner may easily go unnoticed.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
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SUPPORT : (Verified 8/5/14)
California Assisted Living Association
ASSEMBLY FLOOR : 77-0, 5/28/14
AYES: Achadjian, Alejo, Allen, Ammiano, Bigelow, Bloom,
Bocanegra, Bonilla, Bonta, Bradford, Brown, Buchanan, Ian
Calderon, Campos, Chau, Chávez, Chesbro, Conway, Cooley,
Dababneh, Dahle, Daly, Dickinson, Donnelly, Eggman, Fong, Fox,
Beth Gaines, Garcia, Gatto, Gomez, Gonzalez, Gordon, Gorell,
Gray, Grove, Hagman, Harkey, Roger Hernández, Holden, Jones,
Jones-Sawyer, Levine, Linder, Logue, Lowenthal, Maienschein,
Mansoor, Medina, Melendez, Mullin, Muratsuchi, Nazarian,
Nestande, Olsen, Pan, Patterson, Perea, John A. Pérez, V.
Manuel Pérez, Quirk, Quirk-Silva, Rendon, Ridley-
Thomas, Rodriguez, Salas, Skinner, Stone, Ting, Wagner, Waldron,
Weber, Wieckowski, Wilk, Williams, Yamada, Atkins
NO VOTE RECORDED: Frazier, Hall, Vacancy
JL:k 8/6/14 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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