BILL ANALYSIS Ó
-----------------------------------------------------------------
|SENATE RULES COMMITTEE | SB 895|
|Office of Senate Floor Analyses | |
|1020 N Street, Suite 524 | |
|(916) 651-1520 Fax: (916) | |
|327-4478 | |
-----------------------------------------------------------------
THIRD READING
Bill No: SB 895
Author: Corbett (D)
Amended: 5/27/14
Vote: 21
SENATE HUMAN SERVICES COMMITTEE : 5-0, 4/8/14
AYES: Liu, Berryhill, DeSaulnier, Hancock, Wyland
SENATE APPROPRIATIONS COMMITTEE : 7-0, 5/23/14
AYES: De León, Walters, Gaines, Hill, Lara, Padilla, Steinberg
SUBJECT : Residential are facilities for the elderly:
unannounced visits
SOURCE : California Advocates for Nursing Home Reform
DIGEST : This bill requires the Department of Social Services
(DSS) ensure that each licensed residential care facility for
the elderly (RCFE) is inspected at least once every three years
on or before July 1, 2016, and at least once every two years on
or before July 1, 2017, and at least once each year on or before
July 1, 2018, and each year thereafter and authorizes DSS to
conduct additional unannounced inspections under specified
circumstances. It requires DSS, with each inspection, to
conduct an evaluation of the facility for compliance with the
laws and regulations governing residential care facilities for
the elderly and requires it to verify that a facility is in
compliance no later than 10 days after the notification of
deficiencies in compliance and requires inspection reports,
consultation reports, lists of deficiencies, and plans of
CONTINUED
SB 895
Page
2
correction to be open to public inspection on the department's
Internet Web site and in its district offices.
ANALYSIS : Existing law:
1.Establishes the RCFE Act which provides for DSS to license and
regulate RCFEs as a separate category within the existing
residential care licensing structure of DSS.
2.Provides that RCFEs shall be subject to unannounced visits by
DSS and that DSS shall visit facilities as often as necessary
to ensure the quality of care provided.
3.Requires annual unannounced inspections when a license is on
probation, when required by the terms of a facility compliance
plan, when an accusation is pending, when required for federal
financial participation, or to verify that a person who has
been ordered out of the facility is no longer present.
4.Requires DSS to perform random inspections each year on no
fewer than 20% of the RCFE facilities not subject to annual
inspections. Provides that this percentage shall increase by
10% if the total citations issued by DSS exceeds the previous
year by 10%. As a result of this trigger, DSS currently is
required to perform random inspections on 30% of the RCFE
facilities not subject to annual inspection. Requires DSS to
visit every facility no less than every five years.
5.Requires DSS to visit a newly licensed facility within 90 days
after a facility accepts its first resident to evaluate
compliance with regulatory requirements.
6.Permits any person to request an inspection of any RCFE by
transmitting notice of an alleged violation orally or in
writing. Requires DSS to make a preliminary review and an
onsite inspection within 10 days after receiving the complaint
except where the visit would adversely affect the licensing
investigation or the investigation of other agencies,
including, but not limited to, law enforcement agencies.
7.Through regulation, requires DSS to conduct a follow-up visit
CONTINUED
SB 895
Page
3
within 10 working days following the latest date of correction
specified in the notice of deficiency, unless the licensee has
demonstrated that the deficiency was corrected as required.
Provides that no penalty shall be assessed unless a follow-up
visit is conducted.
This bill:
1.Requires DSS to ensure that each RCFE is inspected at least
once every three years on or before July 1, 2016, and at least
once every two years on or before July 1, 2017, and at least
once each year on or before July 1, 2018, and each year
thereafter.
2.Permits DSS to conduct additional unannounced inspections when
a license is on probation, when required by the terms of a
facility compliance plan, when an accusation is pending, when
required for federal financial participation, or to verify
that a person who has been ordered out of the facility is no
longer present.
3.Requires that DSS to verify that a facility is in compliance
no later than 10 days after the notification of a deficiency
or up to an additional 30 days if DSS determines that the
delay will not adversely impact the health, safety, and
security of facility residents.
4.Deletes provisions requiring annual unannounced inspections
for 20% of RCFE facilities, and the additional 10% trigger.
Deletes provisions requiring DSS to visit all facilities no
less than once every five years.
5.Requires all reports on the results of each inspection,
evaluation or consultation be available to the public on DSS's
Internet Web site and in its district offices.
Background
According to the author's office, California's current
inspection requirements for RCFEs fail to adequately ensure the
health and safety of our fast growing elderly population. A
series of recent events has drawn attention to questions about
CONTINUED
SB 895
Page
4
the adequacy of DSS oversight and the state's ability to protect
people who reside in RCFEs.
In July 2013, ProPublica and Frontline reporters wrote and
produced a series of stories on Emeritus, the nation's largest
RCFE provider. Featured in the article was a woman who died
after receiving poor care at in a facility in Auburn,
California. The series documented chronic understaffing and a
lack of required assessments and substandard care.
Reports in September 2013, prompted by a consumer watchdog
group that had hand-culled through stacks of documents in San
Diego, revealed that more than two dozen seniors had died in
recent years in RCFEs under questionable circumstances that
went ignored or unpunished by CCL.
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 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.
Prior Legislation
AB 313 (Monning, Chapter 365, Statutes of 2011) requires each
RCFE to provide residents, their responsible party, and the
local long-term care ombudsman with a 10 day written notice when
DSS commences proceedings to suspend or revoke its license, or a
criminal action relating to health or safety of the residents is
brought against the facility, and makes other changes related to
these actions.
AB 2066 (Monning, Chapter 643 Statutes of 2012) requires RCFEs
to provide a 60-day written notice to residents or the
responsible person within 24 following receipt of DSSs order of
revocation. Permits the licensee to secure an alternative
manager, as specified. Requires RCFEs to refund all or a portion
of preadmission fees to residents transferring as the result of
a license revocation, as specified.
CONTINUED
SB 895
Page
5
SB 897 (Leno, Chapter 376, Statutes of 2011) requires licensed
RCFEs to notify DSS, the Office of the State Long-Term Care
Ombudsman and the facility's residents when the property is
subject to foreclosure or certain other events occur due to
financial distress.
AB 419 (Mitchell, 2011) would have required every community care
facility licensed by DSS to be inspected unannounced at least
once per year using research based, field tested inspection
protocols, as specified. This bill died in the Assembly
Appropriations Committee.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
According to the Senate Appropriations Committee, initial costs
in the low millions of dollars, increasing to about $5 million
(General Fund) per year once the inspection frequency has
increased to at least annually for all RCFEs.
SUPPORT : (Verified 5/21/14)
California Advocates for Nursing Home Reform (source)
Assisted Living Consumer Alliance
California Alliance for Retired Americans
California Commission on Aging
California Continuing Care Residents Association
Consumer Attorneys of California
Consumer Federation of California
County of San Diego
Elder Law and Advocacy
Jewish Family Service of Los Angeles
Johnson Moore Trial Lawyers
Long Term Care Ombudsman Services of San Luis Obispo County
National Senior Citizens Law Center
Ombudsman & HICAP Services of Northern California
Ombudsman Services of Contra Costa
Stand Up for Rosie Coalition
Valentine Law Group
OPPOSITION : (Verified 5/21/14)
Community Residential Care Association of California
CONTINUED
SB 895
Page
6
ARGUMENTS IN SUPPORT : Many supporters of this bill state that
California's current inspection system is one of the weakest in
the country and that for most RCFEs, the state is using an
experimental "key indicator" inspection protocol, which is an
abbreviated version of a comprehensive inspection. Supporters
claim this is a recipe for neglect and abuse. The supporters
state by requiring annual, comprehensive inspections of RCFEs,
oversight will be improved, RCFE residents' rights will be
enhanced, and care standards will be modernized.
ARGUMENTS IN OPPOSITION : The Community Residential Care
Association of California opposes this bill, arguing "This bill
deletes current
language authorizing the Department to determine a workable
correction timeline. In some cases, deficiencies make take more
than 10 days to correct. The current language allows the
Department to determine the timeline based on the violation."
JL:AL:nl 5/27/14 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
**** END ****
CONTINUED