Amended in Senate July 6, 2015

Amended in Assembly May 28, 2015

Amended in Assembly April 27, 2015

Amended in Assembly April 14, 2015

Amended in Assembly March 18, 2015

California Legislature—2015–16 Regular Session

Assembly Bill No. 348

Introduced by Assembly Member Brown

(Coauthors: Assembly Members Gipson and Mathis)

February 17, 2015

An act to amend begin delete Sections 1266, 1279.2, and end delete begin insert Section end insert 1420 of the Health and Safety Code, relating to health care facilities.

LEGISLATIVE COUNSEL’S DIGEST

AB 348, as amended, Brown. begin delete Health end delete begin insert Long-term health care end insert facilities: complaints: investigations.

Existing law provides for the licensure and regulation by the State Department of Public Health of begin delete health care facilities, including end delete long-term health care facilities, as defined. Existing law establishes procedures to be followed when the department receives a written or oral complaint about a long-term health care facility. A complaint is defined to mean any notice to the department, other than a report from the facility, of an alleged violation of applicable requirements of state or federal law or any alleged facts that might constitute a violation. begin insert Existing law establishes the time period for which an investigation of a complaint is required to be completed, and authorizes an extension of that time period under extenuating circumstances. end insert

This bill would begin delete require, effective January 1, 2018, the department to complete its investigation of a complaint or a report from a long-term health facility within 45 working days of its receipt, except that this period may be extended up to an additional 30 working days if the department has diligently attempted, but has not been able, to obtain necessary evidence related to the investigation. The bill would require the department, if it extends an investigation beyond 45 working days, to notify the complainant, in writing, of the basis for the extension. The bill would require, effective July 1, 2016, that the department’s written determination provide specific findings concerning each alleged violation and include a summary of the evidence upon which the determination is based. end delete begin insert require the department to apply the existing time periods for the investigation, inspection, and issuance of a citation under these provisions to a report from the facility of an alleged violation of applicable requirements of state or federal law or any alleged facts that might constitute a violation of those requirements end insert begin insert . end insert The bill would also require the department to analyze its compliance with the begin delete timeframes end delete begin insert time periods end insert for investigations on a quarterly basis and post those findings on its Internet Web site. begin insert The bill would make other technical changes to these provisions, as specified. end insert

begin delete

Existing law provides the complainant with 5 business days after receipt of the notice of the department’s determination in which to request an informal conference, as specified.

end delete begin delete

This bill would instead provide the complainant with 15 days after receipt of the notice in which to request an informal conference.

end delete begin delete

Existing law requires the department, when it receives a complaint or report involving a general acute care hospital, acute psychiatric hospital, or special hospital, that indicates a specified level of danger, to complete an investigation of the complaint or report within 45 days. Existing law also requires the department to submit to the Legislature, and publish on its Internet Web site, a staffing and systems analysis that includes the number and timeliness of complaint investigations, among other things.

end delete begin delete

This bill would authorize a 30-day extension to the time period to complete the investigation if the department has diligently attempted, but has not been able, to obtain necessary evidence related to the investigation. The bill would require the department, if it extends an investigation beyond 45 days, to notify the complainant, in writing, of the basis for the extension. The bill would also require the staffing and systems analysis prepared by the department to include data regarding the department’s compliance with these requirements.

end delete

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

The people of the State of California do enact as follows:

begin insert

begin insert SECTION 1. end insert   

end insert

begin insert Section 1420 of the end insert begin insert Health and Safety Code end insert begin insert is
amended to read: end insert

1420.  

(a)  (1)  Upon receipt of a written or oral complaint,
the state department shall assign an inspector to make a preliminary
review of the complaint and shall notify the complainant within
two working days of the receipt of the complaint of the name of
the inspector. Unless the state department determines that the
complaint is willfully intended to harass a licensee or is without
any reasonable basis, it shall make an onsite inspection or
investigation within 10 working days of the receipt of the
complaint. In any case in which the complaint involves a threat of
imminent danger of death or serious bodily harm, the state
department shall make an onsite inspection or investigation within
24 hours of the receipt of the complaint. In any event, the
complainant shall be promptly informed of the state department’s
proposed course of action and of the opportunity to accompany
the inspector on the inspection or investigation of the facility. Upon
the request of either the complainant or the state department, the
complainant or his or her representative, or both, may be allowed
to accompany the inspector to the site of the alleged violations
during his or her tour of the facility, unless the inspector determines
that the privacy of any patient would be violated thereby.

(2)  When conducting an onsite inspection or investigation
pursuant to this section, the state department shall collect and
evaluate all available evidence and may issue a citation based
upon, but not limited to, all of the following:

(A)  Observed conditions.

(B)  Statements of witnesses.

(C)  Facility records.

(3) (A) For a complaint that involves a threat of imminent
danger of death or serious bodily harm that is received on or after
July 1, 2016, the state department shall complete an investigation
of the complaint within 90 days of receipt of the complaint. At the
completion of the complaint investigation, the state department
shall notify the complainant and licensee in writing of the state
department’s determination as a result of the inspection or
investigation.

(B) The time period described in subparagraph (A) may be
extended up to an additional 60 days if the investigation cannot
be completed due to extenuating circumstances. The state
department shall document these circumstances begin delete in its final
determination end delete and notify the facility and the complainant in writing
of the basis for the extension and the estimated completion date.

(4) (A) For a complaint that does not involve a threat of
imminent danger of death or serious bodily harm pursuant to
paragraph (3) and that is received on or after July 1, 2017, and
prior to July 1, 2018, the state department shall complete an
investigation of the complaint within 90 days of receipt of the
complaint. At the completion of the complaint investigation, the
state department shall notify the complainant and licensee in
writing of the state department’s determination as a result of the
inspection or investigation.

(B) The time period described in subparagraph (A) may be
extended up to an additional 90 days if the investigation cannot
be completed due to extenuating circumstances. The state
department shall document these circumstances begin delete in its final
determination end delete and notify the facility and the complainant in writing
of the basis for the extension and the estimated completion date.

(5) (A) For a complaint that is received on or after July 1, 2018,
the state department shall complete an investigation of the
complaint within 60 days of receipt of the complaint. At the
completion of the complaint investigation, the state department
shall notify the complainant and licensee in writing of the state
department’s determination as a result of the inspection or
investigation.

(B) The time period described in subparagraph (A) may be
extended up to an additional 60 days if the investigation cannot
be completed due to extenuating circumstances. The state
department shall document these circumstances begin delete in its final
determination end delete and notify the facility and the complainant in writing
of the basis for the extension and the estimated completion date.

(b)  Upon being notified of the state department’s determination
as a result of the inspection or investigation, a complainant who
is dissatisfied with the state department’s determination, regarding
a matter which would pose a threat to the health, safety, security,
welfare, or rights of a resident, shall be notified by the state
department of the right to an informal conference, as set forth in
this section. The complainant may, within five business days after
receipt of the notice, notify the director in writing of his or her
request for an informal conference. The informal conference shall
be held with the designee of the director for the county in which
the long-term health care facility which is the subject of the
complaint is located. The long-term health care facility may
participate as a party in this informal conference. The director’s
designee shall notify the complainant and licensee of his or her
determination within 10 working days after the informal conference
and shall apprise the complainant and licensee in writing of the
appeal rights provided in subdivision (c).

(c)  If the complainant is dissatisfied with the determination of
the director’s designee in the county in which the facility is located,
the complainant may, within 15 days after receipt of this
determination, notify in writing the Deputy Director of the
Licensing and Certification Division of the state department, who
shall assign the request to a representative of the Complainant
Appeals Unit for review of the facts that led to both determinations.
As a part of the Complainant Appeals Unit’s independent
investigation, and at the request of the complainant, the
representative shall interview the complainant in the district office
where the complaint was initially referred. Based upon this review,
the Deputy Director of the Licensing and Certification Division
of the state department shall make his or her own determination
and notify the complainant and the facility within 30 days.

(d)  Any citation issued as a result of a conference or review
provided for in subdivision (b) or (c) shall be issued and served
upon the facility within 30 days of the final determination. Service
shall be effected either personally or by registered or certified mail.
A copy of the citation shall also be sent to each complainant by
registered or certified mail.

(e)  A miniexit conference shall be held with the administrator
or his or her representative upon leaving the facility at the
completion of the investigation to inform him or her of the status
of the investigation. The state department shall also state the items
of noncompliance and compliance found as a result of a complaint
and those items found to be in compliance, provided the disclosure
maintains the anonymity of the complainant. In any matter in which
there is a reasonable probability that the identity of the complainant
will not remain anonymous, the state department shall also notify
the facility that it is unlawful to discriminate or seek retaliation
against a resident, employee, or complainant.

(f) Any citation issued as a result of the complaint investigation
provided for in paragraph (3), (4), or (5) of subdivision (a), and in
compliance with Section 1423, shall be issued and served upon
the facility within 30 days of the completion of the complaint
investigation.

begin insert

(g) The department shall apply the time periods for investigation,
inspection, and issuance of a citation established in this section
to a report from the facility of an alleged violation of applicable
requirements of state or federal law or any alleged facts that might
constitute a violation of those requirements.

end insert begin insert

(h) The department shall analyze its compliance with the time
periods for investigations established in this section on a quarterly
basis, and shall, on a quarterly basis, post findings from the
analysis on its Internet Web site. The analysis shall provide data
on the department’s performance, and shall include, at a minimum,
all of the following data elements:

end insert begin insert

(1) The number of open investigations.

end insert begin insert

(2) The number of completed investigations.

end insert begin insert

(3) The number and percentage of investigations completed
within the initial time period established in paragraph (3), (4), or
(5) of subdivision (a).

end insert begin insert

(4) The number and percentage of investigations that required
an extension authorized in paragraph (3), (4), or (5) of subdivision
(a).

end insert begin insert

(5) The number and percentage of investigations that required
an extension and were completed within the extended time period
authorized in paragraph (3), (4), or (5) of subdivision (a).

end insert begin insert

(6) The average length of time to complete an investigation.

end insert begin insert

(7) The average length of time to complete an investigation that
was not completed by the end of the extended time period
authorized in paragraph (3), (4), or (5) of subdivision (a).

end insert begin delete

(g)

end delete

begin insert (i) end insert  For purposes of this section, “complaint” means any oral or
written notice to the state begin delete department, other than a report from the
facility end delete begin insert department end insert of an alleged violation of applicable
requirements of state or federal law or any alleged facts that might
constitute such a violation.

begin delete

(h)

end delete

begin insert (j) end insert  Nothing in this section shall be interpreted to diminish the
state department’s authority and obligation to investigate any
alleged violation of applicable requirements of state or federal law,
or any alleged facts that might constitute a violation of applicable
requirements of state or federal law, and to enforce applicable
requirements of law.

All matter omitted in this version of the bill appears in the bill as amended in the Senate, May 28, 2015. (JR11)