BILL ANALYSIS
AB 215
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Date of Hearing: May 6, 2009
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Kevin De Leon, Chair
AB 215 (Feuer) - As Amended: April 21, 2009
Policy Committee: Health Vote:13-4
Urgency: No State Mandated Local Program:
No Reimbursable:
SUMMARY
This bill requires skilled nursing facilities (SNF) approved for
payment by Medi-Cal and Medicare to post the facility rating
information established by the Centers for Medicaid Services
(CMS) and displayed on the CMS website. Specifically, this
bill:
1)Requires standard content and formatting of the notice,
including a disclaimer about the posting. Notices must include
a "star rating" of one to five stars expressed as a number.
2)Requires a copy of the most recent CMS facility report to be
maintained on the premises for review by residents or the
public, upon request.
3)Requires violations of this bill constitute a class B
violation, established in current law, and subject to a civil
penalty of $100 to $1,000.
FISCAL EFFECT
Annual fee-support special fund costs to DPH of less than
$50,000 to continue oversight of SNF (nursing homes) and ensure
compliance with the specific requirements of the posting in this
bill.
COMMENTS
1)Rationale . This bill is sponsored by the author and supported
by a wide array of advocacy groups concerned with issues of
aging in California. This bill requires the posting of
information currently available on the internet. According to
AB 215
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the author, many patients and families do not have access to
the internet and the quality rating information provided by
CMS in recent months. The CMS Five-Star Quality Rating System,
released in December of 2008, aggregates detailed information
about health inspection reports, staffing, and quality
measures of Medicare and Medi-Cal-certified nursing homes into
a quickly recognizable, easily readable format. Availability
of this information aids consumers and their families when
making patient care choices.
2)The five-star rating for each nursing home is based on
quantification of the following categories:
a) Health Inspections: This category contains findings from
on site inspections, annual survey visits, and complaint
investigations for the previous three years that were
conducted to determine compliance with minimum safety and
quality standards.
b) Quality Measures: This category contains information on
residents collected by nursing homes using 10 physical and
clinical measures to try to demonstrate how well nursing
homes care for residents' needs. Measures include the
percent of residents with moderate to severe pain, the
percent of residents who have changes in their ability to
move about, and, the percent of residents with pressure
ulcers.
c) Staffing Levels: This category includes information
about the average number of hours of care provided by
nursing staff to each resident daily. Staffing information
is collected for registered nurses, licensed practical
nurses, licensed vocational nurses, and certified nursing
assistants. This category also considers the impact of
patient acuity on care and staffing.
3)Some Concerns Reduced . The California Association of Health
Facilities and the California Hospital Association (CHA) have
been opposed to earlier versions of this bill. Recent amends
reduce or remove opposition by extending the deadline for
nursing homes needing to meet compliance with the posting
requirements and the addition of a disclosure about the nature
of the posting, with respect to criticisms of the five-star
methodology resulting in a disproportionate number of
facilities being given three stars or less.
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4)Related Legislation . AB 773 (Lieu), in the current session,
increases the fine for a class B citation at long-term care
facilities to $1,000 to $5,000 per citation. AB 773 also
increases the fine for a class AA citation to $50,000 to
$125,000 per citation, and the fine for a class A citation at
a nursing home to $5,000 to $50,000 per citation.
Analysis Prepared by : Mary Ader / APPR. / (916) 319-2081