BILL ANALYSIS
AB 215
Page 1
ASSEMBLY THIRD READING
AB 215 (Feuer and Smyth)
As Amended April 21, 2009
Majority vote
HEALTH 13-4 APPROPRIATIONS 13-0
-----------------------------------------------------------------
|Ayes:|Jones, Fletcher, Ammiano, |Ayes:|De Leon, Nielsen, |
| |Block, Carter, De La | |Ammiano, |
| |Torre, De Leon, Hall, | |Charles Calderon, Davis, |
| |Hayashi, Hernandez, | |Fuentes, Hall, Harkey, |
| |Bonnie Lowenthal, Hill, | |John A. Perez, Price, |
| |Salas | |Skinner, Solorio, |
| | | |Torlakson |
|-----+--------------------------+-----+--------------------------|
|Nays:|Adams, Conway, Gaines, | | |
| |Audra Strickland | | |
| | | | |
-----------------------------------------------------------------
SUMMARY : Requires long-term health care (LTC) facilities to
post, in accordance with prescribed requirements, the overall
facility rating information determined by the Centers for
Medicare and Medicaid Services (CMS). Specifically, this bill
requires:
1)The ratings be posted in specified, accessible locations and
specifies the content, paper and print size of the display.
2)The display to include notice that a detailed explanation of
the rating is maintained at the facility and is available upon
request, that this same information is available online at the
Nursing Home Care Compare Web site and that the Five-Star
Quality Rating System has strengths and limits.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, annual fee-supported special fund costs to the
Department of Public Health of less than $50,000 to continue
oversight of skilled nursing facilities and ensure compliance
with the specific requirements of the posting in this bill.
COMMENTS : According to the author, this bill is intended to
provide consumers additional information regarding a nursing
home's quality to assist the consumer in choosing a nursing
AB 215
Page 2
home. The author maintains that the federal CMS Five-Star
Quality Rating System distills detailed information about health
inspection reports, staffing, and quality measures of Medicare
and Medicaid-certified nursing homes into an easily understood
format. The author argues many consumers do not have access to
the Internet or cannot find CMS information electronically, and
that the posted ratings make this information much more
accessible. The author further argues that many consumers who
are unaware of the CMS rating system will learn of its existence
through the postings and be able to make more informed
decisions.
California has approximately 1,300 nursing facilities, the vast
majority of which are located in urban settings. Individuals
served in these homes include adults and children with
disabilities, the elderly, and individuals needing temporary
assistance while recovering from an illness or injury.
Oversight of nursing homes is a shared federal-state
responsibility. Under federal law, CMS determines standards
that nursing homes must meet to participate in the Medicare and
Medicaid programs and contracts with states to assess whether
homes meet these standards through annual surveys and complaint
investigations. A range of statutorily defined sanctions is
maintained to ensure homes are in compliance with federal
quality requirements.
In 2008, CMS launched a Five-Star Quality Rating System for
Nursing Homes. The new system assigns each nursing home a
rating between one and five stars. Nursing homes with five
stars are considered by CMS to have above average quality
compared to other nursing homes in the state. Those nursing
homes assigned one star, according to CMS, have quality below
the state average but still within Medicare's minimum
requirements. The overall five-star rating for each nursing
home is based on the results of health inspections, quality
measures, and staffing levels.
Supporters, of this bill, representing labor, consumer, and
senior advocacy groups, assert that requiring skilled nursing
facilities to prominently post quality of care ratings provides
consumers additional information to make a more informed
decision when choosing a nursing home. Supporters state that
despite some concerns with the CMS rating system, residents
deserve to be informed about current ratings issued by the
AB 215
Page 3
federal government.
Aging Services of California (ASC) argues in opposition that
small facilities are unfairly rated by CMS because their census
is too small to be statistically valid. ASC further notes that,
because the CMS Five-Star Quality Rating System is not a
reliable measure, the rating is of limited value to consumers,
and therefore, it is a disservice to both facilities and
consumers to require posting the ratings.
Analysis Prepared by : John D. Miller / HEALTH / (916)
319-2097
FN: 0000640