BILL ANALYSIS
AB 249
Page 1
Date of Hearing: March 31, 2009
ASSEMBLY COMMITTEE ON HEALTH
Dave Jones, Chair
AB 249 (Carter) - As Introduced: February 10, 2009
SUBJECT : Health facilities: marking patient devices.
SUMMARY : Mandates additional requirements for long-term care
health facilities (LTCFs) and establishes requirements for all
other health facilities regarding the identification and
tracking of personal patient equipment and personal property.
Specifically, this bill :
1)Adds the following to the written patient personal property
inventory already established in existing law for LTCFs:
a) Requires the inventory to include a listing, by a unique
identification number, of all patient-owned mobility,
hearing, eating, or breathing equipment, including, but not
limited to, canes, walkers, wheelchairs, hearing aids,
oxygen equipment, and denture containers; and,
b) Provides, if the equipment does not have a serial number
or other unique identification number, the LTCF may assign
a unique identification number and place a tag with that
number on the item.
2)Requires all other health facilities that are not LTCFs to do
the following:
a) Create a log to track, by serial number or other unique
identification number, all patient-owned mobility, hearing,
eating, or breathing equipment, including, but not limited
to, canes, walkers, wheelchairs, hearing aids, oxygen
equipment, and denture containers.
b) Assign a unique identification number and affix a tag
with that number to the item, if the item does not already
have a serial number or other unique identification number.
EXISTING LAW :
1)Provides for the licensure and regulation of health facilities
by the Department of Public Health (DPH).
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2)Defines a health facility to include a: general acute care
hospital; acute psychiatric hospital; skilled nursing
facility; intermediate care facility; intermediate care
facility-developmentally disabled habilitative; special
hospital; intermediate care facility-developmentally disabled;
intermediate care facility-developmentally disabled-nursing;
congregate living health facility; correctional treatment
center; and, nursing facility.
3)Defines a LTCF as: a skilled nursing facility; an intermediate
care facility; an intermediate care facility-developmentally
disabled; an intermediate care facility-developmentally
disabled habilitative; intermediate care
facility-developmentally disabled-nursing; congregate living
health facility; nursing facility; and, a pediatric day health
and respite care facility, as specified.
4)Requires a theft and loss program to be implemented by LTCFs.
5)Requires the theft and loss program to include the following:
a) Establishment and posting of the facility's policy
regarding theft and investigative procedures;
b) Orientation to the policies and procedures for all
employees within 90 days of employment;
c) Documentation of lost and stolen patient property with a
value of twenty-five dollars ($25) or more; and,
d) Documentation, upon request, of theft and loss recorded
for the past 12 months to be made available to DPH, the
county health department, or law enforcement agencies, and
to the office of the State Long-Term Care Ombudsman in
response to a specific complaint.
6)Requires the documentation in 5) above to include the
following:
a) A description of the article;
b) Its estimated value;
c) The date and time the theft or loss was discovered;
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d) If determinable, the date and time the loss or theft
occurred; and,
e) The action taken.
7)Requires LTCF's to do all of the following:
a) Establish a written patient personal property inventory
upon admission and to retain it during the resident's stay
in the LTCF;
b) Provide a copy of the written inventory to the resident
or the person acting on the resident's behalf;
c) Add or delete subsequent items brought into or removed
from the facility from the personal property inventory at
the written request of the resident, the resident's family,
a responsible party, or a person acting on behalf of a
resident;
d) Be absolved of liable for items which have not been
requested to be included in the inventory or for items
which have been deleted from the inventory;
e) Make available a copy of the current inventory upon
request of the resident, responsible party, or other
authorized representative;
f) Inventory and surrender a resident's personal effects
and valuables, upon discharge, to the resident or
authorized representative in exchange for a signed receipt;
g) Inventory and surrender personal effects and valuables
following the death of a resident to the authorized
representative in exchange for a signed receipt;
h) Document, at least semiannually, the facility's efforts
to control theft and loss, including the review of theft
and loss documentation and investigative procedures and
results of the investigation by the administrator and, when
feasible, the resident council;
i) Establish a method of marking, to the extent feasible,
personal property items for identification purposes upon
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admission and, as added to the property inventory list,
including engraving of dentures and tagging of other
prosthetic devices;
j) Report to a law enforcement agency within 36 hours when
the administrator of the facility has reason to believe
patient property with a then current value of one hundred
dollars ($100) or more has been stolen;
aa) Make available copies of reports referenced in j) above
for the preceding 12 months to DPH and law enforcement
agencies;
bb) Maintain a secured area for patients' property which is
available for safekeeping of patient property upon the
request of the patient or the patient's responsible party;
cc) Provide a lock for the resident's bedside drawer or
cabinet upon request of and at the expense of the resident,
the resident's family, or authorized representative; and,
dd) Notify all current residents and all new residents, upon
admission, of the facility's policies and procedures
relating to the facility's theft and loss prevention
program;
FISCAL EFFECT : This bill has not yet been analyzed by a fiscal
committee.
COMMENTS :
1)PURPOSE OF THIS BILL . While existing law already requires
that LTCFs have to institute a theft and loss program,
according to the author, there is a growing problem of medical
equipment theft. The author maintains that the victims -
largely the elderly and disabled - find that they cannot file
a police report because they cannot properly identify the
equipment by serial number. The author argues that LTCFs
generally do not have a policy for marking or otherwise
identifying by owner a patient's vital mobility, hearing,
eating, or breathing equipment such as canes, walkers, hearing
aids, denture containers, and oxygen equipment. Failure to
mark such equipment, the author further argues, creates
confusion for both patients and staff because different
patients often have similar equipment, impeding law
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enforcement efforts to protect seniors.
2)DPH COMPLAINT INVESTIGATIONS . The Licensing and Certification
Division of DPH is required by existing law to investigate
consumer complaints about health care facilities and incidents
reported by facilities. These complaints may be received via
telephone, mail, personal contact, or during a facility
inspection. Once a complaint is received by DPH, a complaint
or incident inspection is conducted. DPH reviews patient
personal property inventory during such an investigation.
Over the last two calendar years (from January 1, 2007 to
December 31, 2008) DPH has received a total of 560 intakes
(including complaints and entity reported incidents) from
LTCF's of "Misappropriation of Property" the allegation
category that captures incidents such as theft and loss.
3)SUPPORT . AARP, the American Federation of State, County and
Municipal Employees and the California Advocates for Nursing
Home Reform (CANHR) support this bill's intent to decrease the
amount of theft and loss within health facilities. AARP
states that nursing home residents need additional securities
for their personal property due to their frailty. CANHR
states that loss and theft of possessions remains one of the
most common and frustrating problems for nursing home
residents and their families.
4)OPPOSE : The California Hospital Association (CHA) is opposed
to this bill and states that the proposed changes are overly
prescriptive and unnecessary. CHA believes that current law
is sufficient to ensure that patient rights are protected and
that health facilities have appropriate and necessary
flexibility to develop and implement effective procedures for
the tracking of personal patient equipment. CHA also states
that the changes required in this bill will increase costs
significantly for health facilities.
5)OPPOSE UNLESS AMENDED . The California Association of Health
Facilities (CAHF) is opposed unless amended to this bill and
argues that LTCFs are already required to have theft and loss
policies for a patient's personal items, and if the facility
fails to make reasonable efforts to safeguard a patient's
personal property, they are required to reimburse the patient
or replace stolen or lost patient property at the item's
current value. CAHF also indicates that it might not be
possible for a facility to assign a unique identification
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number or to tag certain items such as eating utensils whose
marking may not withstand the wear and tear of cleaning or
hearing aids where markings may damage the equipment.
Additionally, CAHF states that despite efforts on the part of
LTCF's to inform residents and family of the inventory upon
admission, families continue to bring items in and out of the
facility without regard to the process of updating the
inventory. This constant exchange of personal property,
according to CAHF, leaves LTCFs responsible for the on-going
exchange of items.
6)PREVIOUS LEGISLATION . AB 2047 (Katz), Chapter 1199, Statutes
of 1998, establishes the theft and loss protections in LTCF's
that this bill would amend.
7)COMMENTS AND QUESTIONS .
a) Author's Amendments . The author plans to address the
concerns raised by CAHF and CHA by accepting the following
amendments:
i) On Page 3, lines 6-13, include:
The inventory shall include a listing, by a unique
identification number, of all patient-owned mobility,
hearing, eating , or breathing equipment, including, but
not limited to canes, walkers, wheelchairs, hearing aids,
oxygen equipment, and denture containers, to the extent
that these items are not subject to frequent removal from
the facility . If the equipment does not have a serial
number or other unique identification number, at the
request of the resident, resident's family, or a
responsible party , the long-term health care facility may
assign a unique identification number and place a tag
with that number on the item if feasible and if it would
not cause damage to the item .
ii) On Page 4, lines 14-23, delete paragraph referencing
requirements for all other health facilities narrowing
focus of this bill to just LTCF's:
1289.6. A health facility, except for a long-term health
care facility, shall create a log to track, by serial
number or other unique identification number, all
patient-owned mobility, hearing, eating, or breathing
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equipment, including, but not limited to, canes, walkers,
wheelchairs, hearing aids, oxygen equipment, and denture
containers. If the item does not have a serial number or
other unique identification number, the health facility
may assign it a unique identification number and affix a
tag with that number to the item. The log shall be
searchable by both patient and unique identification
number.
b) Amendments : As proposed to be amended, this bill would
be limited to LTCFs, and would establish what could be
potentially a loophole in the requirement for LTCFs to
inventory and track patient devices using a unique
identification number. With the amendments, LTCFs could
identify patient devices as "subject to frequent removal
from the facility" and therefore have no new obligation to
track, number, and inventory patient property.
REGISTERED SUPPORT / OPPOSITION :
Support
California Senior Legislature (sponsor)
AARP California
American Federation of State, County and Municipal Employees
California Advocates for Nursing Home Reform
California Alliance for Retired Americans
Opposition
California Hospital Association
Analysis Prepared by : Tanya Robinson-Taylor / HEALTH / (916)
319-2097