Amended in Assembly May 23, 2014

Amended in Assembly April 7, 2014

California Legislature—2013–14 Regular Session

Assembly Bill No. 1816

Introduced by Assembly Member Yamada

February 18, 2014

An act to amend Section 1420 of the Health and Safety Code, relating to long-term health care facilities.

LEGISLATIVE COUNSEL’S DIGEST

AB 1816, as amended, Yamada. Long-term health care facilities.

(1) Existing law provides for the licensure and regulation by the State Department of Public Health of health care facilities, including 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.

This bill begin insert , on or before July 1, 2015, end insert would require the department to begin delete complete its investigation of the complaint within 40 working days of its receipt, except that this period may be extended up to an additional 30 days if the department has diligently attempted, but has not been able, to obtain necessary evidence related to the investigation end delete begin insert set a performance benchmark for completing its investigations within a defined number of days after receiving the complaint, not to exceed 60 working days end insert . The bill would require the department, if it extends an investigation beyond begin delete 40 working days end delete begin insert the number of days specified in the benchmark end insert , to notify the complainant, in writing, of the basis for the extension. begin delete The bill would also require, if the investigation exceeds 70 working days due to circumstances beyond the department’s control, that the department notify the complainant in writing and by telephone or e-mail of the delay in the investigation and the reason for the delay. end delete The bill would require, effective July 1, 2015, begin insert and upon request of the complainant, end insert that the begin delete department’s written determination end delete begin insert department end insert provide specific findings concerning begin delete each end delete begin insert an end insert alleged violation, and include a summary of the evidence upon which the determination is based. The bill would require the department to comply with those specified time periods established for investigations and inspections of complaints from a facility of an alleged violation of applicable requirements of state or federal law or any alleged facts that may constitute an alleged violation of these requirements. begin insert The bill would require the department to analyze its compliance with the benchmark in its annual system and staffing analysis to make that analysis available to the relevant fiscal and policy committees of the Legislature, and to post it on the department’s Internet Web site. end insert

(2) 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.

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

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

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

SECTION 1.  

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

1420.  

(a) (1) Upon receipt of a written or oral complaint, the
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 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 department shall make an onsite inspection
or investigation as soon as practicable, and in no case more than
24 hours of the receipt of the complaint. In any event, the
complainant shall be promptly informed of the 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 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 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)  begin delete The end delete begin insert On or before July 1, 2015, the end insert department shall begin delete complete
its end delete begin insert set a performance benchmark for completing its end insert investigation
begin delete within 40 working days from receipt of end delete begin insert within a defined number
of days after receiving end insert the complaint. begin delete The 40-working-day period
may be extended up to an additional 30 days if the department has
diligently attempted, but has not been able to obtain, necessary
evidence related to the investigation. The department shall analyze
its compliance with this requirement in its annual system and
staffing analysis prepared pursuant to subparagraph (B) of
paragraph (2) of subdivision (d) of Section 1266. This analysis
shall include, but not be limited to, a tabulation of open
investigations and completed investigations that summarizes the
number of extensions and their duration. end delete begin insert The performance
benchmark may be less than, but shall not exceed, 60 working
days. end insert

(4) If the department extends an investigation beyond begin delete 40
working days end delete begin insert the number of days specified in the performance
benchmark end insert , it shall notify the complainant, in writing, of the basis
for the extension, and shall include in the notice begin delete any outstanding
evidence and the sources from which the evidence has been sought, end delete
begin insert the status of the investigation end insert and the anticipated completion date.
begin delete In the unusual event that an investigation must be extended beyond
70 working days due to circumstances beyond the department’s
control, the department shall notify the complainant in writing and
by telephone or e-mail of the delay in the investigation and the
reason for the delay. end delete The department shall, thereafter, complete
the investigation as expeditiously as possible.

(5) Within 10 working days of the completion of the complaint
investigation, the department shall notify the complainant and
licensee, in writing, of the department’s determination as a result
of the inspection or investigation.

(6) Effective July 1, 2015, begin insert upon request of the complainant, end insert the
begin delete department’s written determination end delete begin insert department end insert shall provide
specific findings concerning begin delete each end delete begin insert an end insert alleged violation, and shall
include a summary of the evidence upon which the determination
is made. The written determination shall not disclose the names
of individual residents.

(b) Upon being notified of the department’s determination as a
result of the inspection or investigation, a complainant who is
dissatisfied with the 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 department of the
right to an informal conference, as set forth in this section. The
complainant may, within 15 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 that 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 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 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 three working days of the final
determination, unless the licensee agrees in writing to an extension
of this time. 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 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 department shall also notify the
facility that it is unlawful to discriminate or seek retaliation against
a resident, employee, or complainant.

(f) For purposes of this section, “complaint” means any oral or
written 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
of these requirements.

(g) The department shall apply the timeframes for investigation
or inspection 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.

(h)  begin delete (1) end delete begin delete   end delete It is the intent of the Legislature in enacting the
amendments that added this subdivision that the department
endeavor to complete investigations of complaints begin delete made on behalf
of a resident of a long-term health care facility within 40 days end delete
begin insert within the benchmark established pursuant to this section end insert .

begin delete

(2) It is also the intent of the Legislature that only those
complaints that require additional time because the department
has diligently attempted, but has been unable, to obtain necessary
evidence related to the investigation receive an extension of up to
30 days, as necessary to complete the investigation.

end delete begin delete

(3) It is the Legislature’s further intent that after 70 working
days, if a complaint investigation has not been completed, the
department shall contact the complainant to share with the
complainant the status of the complaint and the reason for the delay
to the extent that the information can be shared.

end delete begin insert

(i) The department shall analyze its compliance with the
benchmark developed pursuant to paragraph (3) of subdivision
(a) in its annual system and staffing analysis prepared pursuant
to paragraph (2) of subdivision (d) of Section 1266. The analysis
required pursuant to this subdivision shall be made available to
the relevant fiscal and policy committees of the Legislature and
shall be posted on the department’s Internet Web site. The analysis
shall provide data on the department’s performance and shall
include, at a minimum, a tabulation of all of the following:

end insert begin insert

(1) Open investigations.

end insert begin insert

(2) Completed investigations.

end insert begin insert

(3) Number and percentage of investigations that meet the
benchmark.

end insert begin insert

(4) Average length of time to complete an investigation.

end insert