BILL ANALYSIS �
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|SENATE RULES COMMITTEE | SB 895|
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UNFINISHED BUSINESS
Bill No: SB 895
Author: Corbett (D)
Amended: 8/22/14
Vote: 21
SENATE HUMAN SERVICES COMMITTEE : 5-0, 4/8/14
AYES: Liu, Berryhill, DeSaulnier, Hancock, Wyland
SENATE APPROPRIATIONS COMMITTEE : 7-0, 5/23/14
AYES: De Le�n, Walters, Gaines, Hill, Lara, Padilla, Steinberg
SENATE FLOOR : 36-0, 5/28/14
AYES: Anderson, Beall, Berryhill, Block, Cannella, Corbett,
Correa, De Le�n, DeSaulnier, Evans, Fuller, Gaines, Galgiani,
Hancock, Hernandez, Hill, Hueso, Huff, Jackson, Knight, Lara,
Leno, Lieu, Liu, Mitchell, Monning, Morrell, Nielsen, Padilla,
Pavley, Roth, Steinberg, Torres, Vidak, Wolk, Wyland
NO VOTE RECORDED: Calderon, Walters, Wright, Yee
ASSEMBLY FLOOR : 61-11, 8/26/14 - See last page for vote
SUBJECT : Residential are facilities for the elderly:
unannounced visits
SOURCE : California Advocates for Nursing Home Reform
DIGEST : This bill adds additional requirements to the
Residential Care Facilities for the Elderly Act (RCFE) and
requires the Department of Social Services (DSS) to post
specified licensing information on its Internet Web site and
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provide additional information on the projected costs of
conducting annual licensing inspections for RCFEs.
Assembly Amendments revise and recast the bill by deleting the
requirements for DSS to inspect each RCFE at least once a year
and post reports on the results of each inspection on its
Internet Web site, and instead require DSS to provide additional
information on the projected costs of conducting annual
inspections and post information on its Internet Web site on how
to obtain an inspection report; also adds legislative intent for
DSS to make inspection reports available on its Internet Web
site by January 1, 2020.
ANALYSIS : Existing law:
1.Establishes the RCFE Act which provides for DSS to license and
regulate RCFEs as a separate category within the existing
residential care licensing structure of DSS.
2.Provides that RCFEs shall be subject to unannounced visits by
DSS and that DSS shall visit facilities as often as necessary
to ensure the quality of care provided.
3.Requires annual unannounced inspections when a license is on
probation, when required by the terms of a facility compliance
plan, when an accusation is pending, when required for federal
financial participation, or to verify that a person who has
been ordered out of the facility is no longer present.
4.Requires DSS to perform random inspections each year on no
fewer than 20% of the RCFE facilities not subject to annual
inspections. Provides that this percentage shall increase by
10% if the total citations issued by DSS exceeds the previous
year by 10%. As a result of this trigger, DSS currently is
required to perform random inspections on 30% of the RCFE
facilities not subject to annual inspection. Requires DSS to
visit every facility no less than every five years.
5.Requires DSS to visit a newly licensed facility within 90 days
after a facility accepts its first resident to evaluate
compliance with regulatory requirements.
6.Permits any person to request an inspection of any RCFE by
transmitting notice of an alleged violation orally or in
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writing. Requires DSS to make a preliminary review and an
onsite inspection within 10 days after receiving the complaint
except where the visit would adversely affect the licensing
investigation or the investigation of other agencies,
including, but not limited to, law enforcement agencies.
7.Through regulation, requires DSS to conduct a follow-up visit
within 10 working days following the latest date of correction
specified in the notice of deficiency, unless the licensee has
demonstrated that the deficiency was corrected as required.
Provides that no penalty shall be assessed unless a follow-up
visit is conducted.
This bill:
1.Brings statute into alignment with regulations pertaining to
the time period a RCFE must remedy a deficiency, as specified.
2.Provides that the failure to remedy a deficiency within the
prescribed timeline would result in a misdemeanor.
3.Requires DSS to post on its Internet Web site information on
how to obtain an inspection report, and would state the intent
of the Legislature that the department make inspection reports
available on its Internet Web site by January 1, 2020.
4.Requires DSS to design, or cause to be designed, a poster that
contains information on the appropriate reporting agency in
case of a complaint or emergency.
5.Requires RCFEs to post the poster in the main entry way of its
facility, and would provide that a violation of this provision
is a misdemeanor under the act.
6.Requires DSS to report the projected costs of conducting
annual inspections of residential care facilities for the
elderly beginning January 1, 2018.
7.Requires DSS to provide the Office of the State Long-Term Care
(LTC) Ombudsman a precautionary notification for the purposes
of providing advocacy services to residents if the Director is
"reasonably contemplating" issuing a temporary suspension
order (TSO) to a RCFE or revoking a facility's license.
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8.Requires DSS to contact the Office of the State LTC Ombudsman
and local placement and advocacy agencies, as specified, and
to notify local agencies and the licensee if DSS has issued
the facility a TSO or has revoked the facility's license.
9.Deletes misdemeanor exemptions for the failure of a
residential facility for the elderly to remedy an identified
deficiency within a specified time period or for failing to
post specified reporting information.
Background
According to the author's office, California's current
inspection requirements for RCFEs fail to adequately ensure the
health and safety of our fast growing elderly population. A
series of recent events has drawn attention to questions about
the adequacy of DSS oversight and the state's ability to protect
people who reside in RCFEs.
In July 2013, ProPublica and Frontline reporters wrote and
produced a series of stories on Emeritus, the nation's largest
RCFE provider. Featured in the article was a woman who died
after receiving poor care at in a facility in Auburn,
California. The series documented chronic understaffing and a
lack of required assessments and substandard care.
Reports in September 2013, prompted by a consumer watchdog
group that had hand-culled through stacks of documents in San
Diego, revealed that more than two dozen seniors had died in
recent years in RCFEs under questionable circumstances that
went ignored or unpunished by CCL.
In late October 2013, 19 frail seniors were abandoned at
Valley Springs Manor in Castro Valley by the licensee and all
but two staff after the state began license revocation
proceedings. DSS inspectors, noting the facility had been
abandoned, left the two unpaid service staff to care for the
abandoned residents with insufficient food and medication,
handing them a $3,800 citation before leaving for the weekend.
The next day sheriff's deputies and paramedics sent the
patients to local hospitals.
Prior Legislation
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AB 313 (Monning, Chapter 365, Statutes of 2011) requires each
RCFE to provide residents, their responsible party, and the
local long-term care ombudsman with a 10 day written notice when
DSS commences proceedings to suspend or revoke its license, or a
criminal action relating to health or safety of the residents is
brought against the facility, and makes other changes related to
these actions.
AB 2066 (Monning, Chapter 643 Statutes of 2012) requires RCFEs
to provide a 60-day written notice to residents or the
responsible person within 24 following receipt of DSSs order of
revocation. Permits the licensee to secure an alternative
manager, as specified. Requires RCFEs to refund all or a portion
of preadmission fees to residents transferring as the result of
a license revocation, as specified.
SB 897 (Leno, Chapter 376, Statutes of 2011) requires licensed
RCFEs to notify DSS, the Office of the State Long-Term Care
Ombudsman and the facility's residents when the property is
subject to foreclosure or certain other events occur due to
financial distress.
AB 419 (Mitchell, 2011) would have required every community care
facility licensed by DSS to be inspected unannounced at least
once per year using research based, field tested inspection
protocols, as specified. This bill died in the Assembly
Appropriations Committee.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
According to the Assembly Appropriations Committee:
Ongoing costs to DSS of approximately $5 million General Fund
(GF) once the inspection frequency has increased to at least
annually for all RCFEs.
Initial costs to DSS in the low millions (GF) annually for
approximately three years during the inspection frequency
phase-in period.
Ongoing costs to DSS in the low hundreds of thousands for
project development, testing and maintenance and other related
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IT contract work necessary to make inspection result details
available on its Web site.
Ongoing costs to DSS of approximately $50,000 (GF) to verify
that deficiencies have been corrected within 10 days of
notification to the facility.
SUPPORT : (Verified 8/26/14)
California Advocates for Nursing Home Reform (source)
Assisted Living Consumer Alliance
California Commission on Aging
California Continuing Care Residents Association
California Long-Term Care Ombudsman Association
Consumer Attorneys of California
County of San Diego
Disability Rights California
Elder Law & Advocacy
Jewish Family Services
Johnson Moore, Trial Lawyers
National Consumer Voice for Quality Long Term Care
National Senior Citizens Law Center
Ombudsman Services of Contra Costa
Valentine Law Group
OPPOSITION : (Verified 8/26/14)
Community Residential Care Association of California
ARGUMENTS IN SUPPORT : Many supporters of this bill state that
California's current inspection system is one of the weakest in
the country and that for most RCFEs, the state is using an
experimental "key indicator" inspection protocol, which is an
abbreviated version of a comprehensive inspection. Supporters
claim this is a recipe for neglect and abuse. The supporters
state by requiring annual, comprehensive inspections of RCFEs,
oversight will be improved, RCFE residents' rights will be
enhanced, and care standards will be modernized.
ARGUMENTS IN OPPOSITION : The Community Residential Care
Association of California opposes this bill, arguing "This bill
deletes current language authorizing the Department to determine
a workable correction timeline. In some cases, deficiencies
make take more than 10 days to correct. The current language
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allows the Department to determine the timeline based on the
violation."
ASSEMBLY FLOOR : 61-11, 8/26/14
AYES: Achadjian, Alejo, Ammiano, Bigelow, Bloom, Bocanegra,
Bonilla, Bonta, Bradford, Brown, Buchanan, Ian Calderon,
Campos, Chau, Ch�vez, Chesbro, Cooley, Dababneh, Daly,
Dickinson, Eggman, Fong, Fox, Frazier, Garcia, Gatto, Gomez,
Gonzalez, Gordon, Gorell, Gray, Hall, Roger Hern�ndez, Holden,
Jones-Sawyer, Levine, Lowenthal, Medina, Melendez, Mullin,
Nazarian, Nestande, Olsen, Pan, Perea, John A. P�rez, V.
Manuel P�rez, Quirk, Quirk-Silva, Rendon, Ridley-Thomas,
Rodriguez, Salas, Skinner, Stone, Ting, Weber, Wieckowski,
Williams, Yamada, Atkins
NOES: Allen, Conway, Donnelly, Grove, Harkey, Jones, Linder,
Logue, Maienschein, Mansoor, Wilk
NO VOTE RECORDED: Dahle, Beth Gaines, Hagman, Muratsuchi,
Patterson, Wagner, Waldron, Vacancy
JL:AL:nld 8/27/14 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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