BILL ANALYSIS �
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THIRD READING
Bill No: SB 1153
Author: Leno (D), et al.
Amended: 4/10/14
Vote: 21
SENATE HUMAN SERVICES COMMITTEE : 5-0, 4/8/14
AYES: Liu, Berryhill, DeSaulnier, Hancock, Wyland
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
SUBJECT : Residential care facilities for the elderly
SOURCE : California Advocates for Nursing Home Reform
DIGEST : This bill authorizes the Department of Social
Services (DSS) to order a suspension of new admissions
prohibiting a residential care facility for the elderly (RCFE)
from admitting new residents if the facility has failed to pay a
fine assessed by DSS or if DSS finds that the facility has
violated applicable laws and the violation presents a direct or
immediate risk to the health, safety, or personal rights of a
resident and is not corrected immediately. Authorizes a
licensee to appeal the suspension and requires DSS to adopt
regulations that specify the appeal procedure.
ANALYSIS :
Existing law:
1.Establishes the RCFE Act which provides for DSS to license and
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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.Permits DSS to deny an application for a license or may
suspend or revoke any license due to a licensee's violation of
the RCFE Act or related regulations.
4.Permits DSS to assess civil penalties of not less than $25 and
not more than $50 per violation, per day for each violation
except where the seriousness of the violation warrants a
higher penalty, in no case to exceed $150 per day per
violation.
5.Provides that the failure of an applicant for licensure or a
licensee to pay all applicable and accrued fees and civil
penalties constitutes grounds for denial or forfeiture of a
license.
6.Provides that upon issuing eviction notices to residents or
submitting a closure plan due to license forfeiture or a
facility change of use, that an RCFE shall not accept new
residents for admission.
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.Permits DSS to order a suspension of new admissions, defined
as a prohibition on admitting new residents, for a facility in
either of the following circumstances:
A. The facility has violated statute or regulation and the
violation indicates that the facility presents a direct and
immediate risk to the health, safety or personal rights of
a resident or residents of the facility, and the violation
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is not corrected immediately.
B. The facility has failed to pay a fine assessed by DSS
after the facility's appeal rights have been exhausted.
1.Requires the suspension on new admissions due to a failure to
pay a fine to remain in effect until the facility pays the
fine assessed by DSS.
2.Requires a suspension of new admissions to remain in effect
until DSS determines that the facility has corrected the
violation. Requires DSS to conduct a follow-up visit to
determine compliance 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 in the notice. Permits
DSS to make unannounced visits after the suspension of new
admissions is lifted to ensure that the facility continues to
maintain correction of the violation. Permits DSS to order
another suspension of new admissions or take other appropriate
enforcement action if the facility does not maintain
correction of the violation.
3.Permits a licensee to appeal a suspension of new admissions,
as defined, to the DSS Director and requires DSS to adopt
regulations that specify the appeal procedure.
4.Prohibits a suspension of new admissions ordered under these
provisions from being stayed pending the facility's appeal or
request for review.
Background
Recent events . 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 receive services within
DSS-licensed facilities.
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
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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 the Community Care Licensing Division
(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 for
the facility. 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
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 hours 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 state's 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.
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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: Yes
SUPPORT : (Verified 4/29/14)
California Advocates for Nursing Home Reform (source)
AARP
Advocacy Inc of Santa Cruz and San Benito Counties
AFSCME
Alliance on Aging of Monterey County
Assisted Living Consumer Alliance
California Assisted Living Association
California Association of Public Authorities for IHSS
California Commission on Aging
California Continuing Care Residents Association
California Long Term Care Association
California Senior Legislature
Congress of California Seniors
Consumer Attorneys of California
Consumer Federation of California
County of San Diego
Elder Abuse Task Force of Santa Clara County
Elder Law and Advocacy, San Diego and Imperial Counties
Johnson Moore
Leading Age California
Long Term Care Ombudsman Services of San Luis Obispo County
National Consumer Voice for Long Term Care
National Senior Citizens Law Center
Ombudsman and HICAP Services of Northern California
Ombudsman Services of Contra Costa
Valentine Law Group
ARGUMENTS IN SUPPORT : California Advocates for Nursing Home
Reform (CANHR), the sponsor of this bill, states that recent
media and advocacy reports have uncovered major problems in
RCFEs. One area that has been universally criticized has been
enforcement of regulatory care standards by DSS. CANHR asserts
that currently, DSS has very few methods to ensure RCFE
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compliance with state standards.
CANHR believes this bill will help protect the state's frail and
vulnerable seniors in RCFEs by giving the DSS' CCL a powerful
new enforcement tool to ensure that RCFEs comply with critical
health and safety regulations and pay civil penalties and fines
that have been assessed against them.
JL:e 4/30/14 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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