Bill Text: CA AB1996 | 2013-2014 | Regular Session | Introduced
Bill Title: Long-term health care facilities: quality of care.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2014-03-25 - In committee: Set, first hearing. Hearing canceled at the request of author. [AB1996 Detail]
Download: California-2013-AB1996-Introduced.html
BILL NUMBER: AB 1996 INTRODUCED
BILL TEXT
INTRODUCED BY Assembly Member Brown
FEBRUARY 20, 2014
An act to amend Sections 1420 and 1422 of the Health and Safety
Code, relating to health facilities.
LEGISLATIVE COUNSEL'S DIGEST
AB 1996, as introduced, Brown. Long-term health care facilities:
quality of care.
Existing law establishes the State Department of Public Health and
sets forth its powers and duties, including, but not limited to, the
licensure and regulation of health facilities, including, but not
limited to, long-term health care facilities, as defined.
Existing law requires inspection of a long-term health care
facility at least once every 2 years.
This bill instead would require inspection at least once every
year and would delete obsolete references to a health facility
inspection pilot program.
Existing law authorizes the appointment of a temporary manager or
receiver to operate a long-term health facility if certain conditions
exist.
This bill would authorize the inspector to refer the matter for
appointment of a temporary manager or receiver under those provisions
if he or she finds that conditions at the facility indicate the need
for the appointment.
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
state 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 state 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 state department shall make an onsite
inspection or investigation within 24 hours of the receipt of the
complaint. In any event, the complainant shall be promptly informed
of the state 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 state 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 state 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) Within 10 working days of the completion of the complaint
investigation, the state department shall notify the complainant and
licensee in writing of the department's determination as a result of
the inspection or investigation.
(4) In addition, if the inspection demonstrates that conditions
exist indicating the need for appointment of a temporary manager or
receiver pursuant to Article 8 (commencing with Section 1325) of
Chapter 2, the inspector shall immediately refer the matter to the
director along with his or her findings and recommendations.
(b) Upon being notified of the state department's determination as
a result of the inspection or investigation, a complainant who is
dissatisfied with the state 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 state
department of the right to an informal conference, as set forth in
this section. The complainant may, within five business 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 which 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 state 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 state 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 state 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 state 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 such a
violation.
SEC. 2. Section 1422 of the Health and Safety Code is amended to
read:
1422. (a) The Legislature finds and declares that it is the
public policy of this state to ensure that long-term health care
facilities provide the highest level of care possible. The
Legislature further finds that inspections are the most effective
means of furthering this policy. It is not the intent of the
Legislature by the amendment of subdivision (b) enacted by Chapter
1595 of the Statutes of 1982 to reduce in any way the resources
available to the state department for inspections, but rather to
provide the state department with the greatest flexibility to
concentrate its resources where they can be most effective. It is the
intent of the Legislature to create a survey process that includes
state-based survey components and that determines compliance with
federal and California requirements for certified long-term health
care facilities. It is the further intent of the Legislature to
execute this inspection in the form of a single survey process, to
the extent that this is possible and permitted under federal law. The
inability of the state to conduct a single survey in no way exempts
the state from the requirement under this section that state-based
components be inspected in long-term health care facilities as
required by law.
(b) (1) (A) Notwithstanding
Section 1279 or any other provision of law, without providing notice
of these inspections, the department, in addition to any inspections
conducted pursuant to complaints filed pursuant to Section 1419,
shall conduct inspections annually, except with regard to those
facilities which have no class "AA," class "A," or class "B"
violations in the past 12 months. The state department shall also
conduct inspections as may be necessary to ensure the health, safety,
and security of patients in long-term health care facilities. Every
facility shall be inspected at least once every two years
year . The department shall vary the cycle in
which inspections of long-term health care facilities are conducted
to reduce the predictability of the inspections.
(B)
(2) Inspections and investigations of long-term health
care facilities that are certified by the Medicare Program or the
Medicaid Program shall determine compliance with federal standards
and California statutes and regulations to the extent that California
statutes and regulations provide greater protection to residents, or
are more precise than federal standards, as determined by the
department. Notwithstanding any other provision of law, the
department may, without taking regulatory action pursuant to Chapter
3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title
2 of the Government Code, implement, interpret, or make specific this
paragraph by means of an All Facilities Letter (AFL) or similar
instruction. Prior to issuing an AFL or similar instruction, the
department shall consult with interested parties and shall inform the
appropriate committees of the Legislature. The department shall also
post the AFL or similar instruction on its Web site so that any
person may observe which California laws and regulations provide
greater protection to its residents or are more precise than federal
standards. Nothing in this subdivision is intended to change existing
statutory or regulatory requirements governing the care provided to
long-term health care facility residents.
(C)
(3) In order to ensure maximum effectiveness of
inspections conducted pursuant to this article, the department shall
identify all state law standards for the staffing and operation of
long-term health care facilities. Costs of the additional survey and
inspection activities required by Chapter 895 of the Statutes of 2006
shall be included as Licensing and Certification Program activities
for the purposes of calculating fees in accordance with Section 1266.
(2) The state department shall submit to the federal Department of
Health and Human Services on or before July 1, 1985, for review and
approval, a request to implement a three-year pilot program designed
to lessen the predictability of the long-term health care facility
inspection process. Two components of the pilot program shall be (A)
the elimination of the present practice of entering into a one-year
certification agreement, and (B) the conduct of segmented inspections
of a sample of facilities with poor inspection records, as defined
by the state department. At the conclusion of the pilot project, an
analysis of both components shall be conducted by the state
department to determine effectiveness in reducing inspection
predictability and the respective cost benefits. Implementation of
this pilot project is contingent upon federal approval.
(c) Except as otherwise provided in subdivision (b), the state
department shall conduct unannounced direct patient care inspections
at least annually to inspect physician and surgeon services, nursing
services, pharmacy services, dietary services, and activity programs
of all the long-term health care facilities. Facilities evidencing
repeated serious problems in complying with this chapter or a history
of poor performance, or both, shall be subject to periodic
unannounced direct patient care inspections during the inspection
year. The direct patient care inspections shall assist the state
department in the prioritization of its efforts to correct facility
deficiencies.
(d) All long-term health care facilities shall report to the state
department any changes in the nursing home administrator or the
director of nursing services within 10 calendar days of the changes.
(e) Within 90 days after the receipt of notice of a change in the
nursing home administrator or the director of nursing services, the
state department may conduct an abbreviated inspection of the
long-term health care facilities.
(f) If a change in a nursing home administrator occurs and the
Board of Nursing Home Administrators notifies the state department
that the new administrator is on probation or has had his or her
license suspended within the previous three years, the state
department shall conduct an abbreviated survey of the long-term
health care facility employing that administrator within 90 days of
notification.
