(1) Existing law provides for the licensing and regulation of health facilities, including, but not limited to, long-term health care facilities, as defined, by the State Department of Health Care Services. Existing law requires a contract for admission to a long-term care facility to state that a resident shall not be involuntarily transferred within, or discharged from, a long-term health care facility unless the resident is given reasonable notice in writing, and transfer or discharge planning, as specified. Willful or repeated violations of the provisions relating to long-term health care facilities is a misdemeanor.

This bill would, consistent with federal law, require long-term health care facilities to provide residents with a notice of transfer or discharge at least 30 days before a resident is transferred or discharged, unless an exception applies. The bill would require the notice of transfer or discharge to be signed by the resident or the resident’s representative and by a facility staff member who declares they delivered the notice to the resident or the resident’s representative. The bill would make a violation of these provisions a class “B” violation and would make knowingly making a false verification regarding the delivery of a notice of transfer or discharge a willful violation for purposes of the criminal provision described above.

The bill would require a notice of discharge or transfer to be provided to a resident or the resident’s representative in a translated or accessible format at the same time as the written notice in English if the resident’s primary language is not English or if the resident is vision impaired or blind, as specified. The bill would also require the translated or accessible-format notices to be made available to the local long-term care ombudsman upon request. The bill would require the translator to attest to the accuracy of the translation, thereby expanding the crime of perjury. The bill would require a resident’s primary language or sensory impairments to be included in the minimum dataset maintained by the facility. The bill would make a violation of these provisions a class “B” violation subject to a $1,000 civil penalty.

Existing law requires that a copy of the notice of transfer or discharge be sent to the local long-term care ombudsman at the same time notice is provided to the resident or the resident’s representative by facsimile machine, email, or first class mail, as specified. Existing law requires, if a resident is subject to a facility-initiated transfer to a general acute care hospital on an emergency basis, the notice to be provided to the local long-term care ombudsman as soon as practicable.

This bill would instead require the notices described above to be sent to the long-term care ombudsman by facsimile, email, or other electronic means. For emergency transfer notices, the bill would require a copy of the notice to be provided to the local long-term care ombudsman as soon as practicable, but in no event later than 24 hours after the transfer.

(2) Existing law requires the State Department of Public Health to establish an inspection and reporting system to ensure that long-term health care facilities are in compliance with state statutes and regulations. Existing law, the Medi-Cal Long-Term Care Reimbursement Act, requires, among other things, that long-term health care facilities timely comply with hearing decisions issued by the department’s Office of Administrative Hearings and Appeals for improperly transferring, discharging, or refusing to readmit a resident. Existing law authorizes the department to assess a penalty of $750 for each calendar day a facility fails to comply with the hearing decision and caps aggregate penalties for each individual hearing decision at $75,000.

The bill would require the State Department of Public Health to prohibit the admission of new residents to a long-term health care facility upon notification by the State Department of Health Care Services that a facility has failed to timely comply with a hearing decision. The bill would require the prohibition to remain in effect until the State Department of Health Care Services notifies the State Department of Public Health that the facility has achieved compliance, the maximum aggregate of penalties have been collected, or the facility has formally sought judicial review of the hearing decision.

The bill would increase the daily penalty described above to $1,000 for each calendar day and increase the maximum aggregate penalty amount to $100,000.