Bill Text: CA AB1752 | 2011-2012 | Regular Session | Amended
Bill Title: Long-term health care facilities: bed hold: appeals.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2012-04-17 - In committee: Set, second hearing. Hearing canceled at the request of author. [AB1752 Detail]
Download: California-2011-AB1752-Amended.html
BILL NUMBER: AB 1752 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY APRIL 9, 2012
INTRODUCED BY Assembly Member Yamada
FEBRUARY 17, 2012
An act to amend Section 1599.1 of the Health and Safety Code,
relating to health care facilities.
LEGISLATIVE COUNSEL'S DIGEST
AB 1752, as amended, Yamada. Long-term health care facilities: bed
hold: appeals.
Under existing law, residents of long-term health care facilities
have certain rights, including the right to be readmitted to a
facility following a hospital stay, as specified, and the right, if
denied readmission by the facility, to appeal this decision.
Existing law establishes the State Health Facilities Citation
Penalties Account within the Special Deposit Fund, available upon
appropriation by the Legislature, for the protection of health or
property of residents of long-term health care facilities.
This bill would require the State Department of Health Care
Services, if readmission is ordered on appeal and the facility
refuses to readmit the resident, to assess a specified
civil penalty of an unspecified amount per day
against the facility each day, until the resident is
readmitted or a maximum penalty amount is reached . The
bill would require that these penalties be deposited into the State
Health Facilities Citation Penalties Account. The bill would require
the department to request that the Attorney General seek injunctive
relief and damages pursuant to specified provisions of law. The bill
would authorize the department to implement these provisions by means
of letters, provider bulletins, or other similar instructions.
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. This act shall be known, and may be cited, as the
Nursing Facility Bed Hold Protection Act of 2012.
SEC. 2. The Legislature finds and declares all of the following:
(a) The protection of residents in California's nursing facilities
is of paramount importance to the citizens of California.
(b) Sixty-four percent of California nursing facility residents
have all or part of their care paid for by Medi-Cal.
(c) Nearly 40 percent of nursing home residents are hospitalized
at least once during their residency.
(d) State and federal law guarantee that a hospitalized resident's
bed will be held for at least seven days if the resident elects. The
bed hold protects a resident's continuity of placement, ensures that
a decision to go to a hospital is unaffected by the risk of losing
his or her home, and protects residents from transfer trauma.
(e) Despite the bed hold requirements, nursing facilities often
refuse to hold a resident's bed, resulting in substantial costs to
the state in reimbursing acute care hospitals for administrative days
under Medi-Cal.
(f) A resident whose bed is not held may file a complaint with the
State Department of Public Health and request an appeal with the
State Department of Health Care Services.
(g) Even when a resident's appeal is granted and the nursing
facility is ordered to readmit the resident, many facilities refuse
to comply and do not suffer any adverse consequences.
(h) It is, therefore, the intent of the Legislature to enact
legislation that would do both of the following:
(1) Penalize nursing facilities that do not honor state and
federally required resident bed holds.
(2) Engage the Attorney General to consider an action to defend
the bed hold rights of nursing facility residents.
SEC. 3. Section 1599.1 of the Health and Safety Code is amended to
read:
1599.1. Written policies regarding the rights of patients shall
be established and shall be made available to the patient, any
guardian, next of kin, sponsoring agency or representative payee, and
the public. Those policies and procedures shall ensure that each
patient admitted to the facility has the following rights and is
notified of the following facility obligations, in addition to those
specified by regulation:
(a) The facility shall employ an adequate number of qualified
personnel to carry out all of the functions of the facility.
(b) Each patient shall show evidence of good personal hygiene and
be given care to prevent bedsores, and measures shall be used to
prevent and reduce incontinence for each patient.
(c) The facility shall provide food of the quality and quantity to
meet the patients' needs in accordance with physicians' orders.
(d) The facility shall provide an activity program staffed and
equipped to meet the needs and interests of each patient and to
encourage self-care and resumption of normal activities. Patients
shall be encouraged to participate in activities suited to their
individual needs.
(e) The facility shall be clean, sanitary, and in good repair at
all times.
(f) A nurses' call system shall be maintained in operating order
in all nursing units and provide visible and audible signal
communication between nursing personnel and patients. Extension cords
to each patient's bed shall be readily accessible to patients at all
times.
(g) (1) If a facility has a significant beneficial interest in an
ancillary health service provider or if a facility knows that an
ancillary health service provider has a significant beneficial
interest in the facility, as provided by subdivision (a) of Section
1323, or if the facility has a significant beneficial interest in
another facility, as provided by subdivision (c) of Section 1323, the
facility shall disclose that interest in writing to the patient, or
his or her representative, and advise the patient, or his or her
representative, that the patient may choose to have another ancillary
health service provider, or facility, as the case may be, provide
any supplies or services ordered by a member of the medical staff of
the facility.
(2) A facility is not required to make any disclosures required by
this subdivision to any patient, or his or her representative, if
the patient is enrolled in an organization or entity that provides or
arranges for the provision of health care services in exchange for a
prepaid capitation payment or premium.
(h) (1) If a resident of a long-term health care facility has been
hospitalized in an acute care hospital and asserts his or her rights
to readmission pursuant to bed hold provisions, or readmission
rights of either state or federal law, and the facility refuses to
readmit him or her, the resident may appeal the facility's refusal.
Appeal hearings shall be conducted by the State Department of Health
Care Services.
(2) The refusal of the facility as described in this subdivision
shall be treated as if it were an involuntary transfer under federal
law, and the rights and procedures that apply to appeals of transfers
and discharges of nursing facility residents shall apply to the
resident's appeal under this subdivision.
(3) If the resident appeals pursuant to this subdivision, and the
resident is eligible under the Medi-Cal program, the resident shall
remain in the hospital and the hospital may be reimbursed at the
administrative day rate, pending the final determination of the
hearing officer, unless the resident agrees to placement in another
facility.
(4) If the resident appeals pursuant to this subdivision, and the
resident is not eligible under the Medi-Cal program, the resident
shall remain in the hospital if other payment is available, pending
the final determination of the hearing officer, unless the resident
agrees to placement in another facility.
(5) If the resident is not eligible for participation in the
Medi-Cal program and has no other source of payment, the hearing and
final determination shall be made within 48 hours.
(6) If readmission is ordered on appeal and the facility refuses
to readmit the resident after it receives the decision, the State
Department of Health Care Services shall provide for the resident's
readmission. The department shall assess a civil penalty of
____dollars ($____) per day five hundred dollars
($500) per day, and the amount of the penalty shall increase by five
hundred dollars ($500) each subsequent day until it reaches five
thousand dollars ($5,000) on the 10th da y. Thereafter,
the penalty amount shall be five thousand dollars ($5,000) per day,
until the total amount assessed is one hundred thousand dollars
($100,000), or against the facility until the resident is
readmitted. Penalties collected pursuant to this paragraph shall be
deposited into the State Health Facilities Citation Penalties Account
created pursuant to Section 1417.2. The department shall request
that the Attorney General seek injunctive relief to enforce the
appeal decision and damages in the same manner as provided for in
Chapter 5 (commencing with Section 17200) of Part 2 of Division 7 of
the Business and Professions Code. If the Attorney General prevails,
the facility shall be liable for costs and attorney's fees.
(A) The department may withhold or deduct any Medi-Cal
reimbursement payments to the facility to collect the civil penalties
assessed pursuant to this paragraph. If any penalty assessed under
this paragraph remains unpaid 60 days after payment is due, the
department may assess a penalty equal to 50 percent of the unpaid
penalty amount and may seek to delay the renewal of the facility's
license.
(B) Notwithstanding the rulemaking provisions of Chapter 3.5
(commencing with Section 11340) of Part 1 of Division 3 of Title 2 of
the Government Code, or any other provision of law, the department
may implement this paragraph, in whole or in part, by means of
letters, provider bulletins, or other similar instructions without
taking regulatory action.
(C) If the facility is granted a writ of mandate pursuant to
Section 1094.5 of the Code of Civil Procedure, it shall not be liable
for the civil penalties authorized by this paragraph.
(i) Effective July 1, 2007, Sections 483.10, 483.12, 483.13, and
483.15 of Title 42 of the Code of Federal Regulations in effect on
July 1, 2006, shall apply to each skilled nursing facility and
intermediate care facility, regardless of a resident's payment source
or the Medi-Cal or Medicare certification status of the skilled
nursing facility or intermediate care facility in which the resident
resides, except that a noncertified facility is not obligated to
provide notice of Medicaid or Medicare benefits, covered services, or
eligibility procedures.
