California Healthline Daily Edition

Summaries of health policy coverage from major news organizations

Lawmakers Unveil 12 Bills To Improve Assisted-Living Facility Care

On Monday, state lawmakers announced 12 bills aimed at improving care at assisted-living centers across California, U-T San Diego reports.

The bills come in response to a recent investigation that found that many assisted-living facilities that have been fined for medical errors have remained in operation without paying the penalties (Schoch/Gardner, U-T San Diego, 1/13).

Background on the Investigation

The investigation was conducted by U-T San Diego in partnership with the California HealthCare Foundation's Center for Health Reporting. CHCF publishes California Healthline.

After analyzing 7,000 state records of assisted-living center inspections, the investigators identified a variety of problems, including:

  • Employees being discouraged from reporting medical mistakes;
  • Failure to schedule medical appointments for residents when ordered by a doctor;
  • Housing residents who needed a higher level of care than staff could provide;
  • Insufficient staffing;
  • Medication errors, including administering incorrect medicine or dosages;
  • Staff ignoring or not treating residents' symptoms; and
  • Unsafe medicine storage.

The investigation found that most of the errors were caused by:

  • Poor oversight by staff; or
  • Lack of training for staff.

Investigators noted that the California Department of Social Services -- which licenses and regulates assisted-living centers -- does not track medical errors at the facilities.

The investigation also found that only half of the $2.9 million in fines levied against assisted-living facilities since July 2007 has been collected by the state. Meanwhile, hundreds of facilities that have unpaid fines remain licensed and continue to operate (California Healthline, 12/16/13).

Details of the Bills

In an effort to remedy some of the problems outlined in the investigation, lawmakers proposed a dozen bills that would overhaul residential care facilities for the elderly, or RCFEs. The measures included in the RCFE Reform Act of 2014 would:

In addition, the package of bills would require assisted-living facilities to obtain liability insurance (Schoch/Gardner, U-T San Diego, 1/13).


The measures are supported by several advocacy groups, including the:

  • California Advocates for Nursing Home Reform;
  • Consumer Federation of California; and
  • Consumer Advocates for RCFE Reform in San Diego (CANHR release, 1/13).
Pat Leary, deputy director at the state DSS, called the bills "a major step forward in rebuilding [the DSS Community Care Licensing Division's] capacity to deal with existing facilities and start on the next generation of what both (assisted-living centers) and other community care facilities need to look like in the future" (Schoch/Gardner, U-T San Diego, 1/13). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.