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:

• Ban admissions of new residents at facilities that do not meet compliance requirements;
• Require that complaint investigations be completed in a timely manner;
• Create an online Consumer Information System with data on every licensed assisted-living facility in the state;
• Increase penalties for violations and create a classification system similar to the one used in state nursing home facilities;
• Require Community Care Licensing to conduct annual, unannounced inspections;
• Require complete disclosure of ownership and prior ownership of any type of facility, as well as history of compliance or noncompliance;
• Strengthen and clarify license revocation and suspension procedures and how to safely relocate residents in a timely manner;
• Promote resident councils and family councils;
• Increase training requirements for administrators and staff of assisted-living facilities;
• Require that trained medical personnel be employed at facilities that accept residents with certain health conditions; and
• Create a statutory bill of rights for residents and give the attorney general, residents and the public the right to seek injunctive relief against violations (McDonald, U-T San Diego, 1/13).

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

Reaction

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).