Lawmakers Unveil 12 Bills To Improve Assisted-Living Facility Care
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).
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).