Senate Hearing To Examine Oversight of Assisted Living Facilities

Senate Human Services Committee Chair Leland Yee (D-San Francisco) plans to hold a hearing later this year to examine the state's oversight of assisted living facilities, U-T San Diego reports.

The hearing comes in response to an investigation by U-T San Diego and the California HealthCare Foundation's Center for Health Reporting. The investigation found that deaths resulting from poor care at assisted living facilities in San Diego often go unreported and that care providers largely are not disciplined for such incidences.

The center is supported by a grant from CHCF, which publishes California Healthline (Schoch, U-T San Diego, 10/8).

Details of Investigation

During a six-month investigation, U-T San Diego reporters reviewed documents from:

• DSS;
• The San Diego County medical examiner;
• Court cases; and
• A local consumer group.

According to the investigation, state law requires resident care facilities for the elderly to undergo an inspection once every five years, but DSS said it is changing the requirement to once every 30 months. The maximum fine when an RCFE resident dies as a result of poor care is $150, compared with a $100,000 fine for a similar death at a nursing home.

The investigation found that since 2008, 27 elderly residents in San Diego County assisted living facilities died from injuries and neglect.

In some of the cases, DSS never investigated or penalized the facilities. In addition, the cases never were made public by regulators or law enforcement.

DSS investigated 18 deaths that it deemed preventable. The maximum fine was levied on caregivers in 12 of the cases, which took place at various facilities, such as:

• Wesley Palms in San Diego;
• Merrill Gardens in Oceanside; and
• Mission Home IV in San Diego.

However, state regulators have said they are not able to determine if more seniors' deaths could have been prevented because they use an antiquated computer system that cannot track such deaths.

In addition, at least 196 deaths in such facilities were reviewed by the county medical examiner, who is not required to report findings to DSS.

Investigators also found that the number of complaints about poor care at RCFEs increased by 13% in the past five years to nearly 3,000. Meanwhile, the number of penalties against such facilities fell by 30% during that time period to 6,787 (California Healthline, 9/9).

Details of Hearing

Yee said he will call the hearing later this year because the investigation made it "clear" that "the state and [DSS] are not doing enough" to prevent neglect and abuse in RCFEs. The Senate Human Services Committee oversees DSS.

He said the hearing will focus on:

• Actions of individual facility operators;
• Facilities' lack of best practices or appropriate procedures for patient care; and
• Need for additional oversight.

Other Lawmakers Call for Changes

Meanwhile, several other lawmakers are calling for changes to the state's oversight of RCFEs.

State Sen. Joel Anderson (R-San Diego) -- vice chair of the Senate Health and Public Safety committees -- in an email said he is considering introducing legislation to change inspection standards for such facilities.

In addition, Assembly member Ian Calderon (D-Whittier) said he plans to reintroduce a bill (AB 364) that would increase inspection frequency at assisted living centers. The measure stalled in committee earlier this year.

"Now we have hard evidence that we need more unannounced visits," Calderon said

Assembly Majority Leader Toni Atkins (D-San Diego) said he will "be monitoring the Senate hearing and consulting with stakeholders to determine what are the most effective proposals to protect the well-being" of RCFE residents (U-T San Diego, 10/8).