Today's Law As Amended

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AB-275 Long-term care facilities: requirements for changes resulting in the inability of the facility to care for its residents.(2017-2018)



SECTION 1.

 Section 1336 of the Health and Safety Code is amended to read:

1336.
 (a)  Notwithstanding any other provisions of  law, a long-term health care facility shall give written notice to the affected patients residents  or to the guardians of the affected patients residents  at least 30 60  days prior to any change in the status of the license or in the operation of the facility resulting in the inability of the facility to care for its patients. residents. 
(b)  If patients’ residents’  placement problems are encountered which that  cannot be satisfactorily resolved within this 30-day 60-day  period, the State Department of Public  Health Services  and the health facility shall agree on an extension which shall not exceed an additional 60 days.
(c)  The facility shall provide an appropriate team of professional staff to assist patients residents  and families in obtaining alternative placement. The facility shall hold a community meeting for residents and their families no later than 30 days after providing the written notice pursuant to subdivision (a). The facility shall provide notice of the meeting to residents and their families and to local health authorities. The facility shall also provide notice of the community meeting to the State Department of Public Health as part of the proposed relocation plan submitted to the department pursuant to paragraph (1) of subdivision (g) of Section 1336.2. 
(d)  This section shall not apply to actions initiated by the department  State Department of Public Health  to suspend or revoke the license.

SEC. 2.

 Section 1336.1 of the Health and Safety Code is amended to read:

1336.1.
 (a) After notifying its affected patients, residents,  the facility shall, in response to inquiries made by prospective patients residents  or their representatives, include notification of the change in the status of the license or the operation of the facility.
(b) The facility shall also  give oral written  notification to the office of the State Long-Term Care Ombudsman of the change in the status of the license or the operation of the facility at least 30 facility, including a voluntary closure and the planned date of closure, at least 60  days prior to any change in the status of the license or the operation of the facility.
(c) The facility shall give written notification to the State Department of Health Care Services and any health plan of an affected resident of the change in the status of the license or the operation of the facility, including a voluntary closure and the planned date of closure, at least 60 days prior to any change in the status of the license or the operation of the facility. This notification shall also include the names of residents that are covered by Medi-Cal or by the specific health plan.

SEC. 3.

 Section 1336.2 of the Health and Safety Code is amended to read:

1336.2.
 (a) Before residents are transferred due to any change in the status of the license or operation of a facility, including a facility closure or voluntary or involuntary termination of a facility’s Medi-Cal or Medicare certification, the facility shall take reasonable steps to transfer affected residents safely and minimize possible transfer trauma by, at a minimum, doing all of the following:
(1) Be responsible for ensuring that the resident’s attending physician, if available, or a physician or the  facility medical director, if available,  the resident does not have an attending physician,  completes the medical assessment of the resident’s condition and susceptibility to adverse health consequences, including psychosocial effects, prior to written notice of transfer being given to the resident. The assessment shall not be considered complete unless it provides, in accordance with these assessments, recommendations for counseling, followup visits, and other recommended services, by designated health professionals, and for preventing or ameliorating potential adverse health consequences in the event of transfer.
(2) Be responsible for ensuring that a licensed marriage and family therapist, a licensed clinical social worker, a licensed psychologist, a licensed psychiatrist, or a licensed professional clinical counselor and  the facility nursing staff and activity director  complete an assessment of the social and physical functioning of the resident based on the relevant portions of the minimum data set, as described in Section 14110.15 of the Welfare and Institutions Code, before written notice of transfer is given to the resident. The assessment shall not be considered complete unless it provides recommendations for preventing or ameliorating potential adverse health consequences in the event of transfer. The assessment may be amended because of a change in the resident’s health care needs. The assessment shall also include a recommendation for the type of facility that would best meet the resident’s needs.
(3) (A)  Be responsible for evaluating the relocation needs of the resident including proximity to the resident’s representative and determine the most appropriate and available type of future care and services for the resident before written notice of transfer is given to the resident or the resident’s representative. The health facility shall discuss the evaluation and medical assessment with the resident or the resident’s representative and make the evaluation and assessment part of the medical records for transfer.
(B)  If the resident or resident’s representative chooses to make a transfer prior to completion of assessments, the facility shall inform the resident or the resident’s representative, in writing, of the importance of obtaining the assessments and followup consultation.
(4) At least 30 60  days in advance of the transfer, inform the resident or the resident’s representative of alternative facilities that are available and adequate to meet resident and family needs.
(5) Arrange for appropriate future medical care and services, unless the resident or resident’s representative has otherwise made these arrangements. This requirement does not obligate a facility to pay for future care and services.
(b) The facility shall provide an appropriate team of professional staff to perform the services required in subdivision (a).
(c) The facility shall also give written notice to affected residents or their representatives, advising them of the requirements in subdivision (a) at least 30 60  days in advance of transfer. If a facility is required to give written notice pursuant to Section 1336, then the notice shall advise the affected resident or resident’s representative of the requirements in subdivision (a). If the transfer is made pursuant to subdivision (g), the notice shall include notification to the resident or resident’s representative that the transfer plan is available to the resident or resident’s representative free of charge upon request.
(d) In the event of a temporary suspension of a facility’s license pursuant to Section 1296, the 30-day 60-day  notice requirement in subdivision (c) shall not apply, but the facility shall provide the relocation services required in subdivision (a) unless the department  State Department of Public Health  provides the services pursuant to subdivision (f).
(e) The department  State Department of Public Health  may make available assistance for the placement of hard-to-place residents based on the department’s  its  determination of the benefit and necessity of that assistance. A hard-to-place resident is a resident whose level of care, physical malady, or behavioral management needs are substantially beyond the norm.
(f) The department  State Department of Public Health  may provide, or arrange for the provision of, necessary relocation services at a facility, including medical assessments, counseling, and placement of patients, residents,  if the department  it  determines that these services are needed promptly to prevent adverse health consequences to patients, residents,  and the facility refuses, or does not have adequate staffing, to provide the services. In these cases, the facility or the licensee shall reimburse the department  State Department of Public Health  for the cost of providing the relocation services. The department’s  State Department of Public Health’s  participation shall not relieve the facility of any responsibility under this section. If the department  State Department of Public Health  does not provide or arrange for the provision of the necessary relocation services, and the facility refuses to provide the relocation services required in subdivision (a), then the department  State Department of Public Health  shall request that the Attorney General’s office or the local district attorney’s office seek injunctive relief 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.
(g) (1)  If 10 or more residents are likely to be transferred due to any voluntary or involuntary change in the status of the license or operation of a facility, including a facility closure or voluntary or involuntary termination of a facility’s Medi-Cal or Medicare certification, the facility shall submit a proposed relocation plan for the affected residents to the department  State Department of Public Health  for approval at least 15 30  days prior to the written transfer notification given to any resident or resident’s representative. The proposed relocation  plan shall provide for implementation of the relocation services in subdivision (a) and shall describe the availability of beds in the area for residents to be transferred, the proposed discharge process, and the staffing available to assist in the transfers. The plan shall become effective upon the date the department grants its approval. The department shall base its approval of a relocation plan on the standards specified in this section. The department shall promptly either approve or reject the plan within 10 working days of receipt from the facility. If the department rejects the plan, the facility may resubmit amended relocation plans, each of which the department shall promptly either approve or reject within 10 working days of receipt from the facility. Until one plan has been approved by the department, and until the facility complies with the requirements in subdivision (a), the facility may not issue a notice of transfer. The facility shall submit the relocation plan to the local long-term care ombudsman at the same time the plan is submitted to the department.  proposed relocation plan shall also include, but not be limited to, all of the following information: 
(A) The number of residents affected by the proposed closure.
(B) The number of residents who do not have a legal representative and do not have the capacity to make decisions for themselves as described in Section 1418.8.
(C) Attestation that each resident will undergo a medical assessment pursuant to paragraph (1) of subdivision (a) before being relocated.
(D) The availability of alternative skilled nursing facility beds or other available long-term care beds within the community.
(E) The reason for the proposed closure.
(F) The actions the facility is taking to transfer affected residents safely and minimize possible transfer trauma.
(2) The proposed relocation plan shall become effective upon the date the State Department of Public Health grants its approval. The State Department of Public Health shall base its approval of a proposed relocation plan on the standards specified in this section, including, but not limited to, its determination that the plan provides adequate protections to minimize transfer trauma for residents. The State Department of Public Health shall promptly either approve or reject the proposed relocation plan within 14 working days of receipt from the facility. If the State Department of Public Health rejects the proposed relocation plan, the facility may resubmit amended proposed relocation plans, each of which the State Department of Public Health shall promptly either approve or reject within 14 working days of receipt from the facility. Until one proposed relocation plan has been approved by the State Department of Public Health, and until the facility complies with the requirements in subdivision (a), the facility may not issue a notice of transfer. The facility shall submit the proposed relocation plan to the local long-term care ombudsperson at the same time the plan is submitted to the State Department of Public Health.
(h) The resident shall have the right to remain in the facility for up to 60 days after the approved written notice of the facility’s intent to transfer the resident if an appropriate placement based on the relocation assessment and relocation recommendations has not been made. The facility shall be required to maintain an appropriate level of staffing in order to ensure the well-being of all the residents as they continue to reside in the facility. The department  State Department of Public Health  shall monitor the facility’s staging of transfers, and, if it determines that the facility’s staging of placements is causing a detrimental impact on those residents being transferred, then the department  State Department of Public Health  shall limit the number of residents being transferred per day until the department  it  determines that when  it would be  is  safe to increase the numbers.
(i) Nothing in this section shall be construed to prohibit a facility from withdrawing a closure date or resident notification prior to any resident being relocated.

SEC. 4.

 Section 1336.3 of the Health and Safety Code is amended to read:

1336.3.
 (a) In the event of an emergency, such as earthquake, fire, or flood which that  threatens the safety or welfare of patients  the residents  in a facility, the facility shall do all of the following:
(1) Notify, as soon as possible, family members, patients’ guardians, the state department,  guardians of residents, the State Department of Public Health,  and the ombudsperson for that facility of the emergency and the steps that the facility plans to take for the patient’s welfare.  welfare of the residents. 
(2) Provide the services set forth in subdivision (a) of Section 1336.2 if further relocation of the patient a resident  is necessary.
(3) Undertake prompt medical assessment of, and provide counseling as needed to, patients residents  whose further relocation is not necessary but who have suffered or may suffer adverse health consequences due to the emergency or sudden transfer.
(b) (1)  Each facility shall adopt a written emergency preparedness plan and shall make that plan available to the state department  State Department of Public Health  upon request. The plan shall comply with the requirements in this section and the state department’s  State Department of Public Health’s  Contingency Plan for Licensed Facilities. The facility, as part of its emergency preparedness planning, shall seek to enter into reciprocal or other agreements with nearby facilities and hospitals to provide temporary care for patients residents  in the event of an emergency. The facility shall report to the state department  State Department of Public Health  the name of any facility or hospital which that  fails or refuses to enter into such agreements and the stated reason for that failure or refusal.
(2)  Section 1336.2 shall not apply in the event of transfers made pursuant to an emergency preparedness plan. In any event, however, the facility shall provide the notice and services described in subdivisions (a) to (c), inclusive.
SEC. 5.
 No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.