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AB-1695 Health facilities.(2019-2020)

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Date Published: 09/06/2019 08:15 PM
AB1695:v93#DOCUMENT

Amended  IN  Senate  September 06, 2019
Amended  IN  Senate  July 11, 2019
Amended  IN  Senate  July 02, 2019
Amended  IN  Assembly  May 21, 2019
Amended  IN  Assembly  April 25, 2019
Amended  IN  Assembly  March 28, 2019

CALIFORNIA LEGISLATURE— 2019–2020 REGULAR SESSION

Assembly Bill
No. 1695


Introduced by Assembly Member Carrillo

February 22, 2019


An act to amend Sections 1265 and 1417.3 of, and to add Sections 1267.6, 1267.61, and 1267.62 to, 1267.61 and 1267.62 to the Health and Safety Code, relating to health facilities.


LEGISLATIVE COUNSEL'S DIGEST


AB 1695, as amended, Carrillo. Health facilities.

(1)Existing law provides for the licensure and regulation of health facilities by the State Department of Public Health. Existing law requires an applicant desiring a license to operate or approval to manage a health facility, as defined, to file an application with the department.

This bill would define “manage” with respect to a skilled nursing facility to mean to assume operational control of the facility, to direct or control aspects of patient care and quality within the facility, or to be involved in the hiring, firing, supervision, and direction of direct care staff.

(2)Existing

Existing law provides for the licensure and regulation of health facilities, including skilled nursing facilities, by the State Department of Public Health. Existing law requires each applicant for a license to operate a skilled nursing facility to disclose to the State Department of Public Health, department, among other things, the names and addresses of any person or organization, or both, having an ownership or control interest of 5% or more in a management company that operates, or is proposed to operate, the facility. Existing law makes it a misdemeanor to violate laws relating to the licensing of health facilities.

This bill would require a prospective transferee or prospective licensee of a free-standing skilled nursing facility, upon the sale, transfer of operation, or other change or transfer of ownership, to submit a notice of intent to the department at least 90 days prior to the transfer or change of ownership. The bill would require the department, within 90 days of submission of the completed notice of intent form, to determine whether the prospective transferee or prospective licensee is responsible and suitable for licensure, based on specified criteria. Under the bill, if the department determines that the prospective transferee or prospective licensee is responsible and suitable for licensure, upon a transfer or change of ownership, the prospective transferee or prospective licensee would be authorized to file an application for a license, which would have the effect of a license until the department takes final action on the application. If the department determines that the prospective transferee or prospective licensee is not responsible and suitable for licensure, the bill would allow the prospective transferee or prospective licensee to request an administrative hearing to appeal that determination. The bill would prohibit a transfer of ownership of the facility unless the prospective transferee or prospective licensee has been determined responsible and suitable for licensure. The bill would also prohibit the department from approving an application for a license to operate, or for approval to manage, a skilled nursing facility unless the prospective transferee or prospective licensee has been determined responsible and suitable for licensure. Notwithstanding these provisions, if the department has not acted within the 90 days required under these provisions, the bill would authorize the transfer of ownership of the facility and application for licensure to proceed on an interim basis, as specified.

This bill would require a licensee of a skilled nursing facility, at least 90 days prior to the finalization of a sale, transfer of operation, or other change or transfer of ownership, ownership interests, to give a written notice of the proposed change in licensee or management company to all residents of the facility and their representatives that contains specified information relating to the prospective licensee, transferee, assignee, or lessee. lessee, or licensee’s parent company or management company. The bill would impose a civil penalty of $100 per day on a licensee for each day the notice is delayed.
This bill would prohibit a prospective transferee, in the capacity of a prospective licensee, during a 60-day transition period, from discharging an employee, other than the nursing home administrator and the director of nursing, without cause. The bill would prohibit, during that 60-day period, an employee from suffering any reduction in wages, benefits, or other terms and conditions of employment as a result of the transfer or change of ownership.
This bill would exempt from the above provisions a skilled nursing facility that is a distinct part of an acute care hospital and would specify that these provisions only apply to license applications submitted after a specified date.

(3)Existing law requires the department to promote quality of care and quality of life for residents, clients, and patients in long-term health care facility services through specific activities, including research, training, and technical assistance, as specified.

This bill would require the department to review whether a skilled nursing facility, with the exception of a facility that is a distinct part of an acute care hospital, has made a reasonable effort to comply with prescribed staffing ratios, whether a facility compensates employees with wage increases and benefits, and whether there has been an unreasonably high turnover of staff, as specified.

(4)Existing law makes it a misdemeanor to violate laws relating to the licensing of health facilities.

Because a violation of the above-described requirements would be a crime, the bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: YES  

The people of the State of California do enact as follows:


SECTION 1.Section 1265 of the Health and Safety Code is amended to read:
1265.

A person, political subdivision of the state, or governmental agency desiring a license for a health facility, approval for a special service under this chapter, or approval to manage a health facility currently licensed as a health facility, as defined in subdivision (a), (b), (c), (d), or (f) of Section 1250, that has not filed an application for a license to operate that facility shall file with the department a verified application on forms prescribed and furnished by the department, containing all of the following:

(a)The name of the applicant and, if an individual, whether the applicant has attained 18 years of age.

(b)The type of facility or health facility.

(c)The location thereof.

(d)The name of the person in charge thereof.

(e)Evidence satisfactory to the department that the applicant is of reputable and responsible character. If the applicant is a firm, association, organization, partnership, business trust, corporation, or company, like evidence shall be submitted as to the members or shareholders thereof, and the person in charge of the health facility for which application for license is made. If the applicant is a political subdivision of the state or other governmental agency, like evidence shall be submitted as to the person in charge of the health facility for which application for license is made.

(f)Evidence satisfactory to the department of the applicant’s ability to comply with this chapter and of rules and regulations promulgated under this chapter by the department.

(g)Evidence satisfactory to the department that the applicant to operate a skilled nursing facility or intermediate care facility possesses financial resources sufficient to operate the facility for a period of at least 45 days. A management company shall not be required to submit this information.

(h)An applicant for a license to operate a skilled nursing facility or intermediate care facility shall disclose to the department evidence of the right to possession of the facility at the time the application will be granted, which may be satisfied by the submission of a copy of applicable portions of a lease agreement or deed of trust. The names and addresses of any persons or organizations listed as owner of record in the real estate, including the buildings and the grounds appurtenant to the buildings, shall be disclosed to the department.

(i)Any other information as may be required by the department for the proper administration and enforcement of this chapter.

(j)Upon submission of an application to the department by an intermediate care facility/developmentally disabled habilitative or an intermediate care facility/developmentally disabled-nursing, the application shall include a statement of need signed by the chairperson of the area board pursuant to Chapter 4 (commencing with Section 4570) of Division 4.5 of the Welfare and Institutions Code. If the area board has not provided the statement of need within 30 days of receipt of the request from the applicant, the department may process the application for license without the statement.

(k)The information required pursuant to this section, other than individuals’ social security numbers, shall be made available to the public upon request, and shall be included in the department’s public file regarding the facility.

(l)With respect to a facility licensed as a health facility, as defined in subdivision (a), (b), or (f) of Section 1250, for purposes of this section, “manage” means to assume operational control of the facility.

(m)With respect to a skilled nursing facility, as defined in subdivision (c) of Section 1250, excluding skilled nursing facilities that are operated as a distinct part of an acute care hospital, for purposes of this section, “manage” means to assume operational control of the facility, to direct or control aspects of patient care and quality within the facility, or to be involved in the hiring, firing, supervision, and direction of direct care staff.

SEC. 2.Section 1267.6 is added to the Health and Safety Code, to read:
1267.6.

(a)Upon the sale, transfer of operation, including management changes, assignment, lease, or other change or transfer of ownership of a free-standing facility defined in subdivision (c) of Section 1250, a prospective transferee or prospective licensee shall, in addition to any other requirements of this chapter, submit a notice of intent to the department at least 90 days prior to the transfer or change of ownership. This provision is not applicable to a skilled nursing facility that is a distinct part of an acute care hospital.

(b)(1)The notice of intent shall be on a form supplied by the department and shall be deemed complete upon submission of all information that the department requires on the form. The form shall require, at a minimum, all of the following:

(A)Name and address of the prospective licensee, transferee, assignee, or lessee.

(B)Names of all prospective owners and their ownership percentages in a list format.

(C)Names of all prospective directors, board members, and managers in a list format.

(D)Name and address of the prospective parent company.

(E)Name and address of the prospective property owner.

(F)Name and address of the prospective management company.

(G)Expected transfer date.

(2)Within 90 days of submission of the completed notice of intent form, the department shall determine whether the prospective transferee or prospective licensee is responsible and suitable for licensure.

(c)For purposes of this section, the department’s determination of whether a prospective transferee or prospective licensee is responsible and suitable for licensure shall include, but not be limited to, a review of all of the following:

(1)The criminal history of the prospective transferee, prospective licensee, or any officer, director, shareholder, or general or limited partner thereof.

(2)The financial capacity of the prospective transferee or prospective licensee to operate the facility and to provide services required by state and federal regulations.

(3)The history of the prospective transferee or prospective licensee in providing long-term care in this state, measured by compliance with applicable statutes and regulations governing the operation of long-term care facilities.

(4)The history of the prospective transferee or prospective licensee in providing long-term care in states other than California, if any, measured by compliance with the applicable statutes and regulations governing the operation of long-term care facilities in those states.

(5)A final determination of liability concerning the prospective transferee or prospective licensee in complying with employment laws.

(d)The department shall notify the prospective transferee or prospective licensee in writing, within the 90-day period described in subdivision (b), of its decision on whether the prospective transferee or prospective licensee is responsible and suitable for licensure.

(1)Upon a determination by the department that the prospective transferee or prospective licensee is responsible and suitable for licensure, and upon a transfer or change of ownership, the prospective transferee or prospective licensee may file an application for a license, which shall have the effect of a license until the department takes final action on the application.

(2)If the department determines that the prospective transferee or prospective licensee is not responsible and suitable for licensure, the department’s determination shall take effect on the date of the department’s notice to the prospective licensee or transferee. The prospective transferee or prospective licensee shall, upon written request, be granted an administrative hearing to appeal the determination. During the pendency of the appeal, the prospective transferee or prospective licensee shall not operate the facility as a licensee, nor manage the facility.

(e)A transfer of ownership of the facility shall not occur unless the prospective transferee or prospective licensee has been determined responsible and suitable for licensure in accordance with this section.

(f)The department shall not approve an application for a license to operate, or for approval to manage, a skilled nursing facility, as defined in Section 1250, unless the prospective transferee or prospective licensee has been determined responsible and suitable for licensure in accordance with this section.

(g)If the department does not determine whether the prospective transferee or prospective licensee is responsible and suitable for licensure within the 90 days required by this section, the transfer of ownership of the facility and application for licensure may proceed on an interim basis until the department has made the final determination on the application pursuant to Section 1265 and subdivisions (e) and (f) shall not apply.

(h)This section applies only to license applications submitted after July 1, 2020.

SEC. 3.SECTION 1.

 Section 1267.61 is added to the Health and Safety Code, to read:

1267.61.
 (a) At least 90 days prior to a finalization of the sale, transfer of operation, including management changes, assignment, lease, or other change or transfer of ownership, ownership interests, the licensee of a facility defined in subdivision (c) of Section 1250, excluding skilled nursing facilities that are operated as a distinct part of an acute care hospital, shall give a written notice of the proposed change in licensee or management company to all residents of the facility and their representatives that contains all of the following information: information applicable to the proposed change:
(1) The name and address of the prospective licensee, transferee, assignee, or lessee. lessee, property owner, or the licensee’s parent company and management company, if applicable.
(2) A list of all prospective licensee or prospective management company’s owners or shareholders and their ownership percentages, and a list of the prospective directors, board members, and managers. percentages.

(3)The name and address of the prospective parent company.

(4)The name and address of the prospective property owner.

(5)The name and address of the prospective management company.

(3) A list of directors, officers, board members, and property owners of the prospective licensee and, if existing, a list of directors, officers, and board members of the prospective licensee’s parent company and proposed management company.

(6)

(4) The expected date of transfer. sale, assignment, lease, or other change.
(b) The licensee shall post a copy of the notice required pursuant to this section on all entrance and exit doors of the facility.
(c) The information required by this section shall be made available to the public by the facility upon request and shall be included in the department’s automated certification licensing administration information management system. licensing database and consumer information website.
(d) A licensee that does not fails to comply with the notification requirements required by of this section is liable for a civil penalty in the amount of of one hundred dollars ($100) per day for each day the notice is delayed.
(e) This section applies only to license applications submitted after July 1, 2020.

SEC. 4.SEC. 2.

 Section 1267.62 is added to the Health and Safety Code, to read:

1267.62.
 (a) In the event of the sale, transfer of operation, including management changes, assignment, lease, or other change or transfer of ownership of a facility defined in subdivision (c) of Section 1250, excluding skilled nursing facilities that are operated as a distinct part of an acute care hospital, a prospective transferee, in the capacity of a prospective licensee, shall retain, for a 60-day transition employment period, all employees who are employed by the licensee, except for the nursing home administrator and the director of nursing.
(b) The prospective licensee shall make a written offer of employment to each employee for the 60-day transition period in the employee’s primary language or another language in which the employee is literate. That offer shall state the time within which the employee shall accept the offer, but that time period may not be fewer than 10 days.
(c) During the 60-day transition period, the prospective licensee shall not discharge without cause an employee retained pursuant to this section. Cause shall be based only on the performance or conduct of the particular employee.
(d) Except as provided in subdivision (c), during the 60-day transition period, an employee shall not suffer any reduction in wages, benefits, or other terms and conditions of employment, economic or otherwise, as a result of the transfer or change of ownership.
(e) This section does not make the department responsible for adjudicating a labor dispute or wrongful termination complaint.

(e)

(f) This section applies only to license applications submitted after January 1, 2020.

SEC. 5.Section 1417.3 of the Health and Safety Code is amended to read:
1417.3.

(a)The department shall promote quality of care and quality of life for residents, clients, and patients in long-term health care facility services through specific activities that include, but are not limited to, all of the following:

(1)Research and evaluation of innovative facility resident care models.

(2)(A)Provision of statewide training on effective facility practices.

(B)Training also shall include topics related to the provision of quality of care and quality of life for facility residents. The topics for training shall be identified by the department through a periodic survey. The curriculum for the training provided under this paragraph shall be developed in consultation with representatives from provider associations, consumer associations, and others, as deemed appropriate by the state department.

(3)The establishment of separate units to respond to facility requests for technical assistance regarding licensing and certification requirements, compliance with federal and state standards, and related operational issues.

(b)State employees providing technical assistance to facilities pursuant to this section are only required to report violations they discover during the provision of the assistance to the appropriate district office if the violations constitute an immediate and serious threat to the health and welfare of, or have resulted in actual harm to, patients, residents, or clients of the facility.

(c)The state department shall measure facility satisfaction and the effectiveness of the technical assistance provided pursuant to paragraph (3) of subdivision (a).

(d)A person employed in the technical assistance or training units under paragraphs (2) and (3) of subdivision (a) shall not also participate in the licensing, surveying, or direct regulation of facilities.

(e)With respect to a skilled nursing facility, as defined in subdivision (c) of Section 1250, excluding skilled nursing facilities that are operated as a distinct part of an acute care hospital, the department shall review the following:

(1)Whether a facility has made a reasonable effort to comply with staffing ratios established pursuant to subdivision (c) of Section 1276.65.

(2)Whether a facility compensates employees with wage increases and benefits established pursuant to subdivision (a) of Section 14110.6 of the Welfare and Institutions Code, as inspected pursuant to subdivision (d) of Section 14110.6 of the Welfare and Institutions Code.

(3)Whether there has been unreasonably high turnover of staff, based on the direct care staff retention data reported pursuant to subdivision (i) of Section 14126.022 of the Welfare and Institutions Code.

(f)This section does not diminish the department’s ongoing survey and enforcement process.

SEC. 6.SEC. 3.

 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.