SB 538

Under current law, the Department of Health Services (DHS), as part of its

regulatory authority, must inspect each nursing home at least once biennially.

Alleged violations by nursing homes of state statutes or rules are of three types,

according to seriousness, ranging from a class "A" violation (creation of a condition

or occurrence relating to the operation and maintenance of a nursing home that

presents a substantial probability that death or serious mental or physical harm to

a resident will result) to a class "C" violation (a condition or occurrence that does not

directly threaten the health, safety, or welfare of a nursing home resident). If DHS

determines that a nursing home's alleged violation is a class "A" violation, DHS

serves a written notice of violation on the nursing home. If a nursing home fails to

abate or eliminate a class "A" violation immediately, or within a time specified in the

notice of violation, DHS must maintain a court action for injunction or other

restraint, although a nursing home may contest a class "A" violation determination

by an administrative hearing that is subject to judicial review. A class "A" violation

is subject to a forfeiture of not more than $10,000.

Also under current law, for nursing homes that are certified to provide care to

Medicare beneficiaries or Medical Assistance (MA) recipients, DHS may also act as

the federal agent in enforcing federal standards of operation. If DHS determines

that an alleged violation by a nursing home creates immediate jeopardy (a situation

in which the nursing home's noncompliance with one or more requirements of federal

financial participation has caused or is likely to cause serious injury, harm,

impairment, or death to a resident), DHS, acting as the federal agent, may serve a

written statement of deficiency on the nursing home. Various federal actions are

available against a nursing home if there is a situation of immediate jeopardy,

including appointment of a temporary manager, termination of a Medicare or MA

provider agreement, transfer of residents, and other remedies.

This bill requires a nursing home that receives a written notice of a class "A"

violation or a federal statement of deficiency that indicates a finding of immediate

jeopardy to provide to each nursing home resident identified in the notice or

statement and the resident's legal representative, if any, within 15 days after

receiving the notice or statement, a written notice. The notice must include a copy

of the notice of violation or statement of deficiency and provide certain other

information. Failure by a nursing home to provide the information required is a class

"C" violation, subject to a forfeiture of not more than $2,500.