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Register for all three webinars in series:PURCHASE TICKETS

Use the links below to register for individual webinars:

Wednesday, November 3rd, 2021Medi-Cal Updates and the Future of Estate Planning for Long Term Care

Wednesday, November 10th, 2021The Role of Counsel for a Conservatee

Wednesday, November 17th, 2021Elder Financial Abuse Litigation: A Panel of Experts

EVENTS

During the past year, residents of long-term care facilities and their family members faced the unimaginable. COVID-19 took the lives of over 13,000 nursing home and assisted living facility residents and staff in California and turned bad facilities into some of the most dangerous places in the state. Unable to visit residents, family members watched their loved ones deteriorate from isolation, lack of adequate staff and lack of adequate care. Throughout this terrible year, CANHR remained open and worked tirelessly to assist the thousands of residents, family members, social workers, and ombudsmen, law enforcement and state legislators who called our hotline or emailed their concerns.

Please read our complete letter HERE and stories of our consumer advocacy during the pandemic HERE. Join our struggle. Please donate generously. With your donation, we can continue our advocacy for all long term care residents.

CANHR Job Opening:
Staff Attorney

To read more details and see the instructions for applying, please visit THIS PAGE. You can also download a PDF of the Staff Attorney job details HERE.

WE HAVE MOVED

CANHR has moved to our new location in Berkeley. If you have difficulty reaching our Consumer phone number at 1-800-474-1116, please try 1-415-974-5171. There has been no disruption to our online services, so you can always reach us via canhrmail@canhr.org, or our online feedback/contact form HERE. Our new mailing address is: CANHR, 1803 6th Street, Berkeley, CA 94710

CANHR's COVID-19 Coronavirus
News & Resources 

In an effort to keep you all better informed, we have created a website, https://canhrnews.com/ specifically for COVID-19 information, news and resources related to Long Term Care. For the duration of this crisis, we are posting frequent updates there.

 
Home Equity Protection Program (HEPP)
funded by the State Bar of CA to prevent financial mortgage scams and more... Please read our FREE BOOKLET of Reverse Mortgage information.

 

#VisitationSavesLives
Join our campaign to restore reasonable visitation to residents in long term care facilities.
 
Hollywood Premier Dumps Resident For NOT Having COVID-19

Read More...


Violation of the Month Archive

New Developments

  • Nursing Home Oversight, or Lack Thereof, Called Out by Legislature
    On October 5, the Assembly Health Committee held an informational hearing on nursing home oversight.  Several critical topics for nursing home residents were explored, from ownership and California's zombie licensing system to the Department of Public Health's (DPH) weak enforcement and oversight.  Long story short, DPH is not doing its job and its failures contribute to resident harm and misery.

    You can watch the hearing, in its entirety, here: https://www.assembly.ca.gov/media/assembly-health-committee-20211005/video.  Or you can watch attorney Kim Valentine's testimony on behalf of the Consumer Attorneys of California or CANHR senior staff attorney Tony Chicotel's testimony separately.
    CalMatters and LAist both posted good summaries of the hearing.
    (posted October 8, 2021)
  • Vaccine Mandates for RCFE Workers Starts November 30
    Following a state and federal requirement for nursing home staff to be vaccinated for COVID-19, the state Department of Public Health has issued a second order covering staff of adult and senior care homes, including Residential Care Facilities for the Elderly (RCFEs).  The order requires all staff, outside care providers, and other workers who come into the facility to be fully vaccinated by November 30.  The Department of Social Services issued a notice to adult and senior care homes, telling them of the new mandate.
    (posted September 29, 2021)
  • CANHR Joins Labor and Civil Rights Organizations Supporting the Rights of LGBTQ Long Term Care Residents
    CANHR has joined with Justice in Aging and LGBTQ Senior Organizations to submit an amicus brief to the California Supreme Court, asking the court to review a Court of Appeal decision that invalidated the “pronoun provision” of the LGBT Long Term Care Facility Residents Bill of Rights.  The brief supports the argument of the Attorney General and joins other amici in requesting review of the lower court decision.

    The brief we signed argues that the Court of Appeal mischaracterized the pronoun provision.  This provision makes it unlawful for a long-term care facility staff member to “[w]illingly and repeatedly fail to use a resident’s preferred name or pronouns after being clearly informed of the preferred name or pronouns,” and the brief argues that other settings where deliberate misuse of pronouns has been found to be discriminatory support the enforcement of the statute.  The particular circumstances of LGBTQ seniors make protection of their rights vital, since they may have more limited choices about how to receive necessary care because they are less likely than non-LGBTQ seniors to have children or other family members available to provide in-home care.  Obtaining assistance should not require giving up the right to be treated with respect.
    (posted September 29, 2021)
  • A Tale of Nursing Home Taxpayer Ripoffs in Three Acts
    SEIU California recently released a slideshow summarizing some of the schemes used by nursing homes to hide their profits and skimp on resident care.  Facilities in California increasingly use vast networks of corporate shell companies and pay inflated rents and service charges to themselves to siphon more than one billion dollars a year.  Facilities use these "related party" expenses to drive down their operating margins, inversely proportional to their payments to themselves, so their owners can claim they need more taxpayer money.  The result is owners making more money while residents suffer more neglect.  Without full transparency of related party expenses, California will continue to be ripped off.  SB 650 (Stern), a bill to promote more nursing home financial transparency, is on the governor's desk and we urge him to sign it.
    (posted September 27, 2021)
  • Vaccination Rates for Nursing Home Staff and Residents Now Available on Care Compare
    The Centers for Medicare & Medicaid Services (CMS) announced in a September 21, 2021 press release that it has added a new feature to its Care Compare website to make it easier to check COVID-19 vaccination rates for nursing home staff and residents. The information is intended to help people make informed decisions when choosing a nursing home. To access the vaccination rate data, search a nursing home’s zip code or city on Care Compare, click on the name of the nursing home, then scroll down to click “View COVID-19 Vaccination Rates” to see the data. The information is intended to help people make informed decisions when choosing a nursing home.

    CMS is updating the data weekly. Medicare and Medi-Cal certified nursing homes have been required to report weekly COVID-19 vaccination data for both residents and staff since May, and CMS has been posting the information on the CMS COVID-19 Nursing Home Data website. The new vaccination rate tool on Care Compare is in addition to the data being posted on the COVID-19 Nursing Home Data website.
    (posted September 22, 2021)
  • CMS Trashes State Abandonment of Dumped Residents
    In a major development for CANHR's six-year effort to force the State of California to enforce its own orders requiring nursing homes to readmit unlawfully evicted residents, the federal Centers for Medicare and Medicaid Services (CMS) has opined that California's position in the case is mistaken.

    In 2015, fed up with an eviction hearing system that gave residents paper victories but not justice, CANHR and three residents who had been illegally dumped into hospitals sued the State arguing that its hearing system was a sham. In the subsequent years of litigating the case, state officials have spent enormous amounts of time and money to defend its abandonment of illegally evicted residents.  

    Recently, the judge in the case asked CMS for its opinion on the merits of the State's arguments. In response, CMS explained that "CMS has repeatedly informed California that [CMS] does not believe the state's procedures comply with [federal law]." CMS also wrote that California's legal arguments do "not align with the requirements of the statute and its implementing regulations." In other words, the State is not fulfilling its legal requirement to enforce hearing decisions and its legal arguments are wrong.

    That's what we've been telling the State for years.

    Enforcing orders requiring nursing homes to readmit illegally evicted residents is not only a lawful imperative, it is a moral imperative. The State shamefully continues to waste taxpayer dollars and state resources on fighting to maintain its rotten abandonment of dumped nursing homes residents. We hope that CMS's opinion will finally convince the State to do its job.

    click to read more
    (posted September 15, 2021)
  • New York Times Calls Out Resident Drugging Hidden by Phony Diagnoses
    New York Times story has called out the growing use of fake schizophrenia diagnoses in nursing homes.  These fake diagnoses conceal the drugging of residents from the public via a shoddy "quality measure" used in the CMS 5-star ratings system.  Incredibly, doctors are not making antipsychotic prescriptions to suit a diagnosis, they are making diagnoses to suit a prescription.

    The perverse incentives that drive this fantasy medicine are described in the story and have been a concern for several years.  Nonetheless, policymakers continue to do nothing and instead enable overdrugging by continuing to find thousands and thousands of instances of drug misuse to be "no harm."
    (posted September 13, 2021)
  • Long Term Care Facility Visitation Lockouts Due to COVID Outbreaks - Are They Legal?
    Despite the ongoing pandemic, in-person visitation is mandatory in California long term care facilities.  However, a number of facilities are shutting down all in-person visitation indefinitely when a staff member or resident tests positive for COVID-19.  Generally, these visitation lockouts are illegal.

    The only time a facility may temporarily shut down in-person visitation is when a local public health authority has directed that visitation be stopped or in nursing homes under very specific circumstances outlined by the Centers for Medicare and Medicaid Services.

    The current visitation rules in nursing homes and assisted living facilities are summarized here.  These rules apply, regardless of COVID outbreaks in a facility.

    If you or your loved one's facility is locking out visitors due to an outbreak, or for any other reason, ask the facility management what rules they are following that permit the lockout and provide the facility with CANHR's visitation summary.  If the facility persists in an unauthorized lockout, file a complaint with the state Department of Public Health and explain that the visitation lockout is an "immediate jeopardy" violation.  If CDPH is not able to restore visitation at the facility within 72 hours of your complaint, contact CANHR and let us know.
    (posted September 3, 2021)
  • Licensing by clerical error: How the state’s mistake decided the course of two nursing homes
    So reads the headline of a highly disturbing CalMatters article about the California Department of Public Health (CDPH) issuing licenses by mistake to a nursing home operator it has found in other instances to be unfit. The August 19, 2021 article involves two Los Angeles area nursing homes – Country Villa South Convalescent Center and Country Villa Los Feliz Nursing Center – that have histories of poor care and, according to a CalMatters analysis, are in the top 4 percent of nursing homes statewide with the highest numbers of resident deaths due to COVID-19. Making matters worse, CDPH reaffirmed the licenses after learning of its clerical error, demonstrating once again that it is in the grasp of the nursing home industry.
    (posted August 19, 2021)
  • Nursing Home Improvement and Accountability Act Introduced in U.S. Senate
    On August 11, Senator Ron Wyden, Chairman of the Senate Finance Committee, Senator Bob Casey, Chairman of the Senate Aging Committee, and several other senators introduced the Nursing Home Improvement and Accountability Act of 2021. The bill aims to increase transparency, accountability and oversight in nursing homes, improve staffing and support innovation in the structure and culture of nursing homes. Among its many provisions, it would require updated staffing studies to be conducted and used to set minimum staffing requirements, mandate a registered nurse to be present 24 hours a day, and ban use of pre-dispute arbitration agreements in nursing homes and related settings.

    CANHR supports this important legislation. You can learn more about it by reading the legislative text, a bill summary, and a section-by-section summary of the bill.
    (posted August 16, 2021)
  • New Vaccine Mandates
    As a new surge attributed to the Delta variant takes hold throughout the State, nursing home residents and their families may be relieved to hear that California has issued the nation’s first order requiring COVID-19 vaccinations for health care workers.

    The new order, issued August 5, mandates that employees of hospitals, nursing homes and other medical facilities have until September 30 to get their first dose of a one-dose regimen or their second dose of a two-dose regimen. The new rule permits exceptions only for religious reasons or for certain rare medical conditions.

    California also ordered visitors to hospitals, skilled nursing homes and facilities for the developmentally disabled to be fully vaccinated or show a negative COVID-19 test within 72 hours before each visit. The order applies only to indoor visits and took effect on August 11.
    (posted August 16, 2021)
  • The New and Much Improved Health and Safety Code Section 1418.8
    Health Care Decisionmaking for Unrepresented Nursing Home Residents in 2021 and Beyond
    Eight years after CANHR filed a lawsuit to challenge the constitutionality of Health and Safety Code Section 1418.8 (“Section 1418.8”), California finally has a better law for balancing the health care needs and rights of “unrepresented” nursing home residents. Unrepresented residents are those who have diminished decisionmaking capacity and lack a surrogate decisionmaker. For nearly thirty years, these residents were essentially at the mercy of nursing home staff members to decide what care they would receive or not receive, including the withdrawal of life sustaining treatment. 

    In 2019, a California appellate court ruled that Section 1418.8 had significant constitutional defects and required changes to protect residents from health care decisions that served the interests of nursing homes instead of their own. (CANHR v. Smith, 37 Cal.App.5th 814) Legislative efforts were deferred in 2020 because of the Covid-19 pandemic but moved quickly in 2021 thanks to Senator Pan’s Senate Bill 460, which was improved by the State Health and Human Services Agency and passed by the legislature in AB 135, a budget bill signed by the Governor on July 16. The signed bill represented the culmination of six months of extensive collaboration between Senator Pan’s office, the nursing home industry, CANHR, the Departments of Aging and Public Health, and many other stakeholders.

    The most pivotal piece of the legislation is the allocation of four million dollars to form a Long-Term Care Patient Representative Program. The program will be spearheaded by the Department of Aging, which will train, certify, and supervise public patient representatives throughout the state, likely provided by county or local non-profit agencies.

    The new Section 1418.8 includes the following key provisions:

    1. A patient representative, unaffiliated with the nursing home, must be part of the resident’s decisionmaking inter-disciplinary team (“IDT”). If there is no patient representative, the facility cannot proceed with its decisionmaking process.  (subsection (e)(1); also see subsection (c)) Public patient representatives will serve for residents who do not have a family member or friend to fill this role.

    2. No treatment decision requiring informed consent may be made by an IDT without the agreement of the patient representative. If the IDT members cannot reach consensus, the facility may not proceed with the proposed intervention unless it obtains a court order.  (subsection (i))

    3. Unrepresented residents must receive two separate written notices related to the IDT: the first to tell them an IDT meeting is going to be held and the second to tell them the results of the IDT meeting and their right to seek judicial review. (subsections (d) and (f))

    4. Nursing homes are required to report important data regarding decisionmaking for unrepresented residents to the Long-Term Care Patient Representative Program.


    The new law sets a deadline of July 1, 2022 for the patient representative program to be up and running.  In the meantime, nursing homes are not required to have patient representatives as part of their IDTs. However, facilities ARE required to provide written notices to unrepresented residents and provide copies of those notices to “a competent person whose interests are aligned with the resident” or to the local long term care Ombudsman program. Those requirements were ordered by an Alameda County Superior Court judge and have been in place since 2020. Download and read the court order HERE.

    click to read more
    (posted August 6, 2021)
  • Podcast: How to Advocate for a Loved One Labeled "A Bad Fit."
    CANHR Staff Attorney Tony Chicotel is featured on a new podcast from the National Consumer Voice for Quality Long-Term Care discussing long term care facility residents who are labeled "a bad fit." Residents and their advocates often feel shame and impotence about dementia-related behaviors and are hesitant to address the failures in care that cause such behaviors.  In the podcast, Tony talks about raising expectations for dementia care and exercising residents' rights to care that maximizes their comfort and quality of life.  The podcast is part of a series to help people pursue good long term care.
    (posted August 4, 2021)
  • New State Vaccination Rule for Nursing Homes and Assisted Living Facilities
    The State of California has taken an important step to safeguard the wellbeing of residents of long term care by mandating that virtually all facilities providing care in congregate settings take steps to ensure that their workers are vaccinated.

    In an order issued July 26, the State mandates that hospitals, skilled nursing facilities, and adult and senior care facilities verify the vaccination status of all employees, and that they require that all unvaccinated employees submit to testing twice weekly in skilled nursing and intermediate care facilities and once weekly in assisted living facilities. Vaccinated, asymptomatic employees need not be tested under the rule. The deadline for compliance is August 23.

    The new rule has been issued just as the new Delta variant of the Covid-19 virus, now widespread throughout the U.S., has been identified by the CDC as both much more transmissible and potentially more virulent than previously thought
    (posted July 30, 2021)
  • How Many Staff Members are Vaccinated at Your Nursing Home?
    It may be fewer than you would expect.

    According to federal data as of July 11, 2021, less than 80 percent of current nursing home staff in California were vaccinated. However, variation from facility to facility was extreme, ranging from 0 to 100 percent. While 827 California nursing homes reported that 75 percent or more of staff are vaccinated, over 350 facilities fall below that rate. More than one hundred California nursing facilities reported that less than half of their staff is vaccinated or reported no data.

    The vaccination rate data is posted on the Centers for Medicare & Medicaid Services (CMS) COVID-19 Nursing Home Data webpage and is updated weekly.

    Whenever possible, CANHR recommends that people looking for nursing homes avoid facilities where less than 75 percent of staff are currently vaccinated. All other things being equal, give preference to facilities where all, or nearly all, of staff and residents are vaccinated.
    (posted July 29, 2021)
  • CMS Restores Tougher Penalties for Nursing Home Violations
    After a lawsuit filed in January 18, 2021 by California Advocates for Nursing Home Reform (CANHR) and the National Consumer Voice for Quality Long-Term Care (Consumer Voice) challenging CMS’s 2017 policy limiting the types of civil money penalties (CMPs) that can be imposed against nursing facilities, CMS has reversed course and announced plans to impose much stiffer penalties for nursing facility violations. READ FULL PRESS RELEASE (PDF) You can read more about the topic in this New York Times article.
    (posted July 28, 2021)
  • CANHR Joins Disability Rights Organizations Supporting Britney Spears' Right to Counsel of Her Choice
    CANHR has joined with 26 other disability rights organizations to submit an amicus brief in the Britney Spears conservatorship case, arguing in support of Ms. Spears' right to have a lawyer of her own choosing. Amazingly, California law is not totally clear about the rights of conservatees or proposed conservatees to select their own attorney. Courts sometimes refuse to allow attorneys selected by conservatees to serve their clients, instead imposing a more "amenable" court-appointed attorney to serve. Thanks to the ACLU for leading this effort to support conservatee rights.
    (posted July 13, 2021)
  • Avoid Long Term Care Facilities with Restrictive Visitation Policies
    Despite plummeting rates of COVID infections and deaths in nursing homes and the lifting of public health-oriented restrictions, long term care facilities throughout the state are still limiting visits from families and friends to a measly 30 minutes per week.  Other facilities, in stark contrast, are permitting extensive daily visitation.  The wide range of visitation policies among facilities has been enabled by the State’s continued waiver of laws that normally require broad visitation access for residents.
      
    Potential residents and their loved ones are strongly encouraged to speak with the managers of facilities they are considering and ask for written copies of their visitation policies.  Facilities that are not willing to share their policies in writing or those that have restrictive policies should be avoided.

    Some facilities are not going to allow more visitation until it starts costing them customers.

    Please see our updated How to Choose a Nursing Home fact sheet for more information.
    (posted July 2, 2021)

  • Office of Inspector General Finds Deaths of Nursing Home Residents Soared by 32 Percent in 2020
    A June 2021 report by the HHS Office of Inspector General found a horrific increase in the death rate of nursing home residents in 2020 beyond deaths caused by Covid-19. The report – COVID-19 Had a Devastating Impact on Medicare Beneficiaries in Nursing Homes During 2020 – reveals that deaths of Medicare beneficiaries in nursing homes during 2020 increased by 169,291 from the previous year. It also found that beneficiaries in nursing homes who were Black, Hispanic, Asian or on Medicaid were more likely to get COVID-19 and to die from it than others. The report concluded that understanding the pandemic’s effects on nursing home residents is necessary to prevent future tragedies.
    (posted June 25, 2021)
  • Advocates Propose Framework for Legislative and Administrative Changes to Benefit Nursing Homes Residents
    A coalition of organizations that advocate for nursing home residents, including CANHR, have proposed a Framework for Nursing Home Reform Post COVID-19. The Framework for federal reform includes multiple proposals under six broad areas – (1) staffing and workforce; (2) regulation and enforcement; (3) ownership and management standards, transparency, and accountability for quality; (4) government payment systems, financial transparency, and accountability; (5) structural changes in the long-term care delivery system; and (6) nursing home redesign and rebuilding. Each proposal requires either legislative change by Congress or administrative action that the Centers for Medicare & Medicaid Services (CMS) could take under its current statutory authority.
    (posted June 25, 2021)
  • LAist Reports Medicare and Medi-Cal Paid Nearly a Half-Billion Dollars to Nursing Home Chain Whose Owner Who Was Denied a License Due to Dangerously Poor Care
    Illustrating why bad actors are in the nursing home business, KPCC reported on June 16, 2021 that nursing homes connected to ReNew Health and its CEO, Crystal Solorzano, received more than $428 million in Medicare and Medi-Cal payments between 2016 and 2019. The story – Despite Multiple Citations for Deficient Care, Government Sent More Than $400M to Troubled Nursing Home Chain – reports that government money flowed to the chain despite violations that put residents’ lives at risk and despite regulators attempts to block Solorzano from acquiring additional nursing homes. According to LAist, “the same government agencies that found those facilities were dirty, understaffed and provided deficient care are also their biggest source of revenue.” The story is part of the ongoing ‘Unprotected’ series examining California’s failures on nursing home oversight, which began with KPCC/LAist’s in-depth investigation of Solorzano’s nursing home chain: Immediate Jeopardy: Death and Neglect Inside A Troubled California Nursing Home Chain.
    (posted June 25, 2021)
  • Sufficient Staffing is the Prescription to Prevent Dangerous Nursing Home Conditions Exposed by the Pandemic
    What policies can best protect nursing home residents now and in the future from the overwhelming infection and death rates seen during the pandemic? That question is the subject of a thought-provoking June 2021 commentary by Professor Charlene Harrington of UCSF and other nursing home experts that was published by the HSOA Journal of Gerontology and Geriatric Medicine: Time to Ensure Sufficient Nursing Home Staffing and Eliminate Inequities in Care.
    (posted June 15, 2021)
  • Advocacy Organizations Call For Restoration of Visitation Rights in Nursing Homes
    Frustrated with visitation policies that are stuck in pre-vaccine 2020, CANHR and several other nursing home resident advocacy organizations called on CMS to restore visitation rights in U.S. nursing homes. Many facilities across the country continue to limit visitation access for residents to 30 minutes per week, leading to extended isolation, deprivation of care, and harm to residents.
    (posted June 14, 2021)
  • News Series Points Out Huge Problems in California Conservatorship System
    ABC 10 in Sacramento recently released a five-episode series on California’s flawed conservatorship system called “The Price of Care.”  The investigative report exposes broad problems in the way conservatorships are granted and monitored while featuring individual stories in which conservatees were placed in long term care facilities, separated from family members, and charged enormous sums by professionals who profit from the system.  While many of the conservatorship criticisms and themes featured in the series will not be new to those familiar with CANHR’s work, the series comes at a pivotal time in state reform efforts.  Two bills in Sacramento, AB 1194 (Low) and SB 724 (Allen), would make important positive changes to the conservatorship process and are discussed in the fifth episode.  ABC 10’s reporting is another example of recent media coverage of conservatorship problems that is contributing to a groundswell in demand for reform.
    (posted June 1, 2021)
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