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In Memoriam: Donna Myers Ambrogi

With great sadness, CANHR mourns the death of Donna Myers Ambrogi, who died at her home in Pilgrim Place in Claremont, California.

Donna was a close personal friend, a colleague and an inspiration. CANHR (BANHR) was born in the Ambrogi living room in San Francisco in 1983. She was one of the founders and first Board members of BANHR, while also founding and heading up the California Law Center for Long Term Care (CALTC). She was a brilliant, passionate social justice warrior for all of her adult life.

With her husband, Tom Ambrogi, Donna travelled the world working for social justice, including working for the first democratic election in South Africa that elected Nelson Mandela. Among many pieces of legislation spearheaded by Donna, was the first nursing home admission agreement law in California that extended the rights of nursing home residents upon admission.

Upon her “retirement” and move to Pilgrim Place, she was elected to the California Senior Legislature, served on CANHR’s Board of Directors and the Pilgrim Place Board and helped start a regional Medicare HMO – all of which involved improving the lives of others. Donna was a light that never stopped shining, and she leaves a void for those of us who knew her. Thank you, Donna, for sharing your advocacy and life with us.

CANHR's COVID-19 Coronavirus
News & Resources 

In an effort to keep you all better informed, we have created a website, 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.


Join our campaign to restore reasonable visitation to residents in long term care facilities.
Stockton Nursing Home Resident Walks Off and Killed by Train


Violation of the Month Archive

On February 24th, CANHR Executive Director Pat McGinnis testified at the California State Senate Committee on Human Services oversight hearing regarding State Oversight of Homes for Vulnerable Adults. To watch a video of the hearing, CLICK HERE or on the image to the left. Director McGinnis' testimony begins just over an hour and twenty four minutes into the proceedings.

New Developments

  • New Visitation Fact Sheet Released.
    CANHR has reviewed the various federal and California guidance regarding visitation in long term care facilities and synthesized the rules into a new fact sheet to guide residents and their families. The fact sheets highlight the types of visitation nursing homes and residential care facilities for the elderly must provide and under what conditions as well as the infection control protocols facilities may impose during visits. Download the Fact Sheet HERE (PDF).
    (posted July 13, 2020)
  • LTCCC Podcast Features #VisitationSavesLives
    A recent podcast from the Long Term Care Community Coalition takes on the tragedy of the visitation ban in long term care facilities. CANHR Staff Attorney Tony Chicotel and CANHR's #VisitationSavesLives campaign is featured in the podcast. The episode is called "The Eyes, Ears, and Voice: Why Nursing Home Visitation Saves Lives."
    (posted July 8, 2020)
  • New Policy from Department of Public Health Restores Some Visitation Rights in Nursing Homes.
    On June 26, the California Department of Public Health released a new policy regarding visitation that, for the first time since March, REQUIRES nursing homes to permit visitors for outdoor and indoor visits. Facilities with no current COVID-19 outbreak must permit outdoor visitation. Indoor visits must be permitted if a facility meets six criteria: 1. no current COVID-19 outbreak, 2. a decline in cases in the community, 3. no new COVID-19 cases in the facility for the past 14 days, 4. no staffing shortages and not using a COVID-19 staffing waiver, 5) an adequate testing plan per AFL 20-53, and 6) an approved COVID-19 Mitigation Plan. For indoor visits, only one designated visitor allowed per resident (per visit - more than one visitor may visit, just not at the same time). All visits (indoor or outdoor) must be scheduled in advance with visitors screened for fever or COVID-19 symptoms. All visitors must comply with social distancing (6 feet or more physical distancing), wear facial coverings, and permit staff monitoring to ensure compliance with infection control guidelines.
    The new policy may have been partially motivated by CANHR's ongoing #VisitationSavesLives campaign. Now that residents have some of their rights back, the campaign will advocate for better state enforcement as well as restoring the visitation rights of assisted living residents, who were not affected by the shift in state policy.
    (posted July 6, 2020)
  • Governor Signs Law Extending AB 1629 Reimbursement System for Skilled Nursing Facilities
    On June 29, 2020, Governor Newsom signed into law AB 81, a budget bill that extends the Medi-Cal reimbursement system for freestanding skilled nursing facilities through the end of 2022. Known as “AB 1629” for the 2004 legislation that created it, the failed payment system has been a magnet for unscrupulous operators who have profited at residents’ and Medi-Cal’s expense.

    The extension does not contain any of the reforms CANHR recommended, however, it is a somewhat reduced windfall for nursing home chains than they and the Newsom Administration had sought. The amended law provides aggregate rate increases of 3.62 percent through the end of calendar year 2020, 3.5 percent in calendar year 2021 and 2.4 percent in calendar year 2022.

    Additionally, skilled nursing facilities will receive increased Medi-Cal payments for any new federal or state mandates plus, under separate authority, a 10 percent rate increase retroactive to March 1, 2020 that will continue until the end of the emergency period.

    Collectively, these provisions will increase Medi-Cal payments to skilled nursing facility operators in California by more than $500 million through 2022. These generous increases are on top of multiple multi-billion dollar bailouts the federal government is providing to the nursing home industry.

    In addition to increasing payments to nursing home operators, the extension made other changes to the payment system. Some of interest include:

    • Beginning in 2021, requiring the Department of Healthcare Services (DHCS) to assess monthly penalties up to $50,000 when SNFs are found to be out of compliance with minimum staffing requirements, minimum wage laws or wage pass-through requirements.

    • Increasing penalties, imposed by the Department of Public Health, on facilities for failing to meet the nursing hours or direct care service hours per patient per day statutory requirements.

    • Requiring DHCS to audit facility costs and revenues that are associated with the COVID-19 Public Health Emergency to determine whether a facility has adequately used increased Medi-Cal payments associated with the emergency only for allowable costs.

    • Requiring a facility that received increased Medi-Cal payments associated with COVID-19 to provide any information requested by DHCS on emergency-related costs and revenues at the time and in the manner specified by DHCS; and requiring DHCS to recoup any amounts of increased Medi-Cal payments that were not used to support the delivery of patient care.

    • Requiring DHCS to convene a stakeholder process by September 1, 2021 to develop a successor supplemental payment or similar quality-based payment methodology to replace the existing program, to begin in 2023.

    A more complete summary of the changes to the payment system can be found here.

    The extension took effect immediately when signed on June 29, 2020.

    click to read more
    (posted July 7, 2020)
  • Great news! SB 1207 (Jackson) on Backup Power in Skilled Nursing Facilities Passes Senate by 36-0 Vote, Moves on to the Assembly!
    Today the California Senate unanimously passed Senator Hannah-Beth Jackson’s bill, SB 1207, to help save the lives of California nursing home residents during power outages that may result from public safety power shutoffs (PSPS), emergencies, natural disasters, and other causes. CANHR and Long Term Care Ombudsman Services of San Luis Obispo County are co-sponsoring SB 1207. The bill codifies existing federal standards that require skilled nursing facilities to have an alternative source of power to protect resident health and safety and maintain safe temperatures for 96 hours during any type of power outage. As the COVID-19 pandemic collides with wildfire season, the critical need to keep residents safe in their facilities and out of emergency shelters is greater than ever. Over 2,200 California nursing home residents have died already from the coronavirus. It has never been more apparent that California needs to do a much better job of protecting the lives of nursing home residents. SB 1207 moves next to the California Assembly, where it will likely be assigned to a policy committee and first be heard sometime during July.
    (posted June 22, 2020)
  • CANR Releases Ten-Point Plan to Reform California Nursing Homes
    This is CANHR's Ten-Point Reform Plan that responds to the nightmarish conditions California nursing home residents have faced throughout the pandemic and for years before the coronavirus arrived. The sweeping plan addresses longstanding failings that the pandemic has exposed for all to see, starting with the need to give top priority to helping people stay out of nursing homes. It also addresses living conditions, safe staffing, emergency preparedness, nursing home slumlords, bad actors, self-dealing schemes, justice for elder abuse victims and independence from the nursing home industry.
    Click HERE to download and read it (pdf).
    (posted June 8, 2020)
  • “The Doctors” Show Takes on Nursing Home Resident Dumping
    A recent episode of “The Doctors” reviewed the continuing problem of nursing homes that dump residents into hospitals and refuse to take them back. CANHR’s lawsuit against the State to stop this practice continues in federal court.
    Segment 1: "Nursing Homes Illegally Evicting Patients?"
    Segment 2: "Know Your Rights as a Nursing Home Patient"
    Segment 3: "How to Make Sure a Nursing Home is Reputable"
    (posted June 3, 2020)
  • Newsom Administration Plans to Gut Home and Community Based Services, Use Savings to Fund Large Increases for Substandard Nursing Homes
    Does California have the money to maintain its vital programs that are aimed at keeping people who need long term care at home and out of nursing homes?
    It turns out it does, but the Administration has decided to terminate, gut and slash those programs in order to further enrich unscrupulous nursing home operators who are using the pandemic as cover for their latest money grab at the Capitol.
    (posted May 26, 2020)
  • GAO Study Finds Persistent Subpar Infection Control and Enforcement in Nursing Homes
    A new GAO study has found an extraordinary number of nursing homes have been cited for poor infection control practices in recent years and state nursing home enforcement agencies almost never find these poor practices harmful. The GAO reports that 82% of the nation's nursing homes were cited for bad infection prevention in 2013-2017, ranging from staff members failing to wash their hands to failing to isolate sick and infectious residents. Almost half of all facilities were cited in multiple consecutive years, indicating a deeply persistent problem with infection control compliance.
    Equally striking, 99% of the thousands of citations were labeled by state enforcement agencies as "non-harmful" to residents, meaning they were not accompanied by any actual enforcement action. This slap on the wrist treatment for bad infection control practices tacitly encouraged horrible infection control in nursing homes which has contributed to the massive number of deaths residents are suffering now from COVID-19.
    The GAO study confirms that years of red flags regarding infection control in nursing homes were ignored, much to our detriment. Stronger enforcement of our infection control standards is desperately needed.
    (posted May 20, 2020)
  • New COVID-19 related Fact Sheet - "Documenting Decisionmaking In a Pandemic"
    There is hardly an element of life that has not gone untouched or completely upended by COVID-19. With ubiquitous “shelter in place” orders and worldwide “social distancing,” finding notaries public and other witnesses for the signing of legal documents has become challenging for many folks and nearly impossible for long term care facility residents. This new Fact Sheet provides some helpful information on solving this problem.
    You can read it by clicking HERE, and download the PDF version HERE.
    (posted April 8, 2020)
  • Nursing Home Residents Seek Immediate Injunction Against State-Sanctioned Resident “Dumping” in Wake of COVID-19 – Plaintiffs Demand that California Adhere to Federal Law
    In a motion filed last Friday, residents in several California nursing homes have petitioned U.S. District Court Judge Haywood S. Gilliam, Jr. to enjoin the State from ongoing violations of federal anti-dumping regulations. As a result of the State’s inaction, the suit alleges that vulnerable nursing home residents have been improperly dumped into hospitals, putting them at risk of COVID-19 and wasting precious resources for sick patients.READ FULL PRESS RELEASE WITH SUPPORTING DOCUMENTS(pdf version)
    (posted April 6, 2020)
  • Urgent Action Needed to Protect California Nursing Home Residents from COVID-19 - New Directives Are Needed to Keep Residents Safe
    California population is more at imminent risk of death or severe illness from COVID-19 than nursing home residents. There is an immediate need for public officials to implement stronger measures to help keep them safe. Although well intended, the actions taken to-date are not nearly sufficient to keep residents safe and some of the measures are counterproductive.READ MORE(pdf version)
    (posted March 20, 2020)
  • U.S. Department of Justice Announces Nursing Home Initiative
    On March 3, Attorney General William P. Barr announced a new initiative to enhance civil and criminal efforts to pursue nursing homes that provide grossly substandard care to their residents. The Department of Justice press release acknowledges that nursing home residents are routinely suffering extreme mistreatment from profiteering owners, stating "all too often, we have found nursing home owners or operators who put profits over patients, leading to instances of gross abuse and neglect." Nonetheless, the release is short on details of what the initiative is going to do or how it will measure success.
    (posted March 4, 2020)
  • Consumer Voice Publishes Advice for LTC Residents and Family Members on Staying Safe from the Coronavirus
    A new advisory from the National Consumer Voice for Quality Long-Term Care gives some timely and helpful tips to residents of long term care facilities and their families on how to stay safe and help prevent the spread of the dangerous coronavirus (COVID-19).
    (posted March 4, 2020)
  • Antipsychotic Use in California Nursing Homes on the Rise
    Despite a few years of hullabaloo about the overuse of antipsychotic drugs and other chemical restraints in nursing homes, use of antipsychotics is unfortunately on the rise in California. After a nearly 25% decrease in antipsychotic use from 2012 - 2016, levels flattened and have now been on the rise since 2018. An appalling one in five California nursing home residents are still routinely drugged with dangerous and typically inappropriate antipsychotic drugs. For the past several years, a great deal of antipsychotic use has not been widely reported due to a CMS quality measure that does not count certain residents who receive antipsychotics. That measure has been gamed so extremely that now almost half of the 20,000 California nursing home residents drugged with antipsychotics are not counted by CMS.
    (posted March 3, 2020)
  • Ny Times Examines Assisted Living Understaffing
    The NY TImes recently reviewed a series of class action lawsuits filed by Kathryn Stebner of Stebner & Associates against large assisted living chains for having inadequate staffing to meet the needs of their residents. The heart of the class action cases, against such providers as Sunrise Senior Living, Atria, Aegis, and Oakmont, are allegations that facilities perform resident needs assessments to set and increase resident charges but do not use those assessments to establish the staffing levels in the facility. Thus, residents are paying for care and services they may not be actually getting. The article also points out that most states, including California, have no minimum staffing ratios. If you have been subjected to a suspect assessment or inappropriate rate increase in a Residential Care Facility for the Elderly, please contact CANHR at 800-474-1116.
    (posted March 3, 2020)
  • Solorzano Nursing Home Dumps Four Residents Into a No Care Home
    Hyde Park Healthcare Center, a nursing home in Los Angeles owned by Crystal Solorzano, was recently found to have dumped four residents, all of whom had extensive care needs, into an unlicensed care facility in April, May, and June of 2019.  The facility staff failed to complete adequate discharge planning for all four residents, including failure to assess whether the residents' needs could be met in the unlicensed home.  The facility failed to get input from the residents' physicians and failed to properly notify the residents of their evictions.  One resident, with tuberculosis (TB), was sent to the unlicensed home with the wrong medications and failed to receive his TB medication for 18 days after his eviction.  Another dumped resident had diabetes and a third had end stage renal disease, raising concerns about their ability to get needed insulin and dialysis, respectively.  At the time of the investigation, the whereabouts of two residents were unknown. The owner of the unlicensed home stated "she rents rooms out in her homes to cover the mortgage payments and that the [facility] was aware [that no care was provided].  The facility's social services designee was fired and the facility was cited and issued a $20,000 state fine along with a hefty federal civil monetary penalty and Medicare payment denial for failing to perform safe discharge planning for the residents.
    (posted March 3, 2020)
  • State Auditor Designates the Department of Public Health as a High-Risk Agency Due to Poor Oversight of Nursing Homes
    In January, the California State Auditor issued a report, State High Risk, that named state agencies that pose a high risk to the public due to mismanagement and other failures. Once again, the California Department of Public Health (CDPH) was so designated, one of only four state agencies to earn this dubious distinction. The report states that CDPH remains a high-risk agency because its failures to properly investigate complaints and issue timely citations continue to jeopardize the safety of nursing home residents.
    It also reveals that CDPH had not implemented eight recommendations from five audits and that CDPH stated it would not implement three other recommendations.
    Read California Health Report’s February 10, 2020 article on the State Auditor’s findings.
    (posted January 21, 2020)
  • Master Plan on Aging Long Term Services and Supports Subcommittee Meeting held on January 13
    The Long-Term Services and Supports Subcommittee of the Master Plan for Aging held meeting #6 Monday, January 13, 2020. The meeting explored "Group Living Settings" including assisted living and nursing homes. Pat McGinnis, CANHR's Executive Director, presented CANHR's recommendations regarding nursing homes, assisted living, home and community based services, and elder abuse and neglect. Representatives of the Long-Term Care Ombudsman program also presented. The California Department of Aging posted a recording of the meeting to YouTube. THIS LINK will take you directly to Pat McGinnis' remarks.
    (posted January 21, 2020)
  • LTCCC Re-Caps Important 2019 Federal Nursing Home Developments
    The Long Term Care Community Coalition out of New York has written up a useful re-cap of all the major federal nursing home developments in 2019. The re-cap can be viewed on the LTCCC website HERE.
    (posted January 15, 2020)
  • LA Nursing Home Makes Habit of Dumping Residents
    The residents of Vernon Healthcare Center may be happy to say goodbye to 2019 after the facility spent much of the year getting citations for illegally dumping residents into inappropriate settings unfit to meet their care needs. At least three residents were sent to board and care homes while one was dumped into a hospital. At least two of the discharges were done without the resident’s physician’s approval. These citations are more evidence of the nursing home discharge crisis recently highlighted by NBC News.
    (posted January 9, 2020)
  • Legislation Introduced to Prohibit Pre-Dispute Arbitration Agreements for Nursing Home Residents
    On December 5, 2019, U.S. Representatives Linda T. Sánchez (D-CA) and Jan Schakowsky (D-IL) introduced the Fairness in Nursing Home Arbitration Act. If enacted, the bill would prohibit long-term care facilities from requiring or soliciting residents to enter into pre-dispute arbitration agreements. CANHR and other leading advocacy organizations for nursing home residents have endorsed the bill.
    (posted December 12, 2019)
  • OIG Reports California Nursing Homes are Poorly Prepared for Emergencies
    An alarming new report – California Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness – by the federal HHS Office of Inspector General (OIG) states California nursing home residents are at increased risk of injury or death during a fire or other emergency due to widespread violations of critical safety standards. In examining emergency preparedness at 20 unnamed California nursing homes from September to December 2018, OIG found serious violations at every nursing home, including 188 violations of emergency preparedness requirements and 137 violations of life safety requirements. One of the nursing homes OIG inspected was later destroyed by a wildfire, illustrating the grave risks facing California nursing home residents today.

    The report states the violations were caused by poor management and high staff turnover. OIG also pointed the finger at the California Department of Public Health (CDPH) for poor enforcement of emergency preparedness standards. It recommended CDPH conduct more follow-up visits at non-compliant nursing homes to ensure they are prepared for emergencies. CDPH, which often seems to tolerate dangerous conditions in nursing homes, rejected the recommendation. Read California Healthline’s November 14, 2019 article on the OIG report.

    click to read more
    (posted December 3, 2019)
  • Health Journal Article Says Nursing Homes Violate Human Rights
    A new article in the International Journal of Health Services analyzes the state of nursing home care in the U.S. and finds systemic violations of domestic laws and regulations and international human rights standards. After reviewing various recent studies and nursing home data, the authors cite abuse, sexual assaults, chemical restraints, persistent understaffing, and various forms of neglect to conclude residents are not protected as required under international standards. In fact, some severe forms of abuse or neglect “could be considered torture.” The authors call for increasing enforcement of domestic rules and zero tolerance for facilities and facility owners that cause repeated abuse or neglect to address the urgent human rights crisis in America’s nursing homes.
    (posted December 3, 2019)
  • Ways & Means Committee Holds Hearing on Care Needs of Aging Americans
    On November 14, 2019, the Ways & Means Committee of the U.S. House of Representatives held a hearing – Caring for Aging Americans – that addressed major problems with America’s long-term care system and systemic changes that are needed to fix them. Several witnesses presented testimony on issues including the plight of caregivers, poor enforcement of nursing home standards, elder justice concerns, dementia and hospice care, the need to improve our eldercare system, and more. Their statements are available on the Ways & Means website. Click here to watch the hearing.
    (posted December 3, 2019)
  • 2020 Medicare Parts A & B Premiums and Deductibles
    On November 8, 2019, the Centers for Medicare & Medicaid Services (CMS) released the 2020 Medicare Parts A and B premiums, deductibles, and coinsurance amounts. Consumers will pay more in 2020 than in 2019, including an increase in the coinsurance under Medicare Part A for days 21-100 of a skilled nursing facility stay to $176 per day ($170.50 in 2019).
    (posted December 3, 2019)
  • Replacement Medication, Medical Supplies and Medical Equipment for Medi-Cal Recipients Impacted by Wildfires and Power Shutoffs
    On October 31, 2019, in response to the Governor’s proclamation of a statewide emergency due to the risk of wildfires, the Department of Health Care Services (DHCS) issued updated guidance for dispensing replacement medication(s) to impacted recipients. On November 7, 2019, DHCS provided additional guidance for dispensing medical supplies and durable medical equipment.
    (posted December 3, 2019)

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