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New Rights for Consumers in CCRCs:
Before and After SB 244

By Lillian L. Hyatt, M.S.W., and a Resident of a CCRC

Excerpted from the Winter 2005 The CANHR Advocate newsletter

Senate Bill 244, a bill authored by Senator Gloria Romero and sponsored by CANHR, provides new rights for consumers in CCRCs, and takes effect January 1, 2006. My reflections indicate some key problems before the passage of SB 244, and the new possibilities and protections for consumers after the enactment of SB 244.

Right to Know (Health & Safety Code (H&S) §1771.7)

Before SB 244: A Marketing Director could dissuade applicants from visiting the assisted living or nursing home care levels with the pretense of protecting resident privacy. I never saw these care levels or reviewed licensing reports. It was only after I was living at the facility for over a year that I discovered a discouraging report about the nursing home.

After SB 244: A prospective resident shall have the right to visit each of the different levels of care and to review inspection reports and findings of complaint investigations covering a period of no less than two years prior to signing a contract.

Before SB 244: Consumers were not aware that they had a right to file complaints with the licensing agency for unresolved problems in the independent living units.

After SB 244: All residents must be informed at the time of or before signing the contract, and at any time when there is a transfer to a different level of care, that they have rights including the right to file complaints without retaliation. These rights are now required to be posted in a prominent place in the facility.

Right to Organize (H&S §1771(c)(9))

Before SB 244: In some CCRCs, administrators discouraged the formation of chapters of the California Continuing Care Residents Association (CALCRA) – an independent resident association. In my facility, the Resident Association President (Resident Associations are sometimes mere extensions of administration) made this announcement at a 2003 meeting: “We don’t need CALCRA here!” No notices of CALCRA meetings were permitted to be put into residents’ in–house mailboxes. An article I submitted to the in–house publication about this bill, SB 244, was rejected although opposition information on the bill was freely published.

After SB 244: The law now permits residents to organize and participate in “independent resident organizations.” As soon as the Governor signed SB 244 into law, I wrote to the newly elected Resident Association President indicating that several residents wanted to form a CALCRA Chapter. He invited me to submit an article to the same publication that had previously censored me.

Level of Care Transfers (H&S §1788(a)(10))

Before SB 244: When I entered my CCRC, I was a healthy woman, but one year later I was diagnosed with a swallowing disorder, which made it necessary for me to rely on pureed foods. When I asked for this service my doctors had prescribed, I was told that in order to get that service I would have to leave my apartment which had cost me initially $183,000 plus $40,000 to upgrade, and go to one room in the skilled nursing home. I was forced to hire an attorney at significant personal expense to enforce my rights and to remain in my own apartment.

After SB 244: Transfers to different care levels are now governed by objective criteria and by a fair and open process that considers the appropriateness and necessity of the transfer with the goal of promoting resident independence. The process requires an explanation of the assessment process, a care conference involving the resident and the resident’s family, physician or other health care providers, a written 30 day notification with reasons stated for the transfer, right to review the transfer at another care conference, and finally the right to request a review by the Continuing Care Contracts Branch of the process used by the provider. If this type of process had been in place, I probably could have avoided the more adversarial proceedings that I was forced to use and been saved unnecessary costs and strained relationships.

While SB 244 does not resolve all CCRC residents’ problems, it does provide new rights, protections, and possibilities for empowerment for CCRC consumers.