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⭒ News & Notes Archive

August 2021

In this Issue

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

See All Facility Letter 21-28 to skilled nursing facilities and All Facility Letter 21-30 to Intermediate Care Facilities for additional guidance on this order.

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.

Centers for Medicare & Medicaid Services (CMS) Restores Tougher Penalties for Nursing Home Violations

After a lawsuit filed on January 18, 2021 by 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. For details, read CANHR’s press release and this New York Times article.

Owner of Nursing Home Chain Drops Appeal on Denied Licenses

On the eve of an appeal hearing scheduled to begin on July 19, the California Department of Public Health (CDPH) reports that Crystal Solorzano dropped her appeal of its determinations that she was not fit to hold licenses at nine nursing homes. Alarmingly, it is not at all clear what comes next for the residents of these troubled facilities. CDPH has not announced any plans to transition operations of the facilities to qualified operators, raising new questions about its tolerance of dangerous conditions in California nursing homes. According to LAist – which has been investigating Solorzano’s nursing home chain – at least 220 people died of COVID-19 at nursing homes connected to Solorzano, including 94 in the nine nursing homes where CDPH rejected Solorzano’s ownership applications. LAist’s latest coverage on the unfolding crisis is at: Owner of Troubled Nursing Homes Drops Appeal.

New California Budget to Phase Out Medi-Cal Asset Test and Bring Other Reforms

There is very welcome news for older adults in California’s new Health Budget Act, which will both phase out the Medi-Cal asset test while adding full-scope Medi-Cal coverage for undocumented adults 50 and over. Over the next two and a half years, California will eliminate the Medi-Cal asset test. First, no sooner than July 1, 2022, the state will raise the asset limit in the programs serving older adults and people with disabilities to $130,000 for an individual and $65,000 for each additional family member. Then, subject to federal approval and no sooner than January 1, 2024, the state will eliminate the asset test completely. See Justice in Aging’s excellent budget summary for more information on these and other important reforms that have been enacted.

New Penalties for Nursing Homes that Defy State Readmission Orders

Another provision of the Health Budget Act establishes penalties for nursing homes that engage in the reprehensible practice of dumping residents and defying state orders to readmit them. It provides a discretionary fine of $750 per day with a maximum penalty of $75,000 when a long-term health care facility fails to comply with a hearing decision ordering readmission. CANHR has long fought the illegal dumping of nursing home residents and sought stronger penalties to end this pervasive practice. There is concern, however, that the new fine is too small, negotiable, and intermittent to provide the deterrence that is needed.

Support H.R. 3733: New Federal Legislation to Protect Resident Visitation in Future Pandemics

On June 30, Congressmembers Claudia Tenney and John Larson introduced H.R. 3733, a bipartisan bill that would guarantee nursing home residents’ right to critical in-person support from up to two essential caregivers, even during a pandemic.  The essential caregivers are designated by the resident or the resident’s representative and would have up to 12 hours of access to the resident each day.  If the bill becomes law, it would be a powerful rebuke to CMS and the states that adopted and maintained dangerous and overreaching bans on visitation during the COVID-19 pandemic. CANHR encourages everyone to contact their Congressmember and urge them to support H.R. 3733. Graphic courtesy of the Essential Caregiver Movement.

Read the Consumer Voice Issue Brief on The Essential Caregivers Act.

California Legislative Reforms Moving Forward

With the September 10 end of the California legislative session fast approaching, it is crunch time for important nursing home reforms. All seven bills that are part of the “Protect Plan” are still under consideration, with the exception of AB 1502 on ownership reform, which has been sidelined until next year. Please encourage your California legislators to support them. You can follow their status on CANHR’s legislative website.

Eighty-Eight Percent of California Nursing Homes Overdue for Inspection

A July 29, 2021 report by the HHS Office of Inspector General (OIG) describes huge backlogs in standard nursing home inspections throughout the nation, with 71 percent of nursing homes having gone at least 16 months without a standard survey as of May 31, 2021. The backlog is even worse in California, where only 12 percent of nursing homes have had standard surveys in the last 16 months. OIG expresses concern that standard surveys are the main tool to ensure that nursing homes meet the minimum standards necessary for the safety and wellbeing of residents. The California Department of Public Health has widely curtailed full inspections at a time when they are most needed to protect residents from neglect and abuse.

CANHR Resources

Watch CANHR’s July 21st Zoom Town Hall on The Current State of Visitation Rights in Long Term Care Facilities:

CANHR’s July 21st Zoom Town Hall on The Current State of Visitation Rights in Long Term Care Facilities