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News & Notes Archive

August / September 2020

In this Issue

Death Toll Passes 5,000 in California Long Term Care Facilities

The tragic death toll in California long term care facilities continues to climb daily. As of September 1, 2020, the California Department of Public Health reported that 4,123 residents of skilled nursing facilities and 139 health care workers in these facilities had died of COVID-19. In assisted living facilities, the California Department of Social Services reports that 884 residents and staff members had died from COVID-19 as of the same date. 

Our hearts go out to the loved ones of all who have died. CANHR deeply grieves their deaths and remains dedicated to honoring them through our advocacy to establish a just and humane long term care system in California. 

California Department of Public Health Issues New Visitation Guidance

On August 25, the California Department of Public Health (DPH) issued All Facilities Letter 20-22.4 (the “AFL”), outlining some significant changes to the State’s ever-evolving guidance relating to visiting nursing homes and other health facilities during the COVID pandemic.
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Good News! Legislature Passes SB 1207 (Jackson) and Sends to Governor for Signature

During the final hours of the legislative session on August 31, the California Legislature gave final approval to SB 1207, a critically important bill by Senator Hannah-Beth Jackson. If signed by the Governor, SB 1207 would 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. Its purpose is to keep residents safe 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 the bill. Governor Newsom’s position on the bill is unknown. The bill is strongly opposed by the nursing home industry, so its fate remains uncertain. CANHR will be sending an alert early next week with information on contacting the Governor to urge him to sign SB 1207. Read letter from CANHR and Long Term Care Ombudsman Services of San Luis Obispo County to Governor Newsom urging him to sign the bill

Older and Overlooked: KQED Airs Series on Wildfire Risks to Residents of Long Term Care Facilities

During the week of August 10-14, KQED aired and published findings from its remarkable investigation into whether nursing homes and assisted living facilities in California are prepared to keep residents safe during emergencies. Its conclusion: Even after care homes abandoned residents during wildfires in recent years, California long term care facilities are still not prepared to keep residents safe during wildfires. Thousands of these facilities were found to be at risk for wildfire. The exceptional series, Older and Overlooked, is posted on the KQED website.

California Nursing Home Inspectors Fight Pandemic-Related Oversight Failures by CDPH

In recent weeks, California nursing home inspectors employed by the California Department of Public Health (CDPH) have exposed serious failures at CDPH and fought CDPH’s highly misguided plan to turn them into consultants to nursing home operators. At risk to their jobs, they have repeatedly drawn public attention to problems that endanger nursing home residents right now. Those who are speaking up are providing a badly needed public service by doing so.
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Facility Evictions Update

The Judicial Council of California voted to end the moratorium on housing evictions on September 1st, 2020. This means that courts will once again hear routine eviction cases so assisted living facilities and nursing homes may pursue court-ordered resident evictions after they have given proper written discharge notice.
Although AB 3088, which provides new COVID-related tenant protections, has been signed into law, the new statute will provide little assistance to most residents of long term care facilities in California. The statute provides some protections to residential and mobile home tenants who cannot pay their rents for reasons related to the COVID pandemic, but it does not address the plight of nursing home or assisted living residents who are being evicted for reasons unrelated to financial hardship resulting from the virus.

If you or a loved one is facing an assisted living or nursing home eviction please review our fact sheets (nursing homes here and assisted living here) or contact CANHR.  

Aged and Disabled Income Disregard Increase Delayed until December

ACWDL 20-02E was sent to the counties informing them of the delay in implementation of the increase in income disregard of countable income above 100% up to 138% of the Federal Poverty Level (FPL) for aged, blind and disabled individuals. The result of SB 104 passed in 2019, this increase would have eliminated a share of cost for thousands of aged and disabled beneficiaries, raising the income level significantly for aged and disabled beneficiaries. Current income levels, effective April 1, 2020 are $1,294 for a single person and $1,747 for a couple.  The income level increase was originally scheduled to be implemented August 1, 2020. At last word, the Department indicated that implementation would be delayed until December 2020.

At Home Benefit – Deferred?

An email sent August 26, 2020 from the Department of Health Care Services reads as follows:  DHCS will no longer be moving forward with the Long-Term Care at Home proposal at this time. Although DHCS still believes in the immense value that the Long-Term Care at Home benefit would bring to some of the most vulnerable beneficiaries in the Medi-Cal program; the Administration and the Legislature were unable to agree on a process to develop and implement the benefit at this time.   There have been a number of unanswered questions about the proposed At Home Benefit, including if the sacrifice to afford this supposedly “budget neutral” proposal would be elimination of Adult Day Health Care/Community Based Adult Services (ADHC/CBAS) and Multi-Purpose Senior Services (MSSP) and a 7% cut to IHSS – all recommended cuts included in the Governor’s May revise budget.  The proposed benefit was hastily conceived and was moving quickly, with few details revealed.  While CANHR is very supportive of affordable and accessible home and community-based services, there were many concerns about the quick pace of this proposal with few answers to the many questions asked.

New Research: Nursing Homes Inflate CMS “Quality Measures” 

It should surprise nobody to hear that new research finds nursing homes inaccurately report the conditions of their residents when submitting “quality measure” data to the Centers for Medicare and Medicaid Services. The self-reported data is used as one of three major components to a facility’s federal 5-star rating. For years, nursing home resident advocates have argued that any ratings system should not rely on unaudited, self-reported data from the nursing homes themselves because they have an incentive to report inflated data. In the new research, quality measure data was compared to Medicare claims data for nursing home residents who were hospitalized. The comparisons demonstrated that nursing homes substantially underreport the number of residents who develop pressure sores while in the facility. The data also showed inaccurate reporting regarding urinary tract infections (UTIs) and resident falls.

CANHR COVID-19 News & Resources

If you have not already done so, please check out CANHR’s COVID-19 website. The rapidly evolving website has hundreds of pages devoted to COVID-19 information, news and resources related to long term care. It contains CANHR alerts and recommendations, information on visitation rights, state and federal directives, links to outbreak data, media stories, webinar recordings and much more. Also visit our Visitation Saves Lives website.

Townhall Recaps

This month, CANHR hosted two virtual townhalls that were open to the public. We were overwhelmed by the interest, with over 460 participants, and will be scheduling additional townhalls in the near future. In the meantime, you can watch the recordings below. 

Getting Good Care in the Pandemic

Good long term care should not be a casualty of COVID-19; in fact, it has never been more important.  But how can residents and their families ensure that good care is being provided when so many rules have been waived and accountability is missing? In this townhall, we reviewed the state of long term care, including visitation, understaffing, and evictions, and then answer questions about the best way to ensure residents are safe and well cared for during the pandemic.

Senior Scams in the Pandemic

During this pandemic, scams targeting seniors are increasing at an alarming rate. In this townhall, we go through several scenarios where con artists use COVID as a pretext to defraud seniors, sometimes costing them their life savings. The information in this townhall is meant to help you and your loved ones protect yourselves from the scam artists taking advantage of seniors’ concerns and fears about the COVID-19 virus.

CANHR’s 2020 Free Fall Webinar Series for Qualified Legal Services Programs and Long Term Care Ombudsman Programs1-1.5 hour of MCLE available per session.

Assessing Capacity during COVID-19Wednesday, September 16th, 2020 2:00pm-3:00pmThis presentation will cover legal and ethical issues that arise when representing clients with diminished capacity for decision-making and best practices for assessing a client’s capacity. There will be a special focus on a new proposed State Bar ethics opinion and the practical considerations for remote client interactions during COVID-19. One hour ethics MCLE.

 Presented by Peter Stern, Esq. and Tony Chicotel, Esq. 

The Wild World of Long Term Care Evictions

Tuesday, September 29th and Wednesday,
September 30th 2:00pm-3:30pm

There has never been a worse time to be a resident of a long term care facility. One reason is that residents are increasingly discarded through inappropriate and illegal evictions. Federal and state laws that are supposed to protect residents are barely enforced. This training for attorneys and long term care resident advocates will cover the new paradigm of long term care and evictions, the relevant laws and procedures, and most importantly, guidance on how to stop illegal evictions in your community. This training will be presented in two parts over consecutive days. MCLE included.

Presented by Jody Spiegel, Esq., Tony Chicotel, Esq. and Michael Dark, Esq.

Free Zoom Workshops for Social Workers

Medi-Cal Eligibility BasicsThursday, September 10, 11:00am – 12:00 This workshop will cover eligibility basics for community-based and long term care Medi-Cal for older adults and persons with disabilities. Presenters will go over updates related to COVID-19.

Alternatives to Nursing Homes

Thursday, September 17, 11:00am – 12:00 

This workshop will provide an overview of Medi-Cal’s spousal impoverishment protections for Home and Community-Based Services (HCBS), along with an overview of the status of HCBS programs during the pandemic. 

Medi-Cal Recovery in 2020

Thursday, September 24, 11:00am – 12:00 

This workshop will cover California’s Medi-Cal Estate Recovery laws, including an overview of strategies to protect the home from estate recovery claims. 

Violation of the Month

Hollywood Premier, a Los Angeles nursing home that was recently in the news for its mishandling of a COVID-19 outbreak, was cited by the Department of Public Health (DPH) for dumping a resident into a hospital and refusing to readmit him because he did NOT have COVID-19. The resident, who had dementia and lived in the facility for eight years, was sent to the hospital on 5/26/2020. On 5/27/2020, the resident was deemed ready to return to Hollywood Premier but the facility refused to allow him to return. The facility managers told DPH it was only admitting COVID-19 positive residents because the facility had become a designated COVID-19 facility. Since the resident did not have COVID-19, the managers reasoned, he could not return home. The facility’s illegal eviction violated federal and state law and a local public health directive. The resident was still stuck in the hospital as of 6/15/2020 when the citation report was written. The facility was cited for failing to provide the resident with a notice of his bed hold rights and its failure to readmit him when he was ready to be discharged from the hospital.

Hollywood Premier Healthcare Center, Class B, $2,000, #920015905, June 18, 2020