In this Issue
- Court Declares Nursing Home Residents Have Right to Sue States (Like California) With “Meaningless” Eviction Appeals
- CANHR v Smith – At Long Last, Constitutional Rights for “Unrepresented” Patients
- CMS Issues Proposed Regulations to Rollback Nursing Home Requirements
- Senate Finance Committee Holds Hearing on Elder Abuse in Nursing Homes
- Horrific Abuse Scandal Exposed at Laguna Honda in San Francisco
- New Study Finds 75 Percent of Nursing Homes Almost Never Have Enough RN staff to Meet Resident Needs
- State Raises Income Limit for Medi-Cal Aged & Disabled Program
Court Declares Nursing Home Residents Have Right to Sue States (Like California) With “Meaningless” Eviction Appeals
On July 18, 2019, The Ninth Circuit Court of Appeals sided with CANHR and three nursing home residents who sued California for ignoring its own administrative orders. The residents were all dumped by their nursing homes into hospitals and illegally refused readmission. Each of the residents successfully appealed the eviction and received a State order for readmission. None of the residents were actually readmitted though as the offending nursing homes ignored the order and the State did nothing to enforce it.
CANHR v. Smith – At Long Last, Constitutional Rights for “Unrepresented” Patients
In a groundbreaking decision, the First District Court of Appeal has ruled that “unrepresented” patients in the health care system have constitutionally protected privacy rights that require significant due process protections before treatment decisions may be imposed without their consent. The case at issue, CANHR v. Smith, challenged the constitutionality of Health and Safety Code Section 1418.8, which permits nursing homes to make treatment decisions for unrepresented residents – those without decision making capacity or a surrogate decision maker. While stating the statute would not be discarded on constitutional grounds, the Court nonetheless found the statute failed to provide constitutionally required protections such as notice to the resident and an advocate/representative to protect their interests.
CMS Issues Proposed Regulations to Rollback Nursing Home Requirements
Aiming to “reduce the regulatory burden on providers,” the Trump administration issued proposed regulations on July 18, 2019 that would rollback important protections for nursing home residents. The proposed rules would weaken many resident protections, including those on notice to the ombudsman about transfers and discharges, abuse reporting, infection control, use of psychoactive drugs, grievances, and other standards. It would also reduce the qualifications for directors of food and nutrition services, cut facility-wide assessments from annually to once every two years, eliminate the requirement for a dedicated compliance officer, and allow some facilities to evade life safety code standards and requirements on room size and bathroom proximity. Implementation of certain requirements would be delayed.
Senate Finance Committee Holds Hearing on Elder Abuse in Nursing Homes
On July 23, 2019, the U.S. Senate Finance Committee held a hearing to address new reports that nursing home residents are increasingly at risk of abuse. Representatives of the Government Accountability Office (GAO) and HSS Office of Inspector General testified on findings of their recent investigations on abuse. The GAO report – Nursing Homes: Improved Oversight Needed to Better Protect Residents from Abuse – concluded that abuse deficiencies more than doubled in recent years, with the largest increase in severe cases. OIG’s representative testified on a series of reports, including a June 2019 report that found nursing home abuse is rarely reported.
Horrific Abuse Scandal Exposed at Laguna Honda in San Francisco
On June 28, 2019, San Francisco’s mayor and other officials held a press conference to discuss a horrific abuse scandal at Laguna Honda, one of the nation’s largest skilled nursing facilities. According to the officials and a press release by the San Francisco Department of Public Health, a group of six employees abused 23 residents over a period of years, subjecting them to verbal and physical abuse, sexual harassment, drugging, humiliation, neglect and other despicable acts.
New Study Finds 75 Percent of Nursing Homes Almost Never Have Enough RN staff to Meet Resident Needs
A July 2019 study published in Health Affairs reports that new Payroll-Based Journal (PBJ) data from nursing homes show that few of them ever have enough registered nurse (RN) staffing to meet resident needs, weekend staffing is low, and there are large fluctuations in daily staffing levels. One of the study’s authors described the finding on RN staffing as “staggering.”
State Raises Income Limit for Medi-Cal Aged & Disabled Program
Beginning January 1, 2020, California will increase the income limit for Medi-Cal’s Aged and Disabled Program to 138% of the Federal Poverty Level (FPL). This change represents a huge gain for over 25,000 seniors and persons with disabilities in California on Medi-Cal, who will no longer need to spend their fixed income on health insurance or Share of Cost.
CANHR on the Move
Left to Right: Leza Coleman, Executive Director for California Long Term Care Ombudsman Association, Tony Chicotel, CANHR Staff Attorney, Joe Rodrigues, State Ombudsman, Libby Anderson, and Lisa Wright Jenkins, Southern California Council on Aging.