California lawmakers on Monday moved to strengthen the state’s oversight of nursing homes, barring anyone from operating a skilled nursing facility without a license.
Democratic Assemblyman Al Muratsuchi said his bill would give the California Department of Public Health stronger authority to block unqualified and unethical owners by shutting down what he said is an increasing number of for-profit nursing home chains operating unlicensed nursing homes.
“This bill seeks to fix a broken state licensing system,” Muratsuchi said.
The problem has only been exacerbated by the pandemic, endangering thousands of those who are elderly or disabled, said Democratic Assemblyman Jim Wood.
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“Part of what we’re trying to do is protect some of the most vulnerable people in our society,” Wood said. “We’ve seen too many perish in nursing homes during COVID. We’re seeing another wave of it now. They’re a fragile population.”
The Assembly passed the bill on a 47-12 vote, sending it to the Senate.
Muratsuchi cited two chains that he said are collectively running several dozen homes without appropriate state licensing.
Many of their licensing applications were denied years ago due to poor conditions, he said, yet they’ve been allowed to keep operating while buying more nursing homes during the pandemic.
His bill would set licensing standards and bar the use of management agreements that critics say the corporations have used to circumvent state licensure requirements. Violators could be hit with civil penalties of $10,000.
“The state’s failure to screen out unfit operators is like a welcome sign to bad actors,” said California Advocates for Nursing Home Reform, which backed the bill as part of a package of reform legislation in the last year.
It said owners’ decisions on staffing, administration and care “have life and death consequences for nursing home residents in the best of times, and never more so than during the pandemic.”
A 2018 state audit also faulted the state’s poor oversight.
The California Association of Health Facilities, which represents most of the state’s nursing homes, opposed the bill without further amendments, but agreed that the process needs reform.
It blamed California for having “the most unworkable and lengthy licensure process in the nation.” However, it said, “nursing facilities did not create this backwards process. It has been perpetuated by the state – and it needs to end.”
The bill goes too far, it said, with “stringent disqualifications criteria (that) would eliminate most if not all potential applicants.”