Section 1422 Of Chapter 2.4. Quality Of Long-term Health Facilities From California Health And Safety Code >> Division 2. >> Chapter 2.4.
1422
. (a) The Legislature finds and declares that it is the public
policy of this state to ensure that long-term health care facilities
provide the highest level of care possible. The Legislature further
finds that inspections are the most effective means of furthering
this policy. It is not the intent of the Legislature by the amendment
of subdivision (b) enacted by Chapter 1595 of the Statutes of 1982
to reduce in any way the resources available to the state department
for inspections, but rather to provide the state department with the
greatest flexibility to concentrate its resources where they can be
most effective. It is the intent of the Legislature to create a
survey process that includes state-based survey components and that
determines compliance with federal and California requirements for
certified long-term health care facilities. It is the further intent
of the Legislature to execute this inspection in the form of a single
survey process, to the extent that this is possible and permitted
under federal law. The inability of the state to conduct a single
survey in no way exempts the state from the requirement under this
section that state-based components be inspected in long-term health
care facilities as required by law.
(b) (1) (A) Notwithstanding Section 1279 or any other provision of
law, without providing notice of these inspections, the department,
in addition to any inspections conducted pursuant to complaints filed
pursuant to Section 1419, shall conduct inspections annually, except
with regard to those facilities which have no class "AA," class "A,"
or class "B" violations in the past 12 months. The state department
shall also conduct inspections as may be necessary to ensure the
health, safety, and security of patients in long-term health care
facilities. Every facility shall be inspected at least once every two
years. The department shall vary the cycle in which inspections of
long-term health care facilities are conducted to reduce the
predictability of the inspections.
(B) Inspections and investigations of long-term health care
facilities that are certified by the Medicare Program or the Medicaid
Program shall determine compliance with federal standards and
California statutes and regulations to the extent that California
statutes and regulations provide greater protection to residents, or
are more precise than federal standards, as determined by the
department. Notwithstanding any other provision of law, the
department may, without taking regulatory action pursuant to Chapter
3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title
2 of the Government Code, implement, interpret, or make specific this
paragraph by means of an All Facilities Letter (AFL) or similar
instruction. Prior to issuing an AFL or similar instruction, the
department shall consult with interested parties and shall inform the
appropriate committees of the Legislature. The department shall also
post the AFL or similar instruction on its Web site so that any
person may observe which California laws and regulations provide
greater protection to its residents or are more precise than federal
standards. Nothing in this subdivision is intended to change existing
statutory or regulatory requirements governing the care provided to
long-term health care facility residents.
(C) In order to ensure maximum effectiveness of inspections
conducted pursuant to this article, the department shall identify all
state law standards for the staffing and operation of long-term
health care facilities. Costs of the additional survey and inspection
activities required by Chapter 895 of the Statutes of 2006 shall be
included as Licensing and Certification Program activities for the
purposes of calculating fees in accordance with Section 1266.
(2) The state department shall submit to the federal Department of
Health and Human Services on or before July 1, 1985, for review and
approval, a request to implement a three-year pilot program designed
to lessen the predictability of the long-term health care facility
inspection process. Two components of the pilot program shall be (A)
the elimination of the present practice of entering into a one-year
certification agreement, and (B) the conduct of segmented inspections
of a sample of facilities with poor inspection records, as defined
by the state department. At the conclusion of the pilot project, an
analysis of both components shall be conducted by the state
department to determine effectiveness in reducing inspection
predictability and the respective cost benefits. Implementation of
this pilot project is contingent upon federal approval.
(c) Except as otherwise provided in subdivision (b), the state
department shall conduct unannounced direct patient care inspections
at least annually to inspect physician and surgeon services, nursing
services, pharmacy services, dietary services, and activity programs
of all the long-term health care facilities. Facilities evidencing
repeated serious problems in complying with this chapter or a history
of poor performance, or both, shall be subject to periodic
unannounced direct patient care inspections during the inspection
year. The direct patient care inspections shall assist the state
department in the prioritization of its efforts to correct facility
deficiencies.
(d) All long-term health care facilities shall report to the state
department any changes in the nursing home administrator or the
director of nursing services within 10 calendar days of the changes.
(e) Within 90 days after the receipt of notice of a change in the
nursing home administrator or the director of nursing services, the
state department may conduct an abbreviated inspection of the
long-term health care facilities.
(f) If a change in a nursing home administrator occurs and the
Board of Nursing Home Administrators notifies the state department
that the new administrator is on probation or has had his or her
license suspended within the previous three years, the state
department shall conduct an abbreviated survey of the long-term
health care facility employing that administrator within 90 days of
notification.