Section 1437.5 Of Chapter 2.4. Quality Of Long-term Health Facilities From California Health And Safety Code >> Division 2. >> Chapter 2.4.
1437.5
. (a) If a facility is certified to participate in the
federal Medicare program as a skilled nursing facility under Title
XVIII of the Social Security Act, in the medicaid program as a
nursing facility under Title XIX of the Social Security Act, or in
both and any of the following occurs, the state department may
rescind its regular license to operate and issue a provisional
license under Section 1437:
(1) The facility's provider agreement is terminated, by the
federal government or the department.
(2) A temporary manager is appointed, under federal law, to
operate it.
(3) Payment becomes due on a federal civil money penalty of seven
thousand dollars ($7,000) per day, or greater, imposed on it.
(4) A federal civil monetary penalty of any amount is imposed and
has continued for a period of 30 days or more.
(5) A federal civil monetary penalty of any amount is imposed and
has accrued in an amount equal to, or greater than, thirty-five
thousand dollars ($35,000).
(b) The state department may not take action pursuant to
subdivision (a) until a final administrative decision is issued if
the facility has requested a hearing pursuant to federal law, until a
facility has waived its right to a hearing under federal law, or
until the time for requesting a hearing under federal law has expired
and a hearing request was not received by federal authorities.
(c) If a receiver or temporary manager is appointed to operate a
skilled nursing facility or an intermediate care facility, specified
in paragraphs (1) and (2) of subdivision (a) of Section 1418,
pursuant to state law, or as otherwise specified in regulations
adopted by the department, the state department may rescind its
regular license to operate and issue a provisional license under this
section.
(d) (1) A provisional license issued pursuant to this section
shall terminate six months from the date of issuance unless extended
by the department.
(2) At least 30 days prior to the termination of a provisional
license, the department shall give the facility a full and complete
inspection. If, at the time of the inspection, it is determined that
the facility meets all applicable requirements for licensure, a
regular license shall be restored. If, at the time of the inspection,
it is determined that the facility does not meet the requirements
for licensure, but the facility has made substantial progress towards
meeting the requirements, as determined by the department, the
provisional license shall be renewed for six months. If, at the time
of the first inspection, the department determines that there has not
been substantial progress towards meeting the requirements for
licensure, or, if at any subsequent inspection the department
determines that there has not been substantial progress towards
meeting requirements identified at the most recent previous
inspection, a regular license shall not be issued.
(e) The facility may request a hearing in writing within 10 days
of the receipt of notice from the department denying a regular
license under this section. The provisional license shall remain in
effect during the pendency of the hearing. The hearing shall be held
in accordance with Section 100171. The hearing officer shall uphold
the denial of a regular license if the department proves, by a
preponderance of the evidence, that the licensee did not meet the
requirements for licensure.