Senate panel oks raising top fine on assisted living centers to 15k
This article originally appeared in the U-T San Diego
The maximum fine for health and safety violations at assisted-living centers would grow 100-fold under overhaul legislation approved by a key Senate committee on Thursday.
The top fine is currently $150, even for violations resulting in the death of elderly residents, an amount criticized as too low in U-T Watchdog’s “Deadly Neglect” series last year.
Legislation by Assemblyman Brian Maienschein, R-San Diego, would increase the maximum fine to $15,000. His bill sailed through earlier legislative steps, but the costs of enforcement were under scrutiny at the Senate Appropriations Committee on Thursday.
Added administrative costs to the state are estimated at $200,000 to $300,000, excluding unknown costs related to possible appeals. No estimate was put on added revenues from higher fines.
The bill was approved 5-0 vote, and next goes to the Senate floor. Co-authored by Assemblyman Mark Stone, D-Scotts Valley, it passed the Assembly in May, 78-0.
The U-T’s series on assisted living homes was done in partnership with the CHCF Center for Health Reporting. The series identified at least 27 deaths due to neglect and abuse at San Diego County care homes.
The articles highlighted a growing system of facilities with little state oversight, where consumers expected but did not receive similar services and protections to those offered at nursing homes. As the series pointed out, nursing homes face much stricter regulation and fines as high as $100,000.
If the fines bill had been rejected by the panel on Thursday, it would have died – the fate of several other assisted living reform bills introduced in response to the U-T’s coverage and other news events last year.
The fine increase was backed by the state’s largest industry group, the California Assisted Living Association, and its best-known advocacy group for seniors in long-term care, California Advocates for Nursing Home Reform.
A newly-formed group, 6Beds Inc., which represents operators of small homes, recently questioned certain proposed fines for smaller offenses, saying they could hurt homes’ financial stability and therefore limit options for seniors.
A 6Beds spokeswoman said Thursday that talks are continuing and that some amendments could still happen on the Senate floor.
Also on Thursday, another committee voted to approve a bill by Sen. Marty Block, D-San Diego, that would require staffs of assisted living homes to have more training. Block has repeatedly noted that manicurists are required by the state to have more training than staffers caring for vulnerable seniors. His bill next goes to the full Assembly.
The two bills were among 15 bills designed to toughen oversight of assisted living homes. Ten were reviewed by appropriations panels on Thursday, with at least five passing, and three failing.
One of the more significant bills to die was one by Assemblyman Ian C. Calderon, D-Whittier, that would have increased the frequency of assisted-living facility inspections and those at other care homes. The state minimum is one inspection every five years. He proposed to increase that to require annual, unannounced, inspections.
Calderon believes it stumbled because of what he called an unrealistically large state estimate of $20 million to increase the inspections, and he wants an independent review.
“I will carry this bill every single year until it happens,” he added. “This is one of the deals where the cost is worth the benefit.
Most of the legislation was packaged as the RCFE Reform Act of 2014, using the state’s acronym for residential care facilities for the elderly.
Legislators must finish amending bills by Aug. 22, and the deadline for final votes is Aug. 31. Successful bills then go to Gov. Jerry Brown, who must sign or veto them by Sept. 30.
To date, he has signed one assisted living bill, and a second, requiring assisted living homes to carry liability insurance, is on its way to his desk. It was authored by Democratic Assembly members Toni Atkins and Shirley Weber, both of San Diego.
Aaron Byzak of the North County consumers’ group Hazel’s Army said he is pleased that several important reforms passed the committee stage but added that he believes more has to be done.
Byzak organized Hazel’s Army after his grandmother died from injuries she received while living at an assisted living home last year.
He wants to see more frequent inspections and more information available online to consumers.
“We need to see the legislature pass these completely,” Byzak said. “We need to see the governor sign them, and then we need to come back next year and do it again.”
Sally Michael, president of the California Assisted Living Association industry group, said, “Overall, we’re mostly pleased with where things are after today. CALA’s top priority bills are still moving and we’re on track to make great strides in enacting stronger oversight of assisted living communities.”
A measure to create a Bill of Rights for assisted living residents — similar to one for nursing home residents — also passed, despite opposition from industry groups. It goes next to the full Senate.
Industry groups say they will continue to oppose the bill, saying it could spawn frivolous lawsuits.
“It is strongly supported by trial lawyers, which is not an insignificant lobby,” said Beth Miller, spokeswoman for 6Beds Inc.
Michael, at CALA, is also opposed to the bill.
“The author made some technical amendments which don’t change the fact that this is still a bill that will allow lawyers to file shakedown lawsuits against assisted living communities,” she said.
The bill’s author, Bob Wieckowski, D-Fremont, said he is open to further talks about possible amendments, but he believes the measure is sorely needed by assisted living residents.
“The committee’s support moves us one step closer to establishing a Bill of Rights for seniors in these facilities that will enable them or their representatives to prevent or stop mistreatment,” he added. “We have an aging population and the status quo is not sufficiently protecting our elderly. It is time to enact these reforms.”
Tony Chicotel, staff attorney at California Advocates for Nursing Home Reform, said he was pleased that several bills passed that were sponsored by his group. But he said he was disappointed by the loss of two bills he considered key, one requiring an online information system for consumers, and the other requiring state inspectors to investigate complaints more quickly.
Assembly Bill 1571, which would have required the California Department of Social Services to build an online system for consumers to track violations at specific homes. Right now, if a family member wants to find out if a home has a history of negligence, violations or medical errors, they have to make an appointment at the regional Social Services office and review the file in person.