SB1406 was signed into law by California’s Governor and will be enforced January 1, 2025. It is unwelcomed news for RCFEs. The bill amended two Health and Safety Codes, 1569.269, resident rights, and 1569.655, rate increases. It is now a new resident right to “request, refuse or discontinue a service.” How a facility would be allowed to discontinue a service can, under Title 22, cause a loss of license (“Basic Services means those services required to be provided by the facility in order to obtain and maintain a license”). Can a resident refuse a service that is needed by the resident to ensure “health and safety” as required by Health and Safety Code 1569.269(a)(16)? The new law will simply read, “To request, refuse, or discontinue a service.” Because DSS did not clarify the previously enacted residents’ rights, it is unlikely there will be an interpretation of what “request, refuse, or discontinue a service” means to a resident or a license. The other new law is that a facility rate or fee increase cannot be implemented until a 90-day notice has been issued. This, too, takes effect in January.
The attempt to increase maximum capacity beyond six beds has “died.” AB770 attempted to bypass city building and fire codes to permit a greater number of elderly to reside in a residential home above six beds, but there will be no change to Health and Safety Code 1569.85.
Although not declared completely dead, AB2650 is currently lying in the “suspense file,” in the State Legislature meaning the attempt at facility data collection is not likely to pass unless the state’s budget makes a specific money appropriation to implement it. It could be resurrected if the state’s appropriations committee decides if the bill will move on. That hearing is “secretive,” because no bill maker should know who voted against his or her “sacred cow” bill.
There are many bills lying in suspense awaiting funding just like AB2650. If the state continues to hemorrhage money and its taxpayers, it is unlikely most of the bills will find the light of day to go another round of debate and voting.
If you neither own nor operate a skilled nursing facility you may be unaware the federal government initiated a mandatory staffing ratio, but the Centers for Medicare & Medicaid Services (CMS) decision has been undergoing legal challenges. The mandate may land on the desk of the US Supreme Court as it is quickly proceeding through the lower courts. The American Health Care Association, the Texas Health Care Association, LeadingAge and others have filed suits to stop the mandate alleging CMS has exceeded its authority in requiring staffing levels in nursing facilities. Former California Attorney General, Xavier Becerra, the Biden-Harris appointee to run the CMS is facing legal challenges in many states. His “mandate” has created great consternation among nursing homes in the United States with fears of facility fines if the staffing ratio drops below the federal level. American Health Care Association et al v. Becerra et al is but one step away from the US Supreme Court if the case progresses to the federal appeals court. The staffing ratio can be as high as three RNs per shift with up to 11 nurses’ aides and two additional nursing staff.
Omnicare, the CVS Health long-term pharmacy, will be laying off about 2,900 employees due to “continued disruption, regulatory pressures and evolving consumer needs and expectations,” according to a company spokesperson. The layoffs are not supposed to affect the “frontline employees” of Omnicare, but those “primarily [in] corporate roles.” CVS Health is seeking to save about $2 billion in operating costs.
California Governor Gavin Newsom recently signed 12 bills into law that claim to protect the state’s seniors while improving services. The bills will affect skilled nursing facilities most including the demand to publicly post a facility’s daily staffing numbers and patient census, or answer questions asked by the public related to staffing and census. This could also affect residential care providers who accept Medi-Cal monies via the assisted living waiver. Brookdale Senior Living has purchased 41 senior living communities it was previously leasing in Nashville, Kansas, Denver, on the West Coast and other influential areas.