By Polly Stryker
The assisted living industry in California is big business: More than 7,500 licensed facilities provide care for more than 175,000 people statewide. Starting Monday, and over the next two weeks, The California Report will bring stories about assisted living facilities in the state.
Assisted living is an alternative to more expensive — and often more institutional — care in a skilled nursing facility. In assisted living, staff help seniors with daily needs, such as meals, medicine-taking and bathing. The homes range from small mom-and-pop places with six beds to corporate chains with over 100 beds. A growing number offer dementia care.
But while these facilities are licensed, the laws regulating them have not had a major update since 1985, and California has lagged behind other states in updating its rules.
A series of reports last year from multiple media outlets — KQED/Center for Investigative Reporting, San Diego Union Tribune/Center for Health Reporting and the San Francisco Chronicle — all found abuse and neglect, sometimes leading to death, at assisted living facilities around the state.
These reports, combined with advocacy momentum, coalesced to spur legislators to try and create the first major update of assisted living facility laws in nearly 30 years.
And an update is desperately needed. For example, if someone in an assisted living facility dies from abuse or neglect, the law allows for a meager fine of $150. The main regulatory agency for the industry, the Department of Social Services, is only required to inspect facilities every five years unless there is a complaint.
Fifteen bills are making their way through the state Legislature, and the month of August is key. The Legislature has until Aug. 29 to move bills to the governor’s desk. If passed, the package of legislation would bring changes that include: increasing possible fines from $150 to $15,000; mandating annual inspections; creating a Resident Bill of Rights; mandating liability insurance; and creating a better online database for consumers. You can read summaries of all the bills from the California Assisted Living Association, the California Advocates for Nursing Home Reform or the Consumer Advocates for RCFE Reform.
Here’s our take on three of the bills:
AB1571, introduced by Assemblywoman Susan Eggman (D-Stockton), would create a better online consumer information system. Right now, if you want to compare assisted living facilities, there’s no easy way to do so, The DSS website doesn’t include specifics of violations. If this bill passes, improvements, including a rating system, would be online by 2019. The California Advocates for Nursing Home Reform (CANHR) is one of the bill’s sponsors.
AB2171, from Assemblyman Bob Wieckowski (D-Fremont), would create a residents’ bill of rights, giving people rights similar to those that people in nursing homes have. Sponsors include CANHR and the Consumer Attorneys of California. They say it would give residents of assisted living facilities rights they could protect in court with an injunction proactively — like the right to live in a safe environment and to be free from neglect or exploitation — instead of having to show proof of injury after the fact. CALA, the assisted living industry group, sees things differently. It fears the bill would open the floodgates for “shakedown lawsuits” by trial lawyers to sue assisted living facilities. It is the only bill the group opposes.
AB1523, from Speaker of the Assembly Toni Atkins (D-San Diego), would require assisted living facilities to carry liability insurance. It’s sponsored by Consumer Advocates for RCFE Reform. If citations and legal actions equal higher insurance rates, the thinking goes that the bad places will be weeded out by the high cost of insurance. CALA, the industry group, supports this bill and says its members carry liability insurance already.
Ultimately, it’s up to Gov. Jerry Brown to sign or veto the bills that make it to his desk by the time the Legislature wraps up its session Aug. 29. Stakeholders say the governor’s office has given little indication as to what he will do. Pat McGinnis, executive director of CANHR says, “I know he doesn’t think of himself as elderly, but he is at an age where he would be eligible for (assisted living) care, so he ought to be thinking about that. Or think if his mother was in one of these places.”
Rachael Myrow and April Dembosky contributed to this report.