California Governor Gavin Newsom has officially signed the Skilled Nursing Facility Ownership and Management Reform Act (AB 1502) into law. AB 1502 is an attempt to crack down on “squatters” who operate nursing homes without proper licensing or reporting. Prior to this law going into effect, anyone could purchase a nursing home and immediately take responsibility for the care of residents, even while their license was pending. Nursing home chain operators could also completely bypass the licensing process to open a new facility. These loopholes allowed bad actors, who often cared more about profits than providing quality care to residents, to operate nursing homes without proper oversight, putting residents at risk of neglect and abuse.
The Skilled Nursing Facility Ownership and Management Reform Act creates safeguards that make it more difficult for negligent nursing home operators to obtain a license. New rules include:
- Applicants that own, operate or manage more than 10% of the state’s skilled nursing facilities will be automatically disqualified from obtaining a new license to open another facility, unless they get an exception from the California Department of Health (CDPH).
- Applicants must submit their licensing application to CDPH at least 120 days before they acquire or begin operating a nursing home. This will virtually eliminate the use of interim management agreements, which allow operators to take control of a nursing home while waiting for their application to be processed.
- Applicants that acquire or operate a nursing home before their application is approved will be sanctioned.
- Nursing home operators and managers must get a new license if they enter into an agreement with a new entity that can make management or financial decisions, including consulting or administrative companies. A new license must also be obtained any time a facility is sold, leased, or under new management or control.
These rules will go into effect for new applicants on July 1, 2023. Although we’ve yet to see how nursing home operators will respond to this rule, the Skilled Nursing Facility Ownership and Management Reform Act is certainly a step in the right direction to reduce nursing home abuse caused by poor facility oversight.
Another important California nursing home law was also enacted in 2023. AB 895 requires that skilled nursing facilities provide prospective residents with a written notice that includes the contact information and website for the local nursing home ombudsman, CDPH’s nursing home licensing website, the California Health Facility Information Database, and CalLongTermCareCompare.org. The notice must also inform the prospective resident that these resources can be used to access information about the facility and report any complaints. Residents must be given this notice before they are admitted.
National Nursing Home Abuse Laws
The Skilled Nursing Facility Ownership and Management Reform Act and AB 895 are the latest California laws designed to protect elders living in nursing homes, but several federal nursing home abuse laws have existed for decades.
The Nursing Home Reform Act of 1987 (NHRA): The NHRA is the federal law that sets quality standards for nursing homes nationwide. Any facility that receives Medicare or Medicaid reimbursement must comply with it. The NHRA sets the requirements for what nursing homes must provide to residents, such as nutrition services, rehabilitation and social services. It also created the Nursing Home Residents Bill of Rights, which gives seniors living in skilled nursing facilities the right to physical, mental and emotional care; the right to privacy and security; the right to see visitors; the right to self-determination; the right to freedom from abuse and neglect; and the right to report complaints without retaliation.
Under this law, states are required to perform random inspections of nursing homes at least once every 15 months. Facilities that fail to comply with the NHRA can be subject to penalties such as fines, denial of Medicaid/Medicare status, or ongoing monitoring by a state oversight agency.
The Elder Justice Act: The Elder Justice Act was signed into law in 2010 as part of the Affordable Care Act. It requires all nursing home staff to report any suspected incidents of abuse and sets forth the penalties for failing to report a crime against a senior. It also allocated more funding and resources to programs that help prevent elder neglect and abuse. Finally, the Elder Justice Act created a national nursing home employee background check database, which makes it easier for nursing homes to verify that they are hiring qualified employees.
The Older Americans Act: Originally passed in 1965, the Older Americans Act was reauthorized in 2020 and will remain in effect until at least 2024. This law creates funding for states to provide community and social services to seniors. It also established the Administration on Aging, which administers federal grants and programming related to seniors. These services play a key role in the prevention and screening of elder abuse.
Future Protections Against Elder Abuse
The Biden Administration has announced plans for nursing home reforms that would be implemented through the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS). Although no new federal laws have been introduced yet, these plans could lay the foundation for future improvements in care for nursing home residents.
President Biden’s plans include:
- CMS will conduct a study to determine a minimum nursing home staffing level that ensures safe and quality care. CMS will issue a proposed rule, which will include punishments for nursing homes that fail to maintain minimum staffing levels.
- CMS will research ways to reduce the inappropriate use of antipsychotic drugs in nursing homes.
- CMS will explore ways to reduce room crowding in skilled nursing facilities and encourage facilities to phase out the use of rooms with three or more residents.
- President Biden will ask Congress to provide $500 million to CMS, an increase of 25%, so the agency can perform more nursing home inspections.
- CMS will take more enforcement action against poorly performing nursing homes and increase the per-dollar limit on financial penalties from $21,000 to $1,000,000.
- CMS will create a database of nursing home operators and owners and allow consumers to review their past violations.
- CMS will explore ways to help states increase pay for nursing home staff, which will help reduce staff turnover and attract skilled employees to the field.
The recently passed and proposed legislation is a promising sign that legislators are serious about protecting seniors from abuse. Let’s hope this is just the beginning of new protections for nursing home residents.
Contact a Nursing Home Abuse Lawyer
An experienced nursing home abuse lawyer can provide a wealth of resources to help you protect your loved one and determine whether to file a nursing home abuse lawsuit. Since 1993, Garcia & Artigliere have been protecting our most vulnerable by being leaders in elder and nursing home abuse litigation. Garcia & Artigliere have obtained more than $3 billion in results for its clients. Contact us today for more information at 800-281-8515.
Stephen M. Garcia represents victims of elder and nursing home abuse and is known as one of the leading civil litigators in the country. He is Senior Partner at Garcia & Artigliere, where the firm’s practice is focused on elder abuse, nursing home abuse, and wrongful death of the elderly.
Find out more about Stephen M. Garcia