in assisted living facilities by educating consumers
and increasing industry accountability
Adoption and implementation of CARR’s Board-Approved TOP TWELVE Advocacy Planks by the California state legislature would effect significant improvements to
1. Move licensing, surveillance and regulatory enforcement of RCFEs from Department of Social Services to Department of Public Health in recognition of the ever growing number of residents having chronic and severe medical conditions who are being admitted and retained in RCFEs.
2. Legislate a mandatory requirement for liability insurance, without opt-out provisions, for all Licensees. Proof of insurance would be required for annual renewal, and insurance companies would be required to timely report to the licensing agency cancellations or defaults.
3. Establish and enforce mandatory nursing and staffing ratios; care quality improves with nurses and additional staff. That's a fact.
4. Increase requirements for education and experience for licensees, administrators and caregivers to assure elders have competent and knowledgeable staff to manage and administer their care.
5. Legislate mandatory engagement of local law enforcement agencies (DA’s office, police, Adult Protection Services agencies) for RCFE complaints alleging elder abuse or neglect.
6. If the Licensee is a legal entity required to be registered with California’s Office of the Secretary of State (CASOS), and the Licensee’s registration is revoked, suspended, forfeited, or cancelled, the Licensee’s RCFE business activities must be immediately suspended. The Licensee shall not be reinstated until such time as the CASOS reinstates the Licensee’s legal entity.
7. Annual renewals of RCFE licenses would be contingent on presentation of current documentation including CASOS registration, civil penalties paid in full, statutory insurance requirements met, and evidence of compliance with all statutorily required training, and 3rd party credit reports showing financial viability of the facility.
8. Redraft Title 22 to eliminate equivocating or ambiguous language that results in inconsistent citation of deficiencies, or facilitates avoidance of citations.
9. Establish a point system for cited Title 22 violations. Cited violations would carry points based on the egregiousness of the violation to the residents’ heath and safety. A noncompliance conference would be automatically triggered by accumulation of a pre-determined number of points over the last three CCL visits to the facility. Renewal fees would be increased for facilities with higher deficiency scores.
10. Standardize the Facility License to assure clear, accurate, and complete consumer information regardless of which state inspector writes the license. The License should state ALL the services a facility is approved to provide, whether or not a waiver or exemption is required for the service.
11. RCFEs must have an operable and dedicated van/bus on the premises for evacuation; vehicle capacity must be proportional to facility capacity.
12. State Licensing’s form documents (LIC) containing confidential information must be redacted, removed from the confidential file, and placed in the public file; LIC documents include LIC 809 (Facility Evaluation Report) and LIC 9099 (Complaint Investigation).
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