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Nursing Home Residents – Rights Campaign of 2005

On February 18, 2005, Senator Elaine Alquist (D-Santa Clara) introduced SB 526, the Nursing Home Residents’ Rights Protection bill of 2005. Developed by a coalition of organizations including AARP California, Alzheimer’s Association - California Council, Bet Tzedek Legal Services, CANHR, California Association for Adult Day Services, National Senior Citizens Law Center, and Protection and Advocacy, Inc., this bill would make major changes to improve the quality of care and quality of life for California nursing home residents.

SB 526 provides an historic opportunity to improve nursing home care in California, coming as it does during the midst of an enduring crisis in care. On a daily basis, thousands of California nursing home residents suffer from neglect and abuse because facilities they live in lack sufficient numbers of properly trained staff. Each year, nursing homes cheat residents out of more than a million hours of required care. Compounding the crisis, the California Department of Health Services (DHS) is barely enforcing residents’ rights and care standards, having been hit hard by budget cuts and a continuing litigation war by nursing home operators. SB 526 seeks to enforce staffing requirements, improve complaint investigations, upgrade residents’ rights and outlaw discrimination against Medi-Cal applicants.


SB 526’s most critical goal is to improve nursing home staffing. Hundreds of operators flaunt California’s minimum staffing requirement, which requires skilled nursing homes to provide at least 3.2 hours of nursing care per resident each day. To improve compliance, the bill would require skilled nursing facilities to document actual staffing levels by submitting payroll records on a quarterly basis. It will create staffing incentives and save money by eliminating profit payments to understaffed nursing homes and penalizing those that commit fraud.

Consumer Complaints

Any funds resulting from improved staffing compliance will be invested into establishing dedicated complaint response units in each DHS Licensing and Certification District Office. Facing a rising tide of complaints, DHS is often slow to investigate and ineffective when it gets around to it. In the last four years, complaint substantiation rates have plummeted from 40 percent to under 25 percent, which means that nearly 75% of the almost 14,000 annual complaints are found to be "unsubstantiated," rendering residents’ rights almost meaningless. The dedicated complaint response units will give DHS the means to investigate complaints in an effective and timely manner.

Residents’ Rights

An important section of the bill updates California’s outdated bill of rights, which shortchanges residents whose care is not funded by Medicare or Medi-Cal. The bill conforms California law with the federal Nursing Home Reform Act of 1987 in several important respects, for example, by giving every resident the right to return to the first available bed after hospitalization and providing uniform rights to all residents to protect them from illegal evictions. It also establishes the most fundamental right, the right to go home.

Medi-Cal Discrimination

The bill would ban the pervasive nursing home discrimination against applicants who are on Medi-Cal or who might need Medi-Cal in the future. Modeled in part after an existing Connecticut law, SB 526 would require Medi-Cal certified facilities to establish single waiting lists and to admit qualified applicants in the order they seek admission.

We Need Your Help

Last year, the nursing home industry rammed through a last-minute bill, AB 1629 that will provide California nursing homes with at least $2.5 billion of new Medi-Cal funds during the next four years. Thus, there is no excuse for the rampant neglect, abuse and discrimination to continue and no need for more money to implement SB 526.

Despite its broad support and unimpeachable goals, SB 526 is expected to face tough opposition from the increasingly powerful nursing home industry, which fights any type of accountability, no matter how reasonable.

The bill needs and deserves your support. In the very near future, it will be heard in the Senate Committee on Health. Please write the Committee Chair, Senator Deborah Ortiz, and other members of the Committee and urge them to vote "yes" on SB 526. You can find a list of Committee members, their addresses and a sample support letter on CANHR’s SB 526 Fact Sheet at Or call us and we will mail or fax the information to you.

The Residents’ Rights Coalition is also engaged in a massive petition campaign to collect signatures in support of SB 526. A copy of the petition is enclosed with this newsletter. Please feel free to duplicate, collect signatures and return to the CANHR office.

Questions about the bill? Call Mike Connors at CANHR. Interested in becoming a CANHR legislative advocate or coordinator to support this bill and other CANHR legislation? Please call Allison Ferris today for more information.